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Can you take Tarlatamab with Zosyn?

No drug interactions found, but 20 warnings to review for the following 2 drugs:

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Drug interactions

There were no interactions found between tarlatamab and Zosyn. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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

20 potential interactions Applies to: 16 conditions, including High Blood Pressure, Heart Failure, Seizures, Hypokalemia, and Hemodialysis.

Bleeding Disorder

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Bleeding Disorder.

The use of extended-spectrum penicillin antibiotics has rarely been associated with coagulation abnormalities manifested as prolonged prothrombin and bleeding times, abnormal platelet aggregation, purpura, and clinical bleeding. These reactions have been most severe and most frequently reported in patients with renal impairment given high dosages of the drugs for prolonged periods, although they have also occurred with usual dosages in patients with normal renal function. Therapy with extended-spectrum penicillins should be administered cautiously in patients with significantly impaired renal function, severe active bleeding, or a hemorrhagic diathesis such as hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, or thrombocytopathy. Clinical monitoring of hematopoietic and renal function is recommended during prolonged and/or high-dose therapy. Bleeding manifestations are reversible upon discontinuation of the antibiotic.

Coagulation Defects and Disorders

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Coagulation Defects and Disorders.

The use of extended-spectrum penicillin antibiotics has rarely been associated with coagulation abnormalities manifested as prolonged prothrombin and bleeding times, abnormal platelet aggregation, purpura, and clinical bleeding. These reactions have been most severe and most frequently reported in patients with renal impairment given high dosages of the drugs for prolonged periods, although they have also occurred with usual dosages in patients with normal renal function. Therapy with extended-spectrum penicillins should be administered cautiously in patients with significantly impaired renal function, severe active bleeding, or a hemorrhagic diathesis such as hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, or thrombocytopathy. Clinical monitoring of hematopoietic and renal function is recommended during prolonged and/or high-dose therapy. Bleeding manifestations are reversible upon discontinuation of the antibiotic.

Cystic Fibrosis

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Cystic Fibrosis.

As with other semisynthetic penicillins, piperacillin therapy has been associated with an increased incidence of fever and rash in cystic fibrosis patients.

Fluid Retention

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Fluid Retention.

Parenteral piperacillin sodium contains approximately 43 mg (1.85 mEq) of sodium per each gram of piperacillin activity. The combination, piperacillin-tazobactam, contains approximately 54 mg (2.35 mEq) of sodium per gram of piperacillin, or 108 mg (4.7 mEq) per 2.25 gram of total drug. 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 piperacillin and other extended-spectrum penicillin antibiotics, 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.

Heart Failure

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Heart Failure.

Parenteral piperacillin sodium contains approximately 43 mg (1.85 mEq) of sodium per each gram of piperacillin activity. The combination, piperacillin-tazobactam, contains approximately 54 mg (2.35 mEq) of sodium per gram of piperacillin, or 108 mg (4.7 mEq) per 2.25 gram of total drug. 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 piperacillin and other extended-spectrum penicillin antibiotics, 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.

Hemodialysis

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Hemodialysis.

Penicillin antibiotics (except for agents in the penicillinase-resistant class) are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

High Blood Pressure

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with High Blood Pressure.

Parenteral piperacillin sodium contains approximately 43 mg (1.85 mEq) of sodium per each gram of piperacillin activity. The combination, piperacillin-tazobactam, contains approximately 54 mg (2.35 mEq) of sodium per gram of piperacillin, or 108 mg (4.7 mEq) per 2.25 gram of total drug. 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 piperacillin and other extended-spectrum penicillin antibiotics, 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.

Hypernatremia

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Hypernatremia.

Parenteral piperacillin sodium contains approximately 43 mg (1.85 mEq) of sodium per each gram of piperacillin activity. The combination, piperacillin-tazobactam, contains approximately 54 mg (2.35 mEq) of sodium per gram of piperacillin, or 108 mg (4.7 mEq) per 2.25 gram of total drug. 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 piperacillin and other extended-spectrum penicillin antibiotics, 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.

Hypokalemia

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Hypokalemia.

Parenteral piperacillin sodium contains approximately 43 mg (1.85 mEq) of sodium per each gram of piperacillin activity. The combination, piperacillin-tazobactam, contains approximately 54 mg (2.35 mEq) of sodium per gram of piperacillin, or 108 mg (4.7 mEq) per 2.25 gram of total drug. 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 piperacillin and other extended-spectrum penicillin antibiotics, 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.

Liver Disease

Moderate:

tarlatamab

Tarlatamab has a moderate potential interaction with Liver Disease.

The effects of moderate to severe hepatic impairment on the pharmacokinetics of tarlatamab are unknown.

Noninfectious Colitis

Major:

Zosyn

The piperacillin in Zosyn 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

Moderate:

tarlatamab

Tarlatamab has a moderate potential interaction with Renal Dysfunction.

