Can you take Cefoperazone with Vancocin?
1 drug interaction and 27 additional warnings found for the following 2 drugs:
- cefoperazone
- Vancocin (vancomycin)
Drug interactions
Moderate drug interactions
Moderate:
cefoperazone vancomycin
Applies to: cefoperazone and Vancocin (vancomycin)
Using cefoperazone together with vancomycin may increase the risk of kidney and/or nerve damage.
Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.
You should seek medical attention if you experience signs and symptoms that may suggest kidney damage such as:
- nausea
- vomiting
- loss of appetite
- increased or decreased urination
- sudden weight gain or weight loss
- fluid retention
- swelling
- shortness of breath
- muscle cramps
- tiredness
- weakness
- dizziness
- confusion
- irregular heart rhythm
Be sure to drink plenty of fluids if you develop diarrhea or vomiting during treatment with these medications, as dehydration can also harm the kidney.
In addition, let your doctor know if you develop:
- seizures
- hearing problems
- numbness, burning or tingling in your hands and feet
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
cefoperazone Alcohol (Ethanol)
Applies to: cefoperazone
Ask your doctor before using cefoperazone together with ethanol (alcohol).
Do not drink alcohol while you are taking cefoperazone.
You may have unpleasant side effects such as:
- fast heartbeats
- warmth or redness under your skin
- tingly feeling
- nausea
- vomiting
Check your food and medicine labels to be sure these products do not contain alcohol.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
26 potential interactions Applies to: 20 conditions, including High Blood Pressure, Heart Failure, Tinnitus, Hearing Loss, and Hemodialysis.
Alcoholism
Moderate:
cefoperazone
Cefoperazone has a moderate potential interaction with Alcoholism.
Disulfiram-like reactions may occur in patients who consume alcohol within 72 hours after administration of a cephalosporin antibiotic that contains an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The reaction appears to result from accumulation of acetaldehyde due to inhibition of acetaldehyde dehydrogenase. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with a history of alcoholism. Patients should be instructed to avoid alcohol-containing products during therapy and up to 72 hours after the last dose.
Biliary Obstruction
Moderate:
cefoperazone
Cefoperazone has a moderate potential interaction with Biliary Obstruction.
Cefoperazone is primarily eliminated by hepatobiliary excretion. In patients with impaired hepatic function and/or biliary obstruction, the half-life of cefoperazone is prolonged 2- to 4-fold but urinary excretion is increased. At usual dosages, adjustments are generally not necessary in either renal or hepatobiliary impairment. However, serum drug concentrations should be monitored if high dosages are used (i.e. > 4 g/day), and the dosage decreased accordingly if drug accumulation occurs. In patients with both hepatic and severe renal impairment, cefoperazone dosage should not exceed 1 to 2 grams per day without close monitoring of serum concentrations.
Bleeding Disorder
Major:
cefoperazone
Cefoperazone has a major potential interaction with Bleeding Disorder.
Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.
Coagulation Defects and Disorders
Major:
cefoperazone
Cefoperazone has a major potential interaction with Coagulation Defects and Disorders.
Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.
Fluid Retention
Moderate:
cefoperazone
Cefoperazone has a moderate potential interaction with Fluid Retention.
Parenteral cefoperazone sodium contains approximately 34 mg (1.5 mEq) of sodium per each gram of cefoperazone 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.
Hearing Loss
Major:
Vancocin
The vancomycin in Vancocin has a major potential interaction with Hearing Loss.
Intravenous use of vancomycin may cause damage to the auditory branch of the eighth cranial nerve. Permanent hearing loss has been reported. Tinnitus sometimes precedes the onset of deafness, which may progress despite withdrawal of the drug. Therapy with vancomycin, particularly if prolonged (> 10 days), should be administered cautiously in patients with preexisting auditory impairment or tinnitus, since it may delay the recognition or confound the diagnosis of a drug-induced ototoxic effect. To minimize the risk of toxicity, the usual dosage should not be exceeded, use with other ototoxic agents should be avoided, and serum drug concentrations should be periodically determined and dosage adjusted to maintain desired levels. Ototoxicity has generally been associated with serum vancomycin levels of 80 to 100 mcg/mL, although toxic reactions have also been reported at levels as low as 25 mcg/mL. Serial audiograms should be obtained in patients old enough to be tested, and the dosage reduced or therapy withdrawn promptly if signs and symptoms of toxicity develop.
Oral vancomycin is generally not associated with systemic toxicity due to poor absorption from the gastrointestinal tract. However, clinically significant serum concentrations have been reported in some patients following multiple oral doses of vancomycin for active Clostridium difficile pseudomembranous colitis. Therefore, when vancomycin is administered orally, clinicians may want to heed the usual warnings and precautions associated with intravenous use of the drug.
