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Drug Interactions between netilmicin and Zosyn

This report displays the potential drug interactions for the following 2 drugs:

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Moderate

piperacillin netilmicin

Applies to: Zosyn (piperacillin / tazobactam) and netilmicin

ADJUST DOSING INTERVAL: Piperacillin may inactivate aminoglycosides in vivo and in vitro. The mechanism is complexation with the aminoglycoside. Typically, this effect is significant only in patients with renal failure or if the agents are mixed in the same IV container or line. Lower serum aminoglycoside levels may be seen, and dosage adjustments may be necessary.

MANAGEMENT: Piperacillin and aminoglycosides should be administered separately during combined therapy.

References

  1. Riff LJ, Jackson GG (1972) "Laboratory and clinical conditions for gentamicin inactivation by carbenicillin." Arch Intern Med, 130, p. 887-91
  2. Reeves DS (1974) "Gentamicin therapy." Br J Hosp Med, Dec, p. 836-51
  3. Davies M, Morgan JR, Anand C (1975) "Interactions of carbenicillin and ticarcillin with gentamicin." Antimicrob Agents Chemother, 7, p. 431-4
  4. Thompson MI, Russo ME, Saxon BJ, Atkin-Thor E, Matsen JM (1982) "Gentamicin inactivation by piperacillin or carbenicillin in patients with end-stage renal disease." Antimicrob Agents Chemother, 21, p. 268-72
  5. Konishi H, Goto M, Nakamoto Y, Yamamoto I, Yamashina H (1983) "Tobramycin inactivation by carbenicillin, ticarcillin, and piperacillin." Antimicrob Agents Chemother, 23, p. 653-7
  6. Halstensen CE, Hirata CA, Heim-Duthoy KL, Abraham PA, Matzke GE (1990) "Effect of concomitant administration of piperacillin on the dispositions of netilmicin and tobramycin in patients with end-stage renal disease." Antimicrob Agents Chemother, 34, p. 128-33
  7. Uber WE, Brundage RC, White RL, et al. (1991) "In vivo inactivation of tobramycin by piperacillin." DICP, 25, p. 357-9
  8. Halstenson CE, Hirata CA, Heim-Duthoy KL, Abraham PA, Matzke GR (1990) "Effect of concomitant administration of piperacillin on the dispositions of netilmicin and tobramycin in patients with end-stage renal disease." Antimicrob Agents Chemother, 34, p. 128-33
  9. Kradjan WA, Burger R (1980) "In vivo inactivation of gentamycin by carbenicillin and ticarcillin." Arch Intern Med, 140, p. 1668-70
  10. Russo ME, Atkin-Thor E (1981) "Gentamicin and ticarcillin in subjects with end-stage renal disease." Clin Nephrol, 15, p. 175-80
  11. Viollier AF, Standiford HC, Drusano GL, Tatem BA, Moody MR, Schimpff SC (1985) "Comparative pharmacokinetics and serum bactericidal activity of mezlocillin, ticarcillin and piperacillin, with and without gentamicin." J Antimicrob Chemother, 15, p. 597-606
  12. Weibert R, Keane W, Shapiro F (1976) "Carbenicillin inactivation of aminoglycosides in patients with severe renal failure." Trans Am Soc Artif Intern Organs, 22, p. 439-43
  13. Konishi H, Goto M, Nakamoto Y, Yamamoto I, Yamashina H (1983) "Tobramycin inactivation by carbenicillin, ticaracillin, and piperacillin." Antimicrob Agents Chemother, 23, p. 653-7
  14. Pickering LK, Rutherford I (1981) "Effect of concentration and time upon inactivation of tobramycin, gentamicin, netilmicin and amikacin by azlocillin, carbenicillin, mecillinam, mezlocillin and piperacillin." J Pharmacol Exp Ther, 217, p. 345-9
  15. Henderson JL, Polk RE, Kline BJ (1981) "In vitro inactivation of gentamicin, tobramycin, and netilmicin by carbenicillin, azlocillin, or mezlocillin." Am J Hosp Pharm, 38, p. 1167-70
  16. (2018) "Product Information. Arikayce (amikacin liposome)." Insmed Incorporated
View all 16 references

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Drug and food interactions

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

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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.

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