PIPRIL IM/IV Infusion
Piperacillin
2g
LEDERLE LABORATORIES DIVISION - JOHN WYETH & BROTHER LTD.
| Pack size | 2g Vial |
|---|---|
| Dispensing mode | POM |
| Source | UK |
| Agent | PHARMATRADE |
| Retail Price | 46.00 AED |
Available as:
Indications
PIPRIL IM/IV Infusion is used for:
Urinary Tract Infection, Uncomplicated, Community-Acquired Pneumonia, Acute Cholangitis, Uncomplicated Gonorrhea, Pseudomonas Infections, Severe infections, Cystic Fibrosis
Adult Dose
Parenteral
Usual Dosage Range
IV: 3-4 g/dose q4-6hr; not to exceed 24 g/24hr
IM: 2-3 g/dose q6-12hr; not to exceed 24 g/24 hr
Urinary Tract, Uncomplicated
6-8 g/day IV/IM (100 to 125 mg/kg/day) divided q6-12 hr
Community-Acquired Pneumonia
6-8 g/day IV/IM (100 to 125 mg/kg/day) divided q6-12 hr
Acute Cholangitis
4 g IV q6hr
Moderate Infections
2-3 g/dose IV/IM q6-12hr; not to exceed 2 g IM/site
Severe Infections
3-4 g IV/IM q4-6hr; not to exceed 24 g/24 hr
Uncomplicated Gonorrhea
2 g once with 1 g probenecid 30 min before injection
Pseudomonas Infections
4 g IV/IM q4hr
Child Dose
Usual Dosage Range
Neonates: 100 mg/kg IV/IM q12hr
Infants and Children: 200-300 mg/kg/day IV/IM divided q4-6hr
Cystic Fibrosis
350-500 mg/kg/day IV/IM divided q4-6hr
Renal Dose
Renal Impairment
CrCl 20-40 mL/min: 3-4 g q8hr
CrCl <20 mL/min: 3-4 g q12hr
Administration
IV/IM Preparation
IV: reconstitute each gram w/ 5 mL SWI, BWI, NS, D5W or other compatible diluents
Slight darkening does not indicate potency loss
IV/IM Administration
Slow direct inj over 3-5 min, OR
Intermittent infusion in at least 50 mL over 20-30 min
IM: upper outer quadrant of buttock
Contra Indications
Allergy to penicillins, cephalosporins, imipenem
Precautions
Risk of bleeding complications, especially in renal impairment
Monitor renal, hepatic & especially hematopoietic functions during prolonged treatment
Hypersensitivity reactions reported; discontinue therapy and institute appropriate therapy if allergic reaction occurs
Found to be an independent risk factor for renal failure and was associated with delayed recovery of renal function as compared to other beta-lactam antibacterial drugs; if alternative treatment options are inadequate or unavailable, monitor renal function during treatment
Combined use of piperacillin/tazobactam and vancomycin may be associated with an increased incidence of acute kidney injury
Serious skin reactions, including toxic epidermal necrolysis and Stevens-Johnson syndrome, acute exanthematous pustulosis, and drug reaction with eosinophilia and systemic symptoms (DRESS) reported; monitor closely if rash develops; discontinue if lesions progress
Hematological effects (including bleeding, leukopenia and neutropenia) have occurred.
Monitor hematologic tests during prolonged therapy
Use may result in fungal or bacterial superinfection; valuate patients for Clostridium difficile if diarrhea occurs
Dosage adjustment recommended in patients with renal impairment or receiving hemodialysis
Use with caution in patients with history of seizure disorder; high levels, that may result from renal impairment, may increase risk of seizures
Pregnancy-Lactation
Pregnancy
Piperacillin and tazobactam cross the placenta in humans; however, there are insufficient data in pregnant women to inform a drug-associated risk for major birth defects and miscarriage; no fetal structural abnormalities observed in rats or mice when piperacillin/tazobactam was administered intravenously during organogenesis at doses 1 to 2 times and 2 to 3 times human dose, respectively, based on body-surface area’ however, fetotoxicity in presence of maternal toxicity was observed in developmental toxicity and peri/postnatal studies conducted in rats (intraperitoneal administration prior to mating and throughout gestation or from gestation day 17 through lactation day 21) at doses less than the maximum recommended human daily dose based on body-surface area
Lactation
Piperacillin is excreted in human milk; tazobactam concentrations in human milk not studied; no information available on effects of piperacillin and tazobactam on breastfed child or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition.
Interactions
May prolong the neuromuscular blocking effect of vecuronium when used perioperatively. May enhance the anticoagulant effect of vit K antagonists (e.g. warfarin). May increase the risk of methotrexate toxicity. Probenecid may increase the peak serum level of piperacillin.
Adverse Effects
Side effects of Piperacillin :
<1%
Seizure
Rash
Hemolytic anemia
Postive Coombs reaction
Prolonged prothrombin time
Interstitial nephritis
Hypersensitivity
Anaphylaxis
Thrombophlebitis
Injection site pain
Headache
Fever
Intestinal infection due to pseudomonas
Mechanism of Action
Piperacillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.
Note
PIPRIL IM/IV 2g Infusion manufactured by LEDERLE LABORATORIES DIVISION - JOHN WYETH & BROTHER LTD.. Its generic name is Piperacillin. PIPRIL IM/IV is availble in United Arab Emirates.
Farmaco UAE drug index information on PIPRIL IM/IV Infusion is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.