Moderate:
Vancocin
The vancomycin in Vancocin has a moderate potential interaction with Hearing Loss.
Vancomycin is potentially ototoxic when administered intravenously or orally. The risk is higher in older patients, patients receiving higher doses, patients receiving other agents that are ototoxic, and patients who have an underlying hearing loss or renal impairment. Monitor closely for signs and symptoms of ototoxicity, which can include tinnitus, hearing loss, dizziness or vertigo.
Heart Failure
Moderate:
cefoperazone
Cefoperazone has a moderate potential interaction with Heart Failure.
Parenteral cefoperazone sodium contains approximately 34 mg (1.5 mEq) of sodium per each gram of cefoperazone 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:
cefoperazone
Cefoperazone 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:
cefoperazone
Cefoperazone has a moderate potential interaction with High Blood Pressure.
Parenteral cefoperazone sodium contains approximately 34 mg (1.5 mEq) of sodium per each gram of cefoperazone 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:
cefoperazone
Cefoperazone has a moderate potential interaction with Hypernatremia.
Parenteral cefoperazone sodium contains approximately 34 mg (1.5 mEq) of sodium per each gram of cefoperazone 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.
Liver Disease
Major:
cefoperazone
Cefoperazone has a major potential interaction with Liver Disease.
Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.
Moderate:
cefoperazone
Cefoperazone has a moderate potential interaction with Liver Disease.
Cefoperazone is primarily eliminated by hepatobiliary excretion. In patients with impaired hepatic function and/or biliary obstruction, the half-life of cefoperazone is prolonged 2- to 4-fold but urinary excretion is increased. At usual dosages, adjustments are generally not necessary in either renal or hepatobiliary impairment. However, serum drug concentrations should be monitored if high dosages are used (i.e. > 4 g/day), and the dosage decreased accordingly if drug accumulation occurs. In patients with both hepatic and severe renal impairment, cefoperazone dosage should not exceed 1 to 2 grams per day without close monitoring of serum concentrations.
Moderate:
cefoperazone
Cefoperazone 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.
Malabsorption Syndrome
Major:
cefoperazone
Cefoperazone has a major potential interaction with Malabsorption Syndrome.
Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.
Malnourishment
Major:
cefoperazone
Cefoperazone has a major potential interaction with Malnourishment.
Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.
Neutropenia
Moderate:
Vancocin
The vancomycin in Vancocin has a moderate potential interaction with Neutropenia.
Reversible neutropenia has been reported with intravenous use of vancomycin, usually starting one week or more after initiation of therapy or after a total dosage of more than 25 g. Thrombocytopenia and agranulocytosis (granulocytes < 500/mm3) has occurred rarely. Patients with preexisting neutropenia should be monitored closely during vancomycin therapy for further decreases in leukocyte counts, and therapy discontinued if appropriate.
Noninfectious Colitis
Major:
cefoperazone
Cefoperazone 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.
Renal Dysfunction
Major:
Vancocin
The vancomycin in Vancocin has a major potential interaction with Renal Dysfunction.
Intravenous use of vancomycin may be associated with oto- and nephrotoxic effects. Eighth cranial nerve damage may manifest as tinnitus and varying degrees of hearing impairment. Nephrotoxicity is usually evidenced by transient elevations in BUN or serum creatinine concentrations, as well as the presence of hyaline and granular casts and albumin in the urine. Rarely, acute interstitial nephritis has been reported. Although vancomycin-induced nephrotoxicity is generally reversible following discontinuation of the drug, death from uremia has occurred. Therapy with vancomycin should be administered cautiously at reduced dosages in patients with renal impairment, since they may be at increased risk for oto- and nephrotoxicity due to drug accumulation. To minimize the risk of toxicity, the usual dosage should not be exceeded, use with other neuro- and nephrotoxic agents should be avoided, and serum drug concentrations should be periodically determined and dosage adjusted to maintain desired levels. Oto- and nephrotoxicity has generally been associated with serum vancomycin levels of 80 to 100 mcg/mL, although toxic reactions have also been reported at levels as low as 25 mcg/mL. Renal and eighth cranial nerve function should be closely monitored, and the dosage reduced or therapy withdrawn if toxicity develops.
Oral vancomycin is generally not associated with systemic toxicity due to poor absorption from the gastrointestinal tract. However, clinically significant serum concentrations have been reported in some patients following multiple oral doses of vancomycin for active Clostridium difficile pseudomembranous colitis. The risk for systemic adverse effects may be greatest in patients with preexisting renal impairment. Therefore, when vancomycin is administered orally, clinicians may want to heed the usual warnings and precautions associated with intravenous use of the drug.
