Cefoperazone Sodium interactions

Food & lifestyle

• alcohol

  Moderate

  Metabolism

  Some cephalosporins may occasionally induce a disulfiram-like reaction when coadministered with alcohol. The interaction has been reported for cefamandole, cefoperazone, cefotetan, and moxalactam. These agents contain an N-methylthiotetrazole (NMTT) side chain that may inhibit aldehyde dehydrogenase (ALDH) similar to disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentration of acetaldehyde, the accumulation of which produces an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrh

  What to do: Patients receiving cephalosporins with the NMTT side chain should avoid the concomitant use of alcohol and alcohol-containing products.

  9 sources

  1. Kline SS, Mauro VF, Forney RB Jr, et al. "Cefotetan-induced disulfiram-type reactions and hypoprothrombinemia." Antimicrob Agents Chemother 31 (1987): 1328-31
  2. Freundt KJ, Kitson TM "Inactivation of aldehyde dehydrogenase by a putative metabolite of cefamandole." Infection 14 (1986): 44-7
  3. Freundt KJ, Schreiner E, Christmann-Kleiss U "Cefamandole: a competitive inhibitor of aldehyde dehydrogenase." Infection 13 (1985): 91
  4. McMahon FG "Disulfiram-like reaction to a cephalosporin." JAMA 243 (1980): 2397
  5. Reeves DS, Davies AJ "Antabuse effect with cephalosporins." Lancet 2 (1980): 540
  6. Brown KR, Guglielmo BJ, Pons VG, Jacobs RA "Theophylline elixir, moxalactam, and a disulfiram reaction." Ann Intern Med 97 (1982): 621-2
  7. Umeda S, Arai T "Disulfiram-like reaction to moxalactam after celiac plexus alcohol block." Anesth Analg 64 (1985): 377
  8. Foster TS, Raehl CL, Wilson HD "Disulfiram-like reaction associated with a parenteral cephalosporin." Am J Hosp Pharm 37 (1980): 858-9

  Show all 9 sourcesShow fewer sources

  9. McMahon FG, Ryan JR, Jain AK, LaCorte W, Ginzler F "Absence of disulfiram-type reactions to single and multiple doses of cefonicid: a placebo-controlled study." J Antimicrob Chemother 20 (1987): 913-8

Conditions

Conditions in which Cefoperazone Sodium needs care, as documented in this source.

• Colitis

  Major

  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.

  31 sources

  1. "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories (2002):
  2. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome (2002):
  3. "Product Information. Zinacef (cefuroxime)." Glaxo Wellcome (2002):
  4. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn (2002):
  5. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  6. "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  7. "Product Information. Amoxil (amoxicillin)." SmithKline Beecham (2001):
  8. "Product Information. Merrem (meropenem)." Astra-Zeneca Pharmaceuticals (2001):

  Show all 31 sourcesShow fewer sources

  9. "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis (2001):
  10. "Product Information. Lincocin (lincomycin)." Pharmacia and Upjohn (2001):
  11. "Product Information. Cubicin (daptomycin)." Cubist Pharmaceuticals Inc (2003):
  12. "Product Information. Xifaxan (rifaximin)." Salix Pharmaceuticals (2004):
  13. "Product Information. Doribax (doripenem)." Ortho McNeil Pharmaceutical (2007):
  14. "Product Information. Penicillin G Procaine (procaine penicillin)." Monarch Pharmaceuticals Inc (2009):
  15. "Product Information. Vibativ (telavancin)." Theravance Inc (2009):
  16. "Product Information. Teflaro (ceftaroline)." Forest Pharmaceuticals (2010):
  17. "Product Information. Penicillin G Sodium (penicillin G sodium)." Sandoz Inc (2022):
  18. "Product Information. Dalvance (dalbavancin)." Durata Therapeutics, Inc. (2014):
  19. "Product Information. Orbactiv (oritavancin)." The Medicines Company (2014):
  20. "Product Information. Bicillin C-R (benzathine penicillin-procaine penicillin)." A-S Medication Solutions (2017):
  21. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
  22. "Product Information. Polymyxin B Sulfate (polymyxin B sulfate)." AuroMedics Pharma LLC (2022):
  23. "Product Information. Zemdri (plazomicin)." Achaogen (2018):
  24. "Product Information. Seysara (sarecycline)." Allergan Inc (2018):
  25. "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):
  26. "Product Information. Aemcolo (rifamycin)." Aries Pharmaceuticals, Inc. (2018):
  27. "Product Information. Fetroja (cefiderocol)." Shionogi USA Inc (2019):
  28. "Product Information. Biaxin (clarithromycin)." AbbVie US LLC (2019):
  29. "Product Information. Zithromax (azithromycin)." Pfizer U.S. Pharmaceuticals Group (2021):
  30. "Product Information. E.E.S.-400 Filmtab (erythromycin)." Arbor Pharmaceuticals (2018):
  31. "Product Information. Priftin (rifapentine)." sanofi-aventis (2020):

