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Interactions between Carboplatin and Cefazolin

1 drug interaction and 15 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

ceFAZolin CARBOplatin

Applies to: cefazolin and carboplatin
Monitor

The concurrent or sequential use of two or more potentially nephrotoxic or neurotoxic drugs may increase the risk of toxicity. Patients who are elderly, debilitated, dehydrated, or who have preexisting renal dysfunction may have a higher risk of developing adverse reactions.

Management

Close clinical and laboratory monitoring of renal and neurologic function and drug serum concentrations (if clinically appropriate) is recommended.

References (2)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."

Food/lifestyle interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Disease interactions

15 potential interactions Applies to: 14 conditions, including High Blood Pressure, Heart Failure, Seizures, Peripheral Neuropathy, and Fever.

Bleeding Disorder

Major:

carboplatin

CARBOplatin has a major potential interaction with Bleeding Disorder.

The use of carboplatin is contraindicated in patients with significant bleeding. Carboplatin causes severe myelosuppression and dose-dependent thrombocytopenia. Patients should be instructed to immediately report any signs or symptoms suggesting bleeding such as petechiae, purpura, epistaxis, hemoptysis, hematuria, and melena. Close clinical monitoring of hematopoietic function is recommended.

Bone Marrow Depression/Low Blood Counts

Major:

carboplatin

CARBOplatin has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of carboplatin is contraindicated in patients with severe myelosuppression. Carboplatin induces dose-dependent leukopenia, thrombocytopenia, and anemia, which is cumulative and also dose limiting. Therapy with carboplatin should be administered cautiously in patients whose bone marrow reserve may be severely depressed by prior chemotherapy or irradiation, whose marrow function is recovering from previous cytotoxic therapy, or in patients with compromised renal function. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Peripheral blood counts should be frequently monitored during carboplatin injection treatment and, when appropriate, until recovery is achieved.

Fever

Major:

carboplatin

CARBOplatin has a major potential interaction with Fever.

The use of carboplatin is contraindicated in patients with severe myelosuppression. Carboplatin induces dose-dependent leukopenia, thrombocytopenia, and anemia, which is cumulative and also dose limiting. Therapy with carboplatin should be administered cautiously in patients whose bone marrow reserve may be severely depressed by prior chemotherapy or irradiation, whose marrow function is recovering from previous cytotoxic therapy, or in patients with compromised renal function. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Peripheral blood counts should be frequently monitored during carboplatin injection treatment and, when appropriate, until recovery is achieved.

Fluid Retention

Moderate:

cefazolin

ceFAZolin has a moderate potential interaction with Fluid Retention.

Parenteral cefazolin sodium contains approximately 46 mg (2 mEq) of sodium per each gram of cefazolin activity. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

Heart Failure

Moderate:

cefazolin

ceFAZolin has a moderate potential interaction with Heart Failure.

Parenteral cefazolin sodium contains approximately 46 mg (2 mEq) of sodium per each gram of cefazolin activity. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

Hemodialysis

Moderate:

cefazolin

ceFAZolin has a moderate potential interaction with Hemodialysis.

Most cephalosporin antibiotics are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis. Cefonicid, cefixime, and ceftriaxone are not significantly removed by hemodialysis.

High Blood Pressure

Moderate:

cefazolin

ceFAZolin has a moderate potential interaction with High Blood Pressure.

Parenteral cefazolin sodium contains approximately 46 mg (2 mEq) of sodium per each gram of cefazolin activity. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

Hypernatremia

Moderate:

cefazolin

ceFAZolin has a moderate potential interaction with Hypernatremia.

Parenteral cefazolin sodium contains approximately 46 mg (2 mEq) of sodium per each gram of cefazolin activity. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

Infection

Major:

carboplatin

CARBOplatin has a major potential interaction with Infection.

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

Liver Disease

Moderate:

cefazolin

ceFAZolin has a moderate potential interaction with Liver Disease.

Cases of hepatitis have been reported with the use of certain cephalosporins. Transient rise in AST, ALT, and alkaline phosphatase levels have also been observed. Caution and monitoring are recommended when these agents are prescribed to patients with hepatic disorders.

Noninfectious Colitis

Major:

cefazolin

ceFAZolin has a major potential interaction with Noninfectious Colitis.

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

Peripheral Neuropathy

Minor:

carboplatin

CARBOplatin has a minor potential interaction with Peripheral Neuropathy.

Mild peripheral neuropathy has been noted during carboplatin therapy and is characterized most frequently by paresthesias. Patients older than 65 years and/or previously treated with cisplatin appear to be at increased risk for peripheral neuropathy. There was no worsening of cisplatin symptoms in 70% of patients who received carboplatin as secondary treatment. Therapy with carboplatin should be administered cautiously in patients with or predisposed to neuropathy.

Renal Dysfunction

Major:

carboplatin

CARBOplatin has a major potential interaction with Renal Dysfunction.

Carboplatin is primarily eliminated by the kidney. Total body and renal clearance of carboplatin are reduced in patients with a creatinine clearance < 60 mL/min. Patients with impaired renal function are at increased risk for toxicity, particularly myelosuppression. Therapy with carboplatin should be administered cautiously in patients with compromised renal function. Clinical monitoring of renal function is recommended.

Moderate:

cefazolin

ceFAZolin has a moderate potential interaction with Renal Dysfunction.

Most beta-lactam antibacterial agents are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibacterial agents and their metabolites may be increased, and the half-lives prolonged, in patients with impaired renal function. Neurotoxic reactions (e.g., encephalopathy, aphasia, asterixis, myoclonus, seizures, nonconvulsive status epilepticus, coma) have been reported in such patients treated parenterally with these agents. Dosage adjustments may be necessary, and modifications should be based on the degree of renal dysfunction as well as severity of infection in accordance with the individual manufacturer product information. Renal function tests should be performed periodically during prolonged and/or high-dose therapy since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.

Seizures

Moderate:

cefazolin

ceFAZolin has a moderate potential interaction with Seizures.

Cephalosporins have been implicated in triggering seizures. Nonconvulsive status epilepticus, encephalopathy, coma, asterixis, neuromuscular excitability, and myoclonia have been reported with cephalosporins, particularly in patients with a history of epilepsy and/or when recommended dosages of cephalosporins were exceeded due to renal dysfunction. Dosage should be adjusted based on the degree of renal function. Anticonvulsant therapy should be continued in patients with known seizure disorders. If CNS adverse reactions including seizures occur, patients should undergo a neurological evaluation to determine whether treatment should be discontinued.

More resources

carboplatin

A total of 562 drugs are known to interact with carboplatin.

cefazolin

A total of 61 drugs are known to interact with cefazolin.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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 interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.