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Unipen (nafcillin) Disease Interactions

There are 4 disease interactions with Unipen (nafcillin):

Major

Penicillinase-Resistant Pcns (Includes Unipen) ↔ Marrow Toxicity

Severe Potential Hazard, Moderate plausibility

Applies to: Neutropenia, Thrombocytopenia

The use of penicillinase-resistant penicillins has been associated with adverse hematologic effects, including neutropenia, leukopenia, granulocytopenia and thrombocytopenia, particularly when given in high parenteral dosages. Agranulocytosis and prolonged bleeding time have been reported rarely. Therapy with penicillinase-resistant penicillins should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow depression, and hematopoietic function should be monitored. Blood counts with differential should be performed prior to initiation of therapy and 1 to 3 times weekly during therapy. Hematologic abnormalities are generally reversible and resolve within several days to two weeks following discontinuation of therapy.

References

  1. "Product Information. Staphcillin (methicillin)." Apothecon Inc, Plainsboro, NJ.
  2. "Product Information. Dynapen (dicloxacillin)." Apothecon Inc, Plainsboro, NJ.
  3. Leventhal JM, Silken AB "Oxacillin-induced neutropenia in children." J Pediatr 89 (1976): 769-71
  4. Carpenter J "Neutropenia induced by semisynthetic penicillin." South Med J 73 (1980): 745-8
  5. Slovick FT, Bamberger DM, Stark KR "Spontaneous clostridial myonecrosis in a man with drug-induced agranulocytosis." South Med J 82 (1989): 1272-4
  6. Clotet B, Vea AM, Rubies-Prat J, Sala MF "Cloxacillin-induced leukopenia." Arch Intern Med 145 (1985): 1531
  7. Brook I "Leukopenia and granulocytopenia after oxacillin therapy." South Med J 70 (1977): 565-6
  8. Klein JO, Finland M "The new penicillins (concluded)." N Engl J Med 269 (1963): 1129-34
  9. Olaison L, Alestig K "A prospective study of neutropenia induced by high doses of B-lactam antiobiotics." J Antimicrob Chemother 25 (1990): 449-53
  10. Kitzing W, Nelson JD, Mohs E "Comparative toxicities of methicillin and nafcillin." Am J Dis Child 135 (1981): 52-5
  11. Westerman EL, Bradshaw MW, Williams TW "Agranulocytosis during therapy with orally administered cloxacillin." Am J Clin Pathol 69 (1978): 559-60
  12. Ahern MJ, Hicks JE, Andriole VT "Neutropenia during high dose intravenous oxacillin therapy." Yale J Biol Med 49 (1976): 351-60
  13. Jeter EK, Scott A, Kizer J, Lazarchick J "Impaired platelet function associated with parenteral nafcillin." Ann Clin Lab Sci 20 (1990): 79-84
  14. Carpenter J "Neutropenia induced by semisynthetic penicillin." South Med J 73 (1980): 745-8
  15. Fallon JA, Tall AR, Janis MG, Brauer MJ "Oxacillin-induced granulocytopenia." Acta Haematol 59 (1978): 163-70
  16. Alexander DP, Russo ME, Fohrman DE, Rothstein G "Nafcillin-induced platelet dysfunction and bleeding." Antimicrob Agents Chemother 23 (1983): 59-62
  17. "Product Information. Unipen (nafcillin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  18. Kahn JB "Oxacillin-induced agranulocytosis." JAMA 240 (1978): 2632
  19. Chu JY, O'Connor DM, Schmidt RR "The mechanism of oxacillin-induced neutropenia." J Pediatr 90 (1977): 668-9
  20. Walbroehl GS, John PG "Antibiotic-associated neutropenia." Am Fam Physician 45 (1992): 2237-41
  21. Couchonnal GJ, Hinthorn DR, Hodges GR, Liu C "Nafcillin-associated granulocytopenia." South Med J 71 (1978): 1356-8
  22. Godin M, Deshayes P, Ducastelle T, Delpech A, Leloet X, Fillastre JP "Agranulocytosis, haemorrhagic cystitis and acute interstitial nephritis during methicillin therapy." J Antimicrob Chemother 6 (1980): 296-7
  23. Neftel K, Muller MR, Hauser SP, Walti M, de Weck AL "More on penicillin-induced leukopenia." N Engl J Med 308 (1983): 901-2
  24. Greene GR, Cohen E "Nafcillin-induced neutropenia in children." Pediatrics 61 (1978): 94-7
  25. "Product Information. Tegopen (cloxacillin)." Apothecon Inc, Plainsboro, NJ.
  26. "Product Information. Bactocill (oxacillin)." SmithKline Beecham, Philadelphia, PA.
  27. Passoff TL, Sherry HS "Oxacillin induced neutropenia. A case report." Clin Orthop 135 (1978): 69-70
  28. Alexander DP, Russo ME, Fohrman DE, Rothstein G "Nafcillin-induced platelet dysfunction and bleeding." Antimicrob Agents Chemother 23 (1983): 59-62
  29. Shah I, Kumar KS, Lerner AM "Agranulocytosis associated with chronic oral administration of cloxacillin for suppression of staphylococcal osteomyelitis." Am J Hematol 12 (1982): 203-6
View all 29 references
Moderate