The effects of severe renal impairment (eGFR 15 to 29 mL/min) and end-stage renal disease (eGFR less than 15 mL/min) on the pharmacokinetics of tarlatamab are unknown.

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Renal Dysfunction.

As with other penicillins, patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure). Therapy with piperacillin should be administered cautiously in patients with preexisting neuromuscular excitability or seizure disorders.

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Renal Dysfunction.

The use of extended-spectrum penicillin antibiotics has rarely been associated with coagulation abnormalities manifested as prolonged prothrombin and bleeding times, abnormal platelet aggregation, purpura, and clinical bleeding. These reactions have been most severe and most frequently reported in patients with renal impairment given high dosages of the drugs for prolonged periods, although they have also occurred with usual dosages in patients with normal renal function. Therapy with extended-spectrum penicillins should be administered cautiously in patients with significantly impaired renal function, severe active bleeding, or a hemorrhagic diathesis such as hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, or thrombocytopathy. Clinical monitoring of hematopoietic and renal function is recommended during prolonged and/or high-dose therapy. Bleeding manifestations are reversible upon discontinuation of the antibiotic.

Moderate:

Zosyn

The piperacillin in Zosyn 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.

Moderate:

Zosyn

The tazobactam in Zosyn has a moderate potential interaction with Renal Dysfunction.

Beta-lactamase inhibitors are available in combination with beta-lactam antibacterial agents. Beta-lactamase inhibitors are primarily eliminated by the kidneys, with 75% to 100% of the administered dose excreted as unchanged drug. The plasma exposures (AUC) of beta-lactamase inhibitors (and the associated beta-lactam antibacterial agents) are increased with decreasing renal function. Dosage adjustments are generally necessary for products containing beta-lactamase inhibitors, and modifications should be based on the degree of renal dysfunction in accordance with the individual manufacturer product information. Because it may change during the course of therapy, renal function should be monitored regularly and the dosage should be adjusted accordingly, as appropriate.

Beta-lactamase inhibitors and beta-lactam antibacterial agents can be removed by hemodialysis. The dose should be administered after hemodialysis on hemodialysis days.

Seizures

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Seizures.

As with other penicillins, patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure). Therapy with piperacillin should be administered cautiously in patients with preexisting neuromuscular excitability or seizure disorders.

Thrombocytopathy

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Thrombocytopathy.

The use of extended-spectrum penicillin antibiotics has rarely been associated with coagulation abnormalities manifested as prolonged prothrombin and bleeding times, abnormal platelet aggregation, purpura, and clinical bleeding. These reactions have been most severe and most frequently reported in patients with renal impairment given high dosages of the drugs for prolonged periods, although they have also occurred with usual dosages in patients with normal renal function. Therapy with extended-spectrum penicillins should be administered cautiously in patients with significantly impaired renal function, severe active bleeding, or a hemorrhagic diathesis such as hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, or thrombocytopathy. Clinical monitoring of hematopoietic and renal function is recommended during prolonged and/or high-dose therapy. Bleeding manifestations are reversible upon discontinuation of the antibiotic.

Thrombocytopenia

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Thrombocytopenia.

The use of extended-spectrum penicillin antibiotics has rarely been associated with coagulation abnormalities manifested as prolonged prothrombin and bleeding times, abnormal platelet aggregation, purpura, and clinical bleeding. These reactions have been most severe and most frequently reported in patients with renal impairment given high dosages of the drugs for prolonged periods, although they have also occurred with usual dosages in patients with normal renal function. Therapy with extended-spectrum penicillins should be administered cautiously in patients with significantly impaired renal function, severe active bleeding, or a hemorrhagic diathesis such as hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, or thrombocytopathy. Clinical monitoring of hematopoietic and renal function is recommended during prolonged and/or high-dose therapy. Bleeding manifestations are reversible upon discontinuation of the antibiotic.

Vitamin K Deficiency

Moderate:

Zosyn

The piperacillin in Zosyn has a moderate potential interaction with Vitamin K Deficiency.

The use of extended-spectrum penicillin antibiotics has rarely been associated with coagulation abnormalities manifested as prolonged prothrombin and bleeding times, abnormal platelet aggregation, purpura, and clinical bleeding. These reactions have been most severe and most frequently reported in patients with renal impairment given high dosages of the drugs for prolonged periods, although they have also occurred with usual dosages in patients with normal renal function. Therapy with extended-spectrum penicillins should be administered cautiously in patients with significantly impaired renal function, severe active bleeding, or a hemorrhagic diathesis such as hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, or thrombocytopathy. Clinical monitoring of hematopoietic and renal function is recommended during prolonged and/or high-dose therapy. Bleeding manifestations are reversible upon discontinuation of the antibiotic.

More resources

tarlatamab

A total of 378 drugs are known to interact with tarlatamab.

Zosyn

A total of 78 drugs are known to interact with Zosyn.

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.