Piperacillin

Piperacillin is an antibiotic used to treat infections caused by certain types of bacteria.

Piperacillin is available under the following different brand names: Pipracil.

• Dosage Forms and Strengths
• Powder for injection
• 2 mg
• 3 mg
• 4 mg
• 40 mg

Dosage Considerations – Should be Given as Follows:

Usual Dosage Range

• Adult, Intravenous (IV): 3-4 g/dose every 4-6 hours; not to exceed 24 g/24 hours
• Adult, Intramuscular (IM): 2-3 g/dose every 6-12 hours; not to exceed 24 g/24 hours
• Neonates: 100 mg/kg IV/IM every 12 hours
• Infants and Children: 200-300 mg/kg/day IV/IM divided every 4-6 hours
• Geriatric, IV: 2-4 g every 6-8 hours
• Geriatric, IM: 1-2 g every 8-12 hours

Urinary Tract, Uncomplicated

• 6-8 g/day intravenous/intramuscular (IV/IM) (100 to 125 mg/kg/day) divided every 6-12 hours

Community-Acquired Pneumonia

• 6-8 g/day intravenous/intramuscular (IV/IM) (100 to 125 mg/kg/day) divided every 6-12 hours

Acute Cholangitis

• 4 g intravenous (IV) every 6 hours

Moderate Infections

• 2-3 g/dose intravenous/intramuscular (IV/IM) every 6-12 hours; not to exceed 2 g IM/site

Severe Infections

• 3-4 g intravenous/intramuscular (IV/IM) every 4-6 hours; not to exceed 24 g/24 hours

Uncomplicated Gonorrhea

• 2 g once with 1 g probenecid 30 min before injection

Pseudomonas Infections

• 4 g intravenous/intramuscular (IV/IM) every 4 hours

Cystic Fibrosis, Pediatric

• 350-500 mg/kg/day intravenous/intramuscular (IV/IM) divided every 4-6 hours

Renal Impairment

• CrCl 20-40 mL/minute: 3-4 g every 8 hours
• CrCl less than 20 mL/minute: 3-4 g every 12 hours

Other Indications and Uses

• Extended spectrum: Acinetobacter spp., Alcaligenes xylosoxidans, Bacteroides spp., Citrobacter diversus, Citrobacter freundii, E. coli, Fusobacteriae, H. influenzae, Klebsiella spp., N. gonorrhoeae, Peptococcus spp., Peptostreptococcus spp., indole-pos. Proteus spp., Providencia spp., Pseudomonas spp., Serratia spp., Streptococcus faecalis, Yersinia enterolitica

Common side effects of piperacillin include:

• Diarrhea
• Dizziness
• Fever
• Headache
• Hemolytic anemia
• Hypersensitivity
• Injection site pain
• Interstitial nephritis
• Intestinal infection due to pseudomonas
• Nausea
• Oral thrush
• Positive Coombs reaction
• Prolonged prothrombin time
• Rash
• Seizure
• Severe allergic reaction (anaphylaxis)
• Thrombophlebitis
• Vaginal yeast infection
• Vomiting

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Piperacillin has no known severe interactions with other drugs.
• Serious interactions of piperacillin include:
  • antithrombin alfa
  • antithrombin III
  • argatroban
  • BCG vaccine live
  • bivalirudin
  • cholera vaccine
  • dalteparin
  • enoxaparin
  • heparin
  • lepirudin
  • tinzaparin
  • warfarin
• Moderate interactions of piperacillin include:
  • azithromycin
  • bazedoxifene/conjugated estrogens
  • chloramphenicol
  • clarithromycin
  • demeclocycline
  • dichlorphenamide
  • doxycycline
  • erythromycin base
  • erythromycin ethylsuccinate
  • erythromycin lactobionate
  • erythromycin stearate
  • minocycline
  • probenecid
  • sodium picosulfate/magnesium oxide/anhydrous citric acid
  • tetracycline
  • vancomycin
• Mild interactions of piperacillin include:
  • amikacin
  • aspirin
  • aspirin rectal
  • aspirin/citric acid/sodium bicarbonate
  • chlorothiazide
  • choline magnesium trisalicylate
  • gentamicin
  • hydrochlorothiazide
  • kanamycin
  • meclofenamate
  • neomycin PO
  • rose hips
  • streptomycin
  • tobramycin
  • willow bark

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

Warnings

This medication contains piperacillin. Do not take Pipracil if you are allergic to piperacillin or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Allergy to penicillins, cephalosporins, imipenem

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Piperacillin?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Piperacillin?"

Cautions

• Risk of bleeding complications, especially in renal impairment
• Monitor renal, hepatic and especially hematopoietic functions during prolonged treatment

Pregnancy and Lactation

• Use piperacillin with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
• Do not use piperacillin if nursing or do not nurse.