• Hypoprothrombinemias

  Major

  Hypoprothrombinemia, with or without bleeding, has been reported rarely with various cephalosporins, particularly those containing an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The sulfhydryl group of this side chain is suspected of interfering with the hepatic synthesis of prothrombin. Risk factors include advanced age, debility, vitamin K deficiency, malnutrition, malabsorption, and severe renal or hepatobiliary impairment. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with any of these risk factors and/or significant active bleeding or a hemorrhagic diathesis. Prophylactic administration of vitamin K may be indicated in some patients, especially when intestinal sterilization and surgical procedures are performed.

  37 sources

  1. Lerner PI, Lubin A "Coagulopathy with cefazolin in uremia." N Engl J Med 290 (1974): 1324
  2. Fujita Y, Inoue S, Yorifuji R, et al. "Effects of cefotaxime on blood coagulation in patients with renal insufficiency." Drugs 35 (1988): 196-8
  3. Kline SS, Mauro VF, Forney RB Jr, et al. "Cefotetan-induced disulfiram-type reactions and hypoprothrombinemia." Antimicrob Agents Chemother 31 (1987): 1328-31
  4. Holt J "Hypoprothrombinemia and bleeding diathesis associated with cefotetan therapy in surgical patients." Arch Surg 123 (1988): 523
  5. Conjura A, Bell W, Lipsky JJ "Cefotetan and hypoprothrombinemia." Ann Intern Med 108 (1988): 643
  6. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA "Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan." Arch Surg 126 (1991): 524-5
  7. Wurtz RM, Sande MA "Cefotetan and coagulopathy." J Infect Dis 160 (1989): 555-6
  8. Shimada K, Matsuda T, Inamatsu T, Urayama K "Bleeding secondary to vitamin K deficiency in patients receiving parenteral cephem antibiotics." J Antimicrob Chemother 14 (1984): 325-30