Antibiotics (Includes Unipen) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
  4. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601
  5. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5
  6. Burt RA "A review of the drug events reported by 12,917 patients treated with cephalexin." Postgrad Med J 59 (1983): 47-50,51-3
  7. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  8. Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
  9. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  10. Bauwens JE, McFarland LV, Melcher SA "Recurrent clostridium difficile disease following ciprofloxacin use." Ann Pharmacother 31 (1997): 1090
  11. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  12. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  13. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  14. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  15. Calandra GB, Brown KR, Grad LC, et al "Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin." Am J Med 78 (1985): 73-8
  16. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  17. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  18. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  19. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  20. Van Ness MM, Cattau EL Jr "Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment." Am J Gastroenterol 82 (1987): 374-7
  21. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82
  22. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  23. Cannon SR, Dyson PH, Sanderson PJ "Pseudomembranous colitis associated with antibiotic prophylaxis in orthopaedic surgery." J Bone Joint Surg Br 70-B (1988): 600-2
  24. Wang C, Calandra GB, Aziz MA, Brown KR "Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience." Rev Infect Dis 7 (1985): s528-36
  25. Clissold SP, Todd PA, Campoli-Richards DM "Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy." Drugs 33 (1987): 185-241
  26. Pokorney BH, Nichols TW, Jr "Pseudomembranous colitis. A complication of sulfasalazine therapy in a patient with Crohn's colitis." Am J Gastroenterol 76 (1981): 374-6
  27. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  28. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  29. Osler T, Lott D, Bordley J, et al "Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon." Dis Colon Rectum 29 (1986): 140-3
  30. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  31. Midtvedt T, Carlstedt-Duke B, Hoverstad T, et al "Influence of peroral antibiotics upon the biotransformatory activity of the intestinal microflora in healthy subjects." Eur J Clin Invest 16 (1986): 11-7
  32. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  33. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  34. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  35. Gordin F, Gibert C, Schmidt ME "Clostridium difficile colitis associated with trimethoprim-sulfamethoxazole given as prophylaxis for pneumocystis carinii pneumonia." Am J Med 96 (1994): 94-5
  36. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  37. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
  38. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  39. Edlund C, Brismar B, Nord CE "Effect of lomefloxacin on the normal oral and intestinal microflora." Eur J Clin Microbiol Infect Dis 1 (1990): 35-9
  40. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  41. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  42. Leigh DA, Simmons K, Williams S "Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study." J Antimicrob Chemother 6 (1980): 639-45
  43. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
  44. "Multum Information Services, Inc. Expert Review Panel"
  45. Edlund C, Lidbeck A, Kager L, Nord CE "Effect of enoxacin on colonic microflora of healthy volunteers." Eur J Clin Microbiol 6 (1987): 298-300
  46. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  47. Brause BD, Romankiewicz JA, Gotz V, Franklin JE Jr, Roberts RB "Comparative study of diarrhea associated with clindamycin and ampicillin therapy." Am J Gastroenterol 73 (1980): 244-8
View all 47 references
Moderate

Nafcillin (Includes Unipen) ↔ Renal/Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Renal Dysfunction

Nafcillin is primarily metabolized by the liver but also partially excreted unchanged by the kidney. The serum concentration of nafcillin may be increased and the half-life prolonged in patients with significantly impaired renal and/or hepatic function. In general, dosage adjustments are not necessary in either renal or hepatic impairment alone, but may be appropriate in patients with both renal and hepatic failure. Renal and liver function tests should be performed periodically during prolonged therapy.

References

  1. Diaz CR, Kane JG, Parker RH, Pelsor FR "Pharmacokinetics of nafcillin in patients with renal failure." Antimicrob Agents Chemother 12 (1977): 98-101
  2. Rudnick M, Morrison G, Walker B, Singer I "Renal failure, hemodialysis, and nafcillin kinetics." Clin Pharmacol Ther 20 (1976): 413-25
  3. "Product Information. Unipen (nafcillin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. Marshall JP, Salt WB, Elam RO, et al "Disposition of nafcillin in patients with cirrhosis and extrahepatic biliary obstruction." Gastroenterology 73 (1977): 1388-92
View all 4 references
Moderate

Nafcillin (Includes Unipen) ↔ Sodium/Potassium

Moderate Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Fluid Retention, Hypertension, Hypernatremia, Hypokalemia

Each gram of parenteral nafcillin sodium contains approximately 67 mg (2.9 mEq) of sodium and is buffered with 40 mg of sodium citrate. Each 250 mg capsule of nafcillin sodium contains approximately 17 mg (0.7 mEq) of sodium buffered with calcium carbonate. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention. In addition, hypokalemia has been reported rarely during therapy with the penicillinase-resistant penicillins, which may be particularly important to bear in mind when treating patients with low potassium reserves or fluid and electrolyte imbalance. Clinical monitoring of electrolytes is recommended if these agents are used for prolonged periods.

References

  1. Schlaeffer F "Oxacillin-associated hypokalemia." Drug Intell Clin Pharm 22 (1988): 695-6
  2. "Product Information. Unipen (nafcillin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. Andreoli SP, Kleiman MB, Glick MR, Bergstein JM "Nafcillin, pseudoproteinuria, and hypokalemic alkalosis." J Pediatr 97 (1980): 841-2

Unipen (nafcillin) drug Interactions

There are 299 drug interactions with Unipen (nafcillin)

Unipen (nafcillin) alcohol/food Interactions

There are 2 alcohol/food interactions with Unipen (nafcillin)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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