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Drug Interactions between Pipracil and Vancocin

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

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Major

piperacillin vancomycin

Applies to: Pipracil (piperacillin) and Vancocin (vancomycin)

MONITOR CLOSELY: When administered concomitantly, vancomycin and piperacillin may have additive nephrotoxic effects. A limited number of retrospective studies have found an increased incidence of acute kidney injury in patients treated with vancomycin and piperacillin-tazobactam relative to vancomycin alone. No pharmacokinetic interactions have been noted between these agents.

MANAGEMENT: Caution is advised when vancomycin is used concomitantly with other nephrotoxic drugs such as piperacillin. Clinical and laboratory monitoring of renal function is recommended.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. Meaney CJ, Hynicka LM, Tsoukleris MG (2014) "Vancomycin-associated nephrotoxicity in adult medicine patients: incidence, outcomes, and risk factors." Pharmacotherapy, 34, p. 653-61
  4. Moenster RP, Linneman TW, Finnegan PM, Hand S, Thomas Z, McDonald JR (2014) "Acute renal failure associated with vancomycin and รข-lactams for the treatment of osteomyelitis in diabetics: piperacillin-tazobactam as compared with cefepime." Clin Microbiol Infect, 2013, O384-9
  5. Kim T, Kandiah S, Patel, M, et al. (2015) "Risk factors for kidney injury during vancomycin and piperacillin/tazobactam administration, including increased odds of injury with combination therapy." BMC Res Notes, 8, p. 579
  6. Peyko V, Smalley S, Cohen H (2016) "Prospective comparison of acute kidney injury during treatment with the combination of piperacillin-tazobactam and vancomycin versus the combination of cefepime or meropenem and vancomycin." J Pharm Pract, pii, Epub
  7. Hammond DA, Smith MN, Painter JT, Meena NK, Lusardi K (2016) "Comparative incidence of acute kidney injury in critically ill patients receiving vancomycin with concomitant piperacillin-tazobactam or cefepime: A restrospective cohort study." Pharmacotherapy, Epub
  8. Karino S, Kaye KS, Navalkele B, et al. (2016) "Epidemiology of acute kidney injury in critically ill patients receiving concomitant vancomycin and piperacillin/tazobactam: Opportunities for antimicrobial stewardship." Antimicrob Agents Chemother, pii, Epub
  9. Burgess LD, Drew RH (2014) "Comparison of the incidence of vancomycin-induced nephrotoxicity in hospitalized patients with and without concomitant piperacillin-tazobactam." Pharmacotherapy, 34, p. 670-6
  10. Gomes DM, Smotherman C, Birch A, et al. (2014) "Comparison of acute kidney injury during treatment with vancomycin in combination with piperacillin-tazobactam or cefepime." Pharmacotherapy, 34, p. 662-9
  11. Reed EE, Johnston J, Severing J, Stevenson KB, Deutscher M (2014) "Nephrotoxicity risk factors and intravenous vancomycin dosing in the immediate postoperative period following antibiotic-impregnated cement spacer replacement." Ann Pharmacother, 48, p. 962-9
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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.

Further information

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

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