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Pipracil Side Effects

Generic name: piperacillin

Medically reviewed by Last updated on Jan 30, 2024.

Note: This document contains side effect information about piperacillin. Some dosage forms listed on this page may not apply to the brand name Pipracil.

Applies to piperacillin: injectable powder for injection.


This drug was generally well tolerated. Local side effects (after IV or IM injection) were most common.[Ref]


Common (1% to 10%): Diarrhea, loose stools

Frequency not reported: Nausea, vomiting, bloody diarrhea, pseudomembranous colitis, Clostridium difficile-associated diarrhea[Ref]

The onset of pseudomembranous colitis symptoms has been reported during or after antimicrobial therapy.[Ref]


Common (1% to 10%): Rash, pruritus

Frequency not reported: Vesicular eruptions/vesiculation, erythema multiforme, urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome, drug reactions with eosinophilia and systemic symptoms (DRESS), petechial rash/purpura, exanthematous pustulosis, bullous dermatosis, erythema nodosum, exanthems, exfoliative dermatitis, Jarisch-Herxheimer reaction[Ref]

An increased incidence of rash has been reported in cystic fibrosis patients.

DRESS has been reported, particularly with piperacillin-tazobactam.

Petechial rash or purpura due to thrombocytopenia has been reported.[Ref]


Common (1% to 10%): Thrombophlebitis, injection site pain, injection site induration, injection site erythema

Frequency not reported: Ecchymosis, deep vein thrombosis, hematomas[Ref]

Thrombophlebitis was more likely when insufficiently diluted solution was injected into the vein.[Ref]


Common (1% to 10%): Drug fever

Frequency not reported: Fever, edema, fatigue, decreased serum potassium levels, superinfection (including candidiasis), hemorrhagic manifestations[Ref]

An increased incidence of fever has been reported in cystic fibrosis patients.

Patients with liver disease or those receiving cytotoxic therapy or diuretics have reported decreased serum potassium levels with high doses of this drug.[Ref]


Frequency not reported: Anaphylactic/anaphylactoid reactions (some leading to shock and fatalities)[Ref]


Frequency not reported: Agranulocytosis, hemolytic anemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia, eosinophilia, bleeding disorders, positive Coombs tests, hemorrhage/bleeding, decreased prothrombin time, platelet dysfunction, prolonged bleeding times[Ref]

Risk factors for reversible leukopenia (neutropenia) included prolonged therapy with high doses or concomitant drugs that cause this effect.[Ref]

Nervous system

Frequency not reported: Headache, dizziness, seizures/convulsions, prolonged muscle relaxation, paralysis, neurotoxicity, encephalopathy, neuromuscular excitability[Ref]

Neuromuscular excitability and convulsions have been reported when higher than recommended doses were given IV.[Ref]


Frequency not reported: Elevated serum creatinine, elevated BUN, interstitial nephritis, renal failure[Ref]

Drug-induced interstitial nephritis is a rare but potentially serious side effect of all penicillins.[Ref]


Frequency not reported: Elevated liver enzymes (LDH, AST, ALT), hyperbilirubinemia, hepatotoxicity, cholestatic hepatitis[Ref]


Frequency not reported: Hypokalemia, electrolyte disturbances, acid-base disturbances[Ref]


Frequency not reported: Epistaxis


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10. Strandvik B (1984) "Adverse reactions to piperacillin in patients with cystic fibrosis." Lancet, 06/16/84, p. 1362

11. Stead RJ, Kennedy HG, Hodson ME, Batten JC (1984) "Adverse reactions to piperacillin in cystic fibrosis." Lancet, 04/14/84, p. 857

12. Pleasants RA, Walker TR, Samuelson WM (1994) "Allergic reactions to parenteral beta-lactam antibiotics in patients with cystic fibrosis." Chest, 106, p. 1124-8

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14. Moore M, McNamara TR, Johnson J (1985) "Elevated bleeding time and epistaxis associated with piperacillin therapy." South Med J, 78, p. 363

15. Kirkwood CF, Lasezkay GM (1985) "Neutropenia associated with mezlocillin and piperacillin." Drug Intell Clin Pharm, 19, p. 112-4

16. Lee M, Stobnicki M, Sharifi R (1986) "Hemorrhagic complications of piperacillin therapy." J Urol, 136, p. 454-5

17. Bressler RB, Huston DP (1986) "Piperacillin-induced anemia and leukopenia." South Med J, 79, p. 255-6

18. Fass RJ, Copelan EA, Brandt JT, Moeschberger ML, Ashton JJ (1987) "Platelet-mediated bleeding caused by broad-spectrum penicillins." J Infect Dis, 155, p. 1242-8

19. Gentry LO, Jemsek JG, Natelson EA (1981) "Effects of sodium piperacillin on platelet function in normal volunteers." Antimicrob Agents Chemother, 19, p. 532-3

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21. Yan MT, Chu HY, Chau T, Lin SH (2009) "Profound thrombocytopenia associated with piperacillin in a hemodialysis patient." Clin Nephrol, 72, p. 240-3

22. Mackie K, Pavlin EG (1990) "Recurrent paralysis following piperacillin administration." Anesthesiology, 72, p. 561-3

23. Parkmatsumoto YC, Tazawa T (1996) "Piperacillin-induced encephalopathy." J Neurol Sci, 140, p. 141-2

24. Malanga CJ, Kokontis L, Mauzy S (1997) "Piperacillin-induced seizures." Clin Pediatr (Phila), 36, p. 475-6

Further information

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

Some side effects may not be reported. You may report them to the FDA.