Moderate:
cefoperazone
Cefoperazone has a moderate potential interaction with Renal Dysfunction.
Cefoperazone is primarily eliminated by hepatobiliary excretion. In patients with impaired hepatic function and/or biliary obstruction, the half-life of cefoperazone is prolonged 2- to 4-fold but urinary excretion is increased. At usual dosages, adjustments are generally not necessary in either renal or hepatobiliary impairment. However, serum drug concentrations should be monitored if high dosages are used (i.e. > 4 g/day), and the dosage decreased accordingly if drug accumulation occurs. In patients with both hepatic and severe renal impairment, cefoperazone dosage should not exceed 1 to 2 grams per day without close monitoring of serum concentrations.
Moderate:
Vancocin
The vancomycin in Vancocin has a moderate potential interaction with Renal Dysfunction.
Vancomycin is potentially ototoxic when administered intravenously or orally. The risk is higher in older patients, patients receiving higher doses, patients receiving other agents that are ototoxic, and patients who have an underlying hearing loss or renal impairment. Monitor closely for signs and symptoms of ototoxicity, which can include tinnitus, hearing loss, dizziness or vertigo.
Thrombocytopathy
Major:
cefoperazone
Cefoperazone has a major potential interaction with Thrombocytopathy.
Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.
Thrombocytopenia
Major:
cefoperazone
Cefoperazone has a major potential interaction with Thrombocytopenia.
Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.
Moderate:
Vancocin
The vancomycin in Vancocin has a moderate potential interaction with Thrombocytopenia.
Reversible neutropenia has been reported with intravenous use of vancomycin, usually starting one week or more after initiation of therapy or after a total dosage of more than 25 g. Thrombocytopenia and agranulocytosis (granulocytes < 500/mm3) has occurred rarely. Patients with preexisting neutropenia should be monitored closely during vancomycin therapy for further decreases in leukocyte counts, and therapy discontinued if appropriate.
Tinnitus
Major:
Vancocin
The vancomycin in Vancocin has a major potential interaction with Tinnitus.
Intravenous use of vancomycin may cause damage to the auditory branch of the eighth cranial nerve. Permanent hearing loss has been reported. Tinnitus sometimes precedes the onset of deafness, which may progress despite withdrawal of the drug. Therapy with vancomycin, particularly if prolonged (> 10 days), should be administered cautiously in patients with preexisting auditory impairment or tinnitus, since it may delay the recognition or confound the diagnosis of a drug-induced ototoxic effect. To minimize the risk of toxicity, the usual dosage should not be exceeded, use with other ototoxic agents should be avoided, and serum drug concentrations should be periodically determined and dosage adjusted to maintain desired levels. Ototoxicity has generally been associated with serum vancomycin levels of 80 to 100 mcg/mL, although toxic reactions have also been reported at levels as low as 25 mcg/mL. Serial audiograms should be obtained in patients old enough to be tested, and the dosage reduced or therapy withdrawn promptly if signs and symptoms of toxicity develop.
Oral vancomycin is generally not associated with systemic toxicity due to poor absorption from the gastrointestinal tract. However, clinically significant serum concentrations have been reported in some patients following multiple oral doses of vancomycin for active Clostridium difficile pseudomembranous colitis. Therefore, when vancomycin is administered orally, clinicians may want to heed the usual warnings and precautions associated with intravenous use of the drug.
Vitamin K Deficiency
Major:
cefoperazone
Cefoperazone has a major potential interaction with Vitamin K Deficiency.
Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.
More resources
cefoperazone
A total of 62 drugs are known to interact with cefoperazone.
- Cefoperazone is in the drug class third generation cephalosporins.
- Cefoperazone is used to treat the following conditions:
Vancocin
A total of 193 drugs are known to interact with Vancocin.
- Vancocin is in the drug class glycopeptide antibiotics.
-
Vancocin is used to treat the following conditions:
- Bacteremia
- Bacterial Endocarditis Prevention
- Bacterial Infection
- Bone infection
- Burns, External
- Clostridioides difficile Infection
- Endocarditis
- Enterocolitis
- Febrile Neutropenia
- Meningitis
- Methicillin-Resistant Staphylococcus Aureus Infection
- Nosocomial Pneumonia
- Peritonitis
- Pneumonia
- Prevention of Perinatal Group B Streptococcal Disease
- Pseudomembranous Colitis
- Sepsis
- Shunt Infection
- Skin or Soft Tissue Infection
- Surgical Prophylaxis
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.