  Show all 37 sourcesShow fewer sources

  9. Fass RJ, Copelan EA, Brandt JT, Moeschberger ML, Ashton JJ "Platelet-mediated bleeding caused by broad-spectrum penicillins." J Infect Dis 155 (1987): 1242-8
  10. Sanburg AL, Hughes JD, Nichols C "Antibiotic-induced hypoprothrombinaemia." Med J Aust 143 (1985): 387-8
  11. Alitalo R, Ruutu M, Valtonen V, et al. "Hypoprothrombinaemia and bleeding during administration of cefamandole and cefoperazone." Ann Clin Res 17 (1985): 116-9
  12. Bertino JS, Kozak AJ, Reese RE, Chiarello LA "Hypoprothrombinemia associated with cefamandole use in a rural teaching hospital." Arch Intern Med 146 (1986): 1125-8
  13. Yangco BG, Palumbo JA, Nolen T, et al. "Comparative multicentre evaluation of the safety and efficacy of ceftazidime versus cefamandole for pneumonia." J Antimicrob Chemother 18 (1986): 521-9
  14. O'Donnell D "Hypoprothrombinaemia associated with use of cephamandole." Aust N Z J Surg 61 (1991): 471-2
  15. Tibbitts JS, Lipsky JJ "Effect of biliary diversion on the ability of cefamandole to inhibit vitamin K metabolism." Drug Metabol Drug Interact 7 (1989): 149-60
  16. Cristiano P "Hypoprothrombinemia associated with cefoperazone treatment." Drug Intell Clin Pharm 18 (1984): 314-6
  17. Meisel S "Hypoprothrombinemia due to cefoperazone." Drug Intell Clin Pharm 18 (1984): 316
  18. Parker SW, Baxter J, Beam TR "Cefoperazone-induced coagulopathy." Lancet 1 (1984): 1016
  19. Andrassy K, Koderisch J, Fritz S, et al. "Alteration of hemostasis associated with cefoperazone treatment." Infection 14 (1986): 27-31
  20. Mueller RJ, Green D, Phair JP "Hypoprothrombinemia associated with cefoperazone therapy." South Med J 80 (1987): 1360-2
  21. Brown RB, Klar J, Lemeshow S, Teres D, Pastides H, Sands M "Enhanced bleeding with cefoxitin or moxalactam." Arch Intern Med 146 (1986): 2159-64
  22. Shenkenberg TD, Mackowiak PA, Smith JW "Coagulopathy and hemorrhage associated with cefoperazone therapy in a patient with renal failure." South Med J 78 (1985): 488-9
  23. D'Elia JA, Kaldany A, Miller DG, et al. "Moxalactam bleeding and renal insufficiency." JAMA 249 (1983): 1565
  24. Clark J, Hochman R, Rolla A, et al. "Coagulopathy associated with the use of cephalosporin or moxalactam antibiotics in acute and chronic renal failure." Clin Exp Dial Apheresis 7 (1983): 177-90
  25. Shimanda K, Matsuda T, Inamatsu T, Urayama K "Bleeding secondary to vitamin K deficiency in patients receiving parenteral cephem antibiotics." J Antimicrob Chemother 14 (1984): 325-30
  26. Sanburg AL, Hughes JD, Nichols C "Antibiotic-induced hypoprothrombinaemia." Med J Aust 143 (1985): 387-8
  27. Natelson EA, Brown CH, 3d Bradshaw MW, Alfrey CP, Jr Williams TW, Jr "Influence of cephalosporin antibiotics on blood coagulation and platelet function." Antimicrob Agents Chemother 9 (1976): 91-3
  28. Freedy HR, Cetnarowski AB, Lumish RM, Schafer FJ "Cefoperazone-induced coagulopathy." Drug Intell Clin Pharm 20 (1986): 281-3
  29. Osborne JC "Hypoprothrombinemia and bleeding due to cefoperazone." Ann Intern Med 102 (1985): 721-2
  30. Haubenstock A, Schmidt P, Zazgornik J, Balcke P, Kopsa H "Hypoprothrombinaemic bleeding associated with ceftriaxone." Lancet 1 (1983): 1215-6
  31. "Product Information. Zefazone (cefmetazole)." Pharmacia and Upjohn (2002):
  32. "Product Information. Cefobid (cefoperazone)." Roerig Division (2002):
  33. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals (2002):
  34. "Product Information. Mandol (cefamandole)." Lilly, Eli and Company (2001):
  35. Shearer MJ, Bechtold H, Andrassy K, Koderisch J, McCarthy PT, Trenk D, Jahnchen E, Ritz E "Mechanism of cephalosporin-induced hypoprothrombinemia: relation to cephalosporin side chain, vitamin K metabolism, and vitamin K status." J Clin Pharmacol 28 (1988): 88-95
  36. Riancho JA, Olmos JM, Sedano C "Life-threatening bleeding in a patient treated with cefonicid." Ann Intern Med 123 (1995): 472-3
  37. Breen GA, Stpeter WL "Hypoprothrombinemia associated with cefmetazole." Ann Pharmacother 31 (1997): 180-4

• Alcoholic Intoxication

  Moderate

  Disulfiram-like reactions may occur in patients who consume alcohol within 72 hours after administration of a cephalosporin antibiotic that contains an N-methylthiotetrazole (NMTT) side chain (cefamandole, cefmetazole, cefoperazone, cefotetan). The reaction appears to result from accumulation of acetaldehyde due to inhibition of acetaldehyde dehydrogenase. Therapy with cephalosporins containing the NMTT side chain should be administered cautiously in patients with a history of alcoholism. Patients should be instructed to avoid alcohol-containing products during therapy and up to 72 hours after the last dose.

  12 sources

  1. Kline SS, Mauro VF, Forney RB Jr, et al. "Cefotetan-induced disulfiram-type reactions and hypoprothrombinemia." Antimicrob Agents Chemother 31 (1987): 1328-31
  2. Freundt KJ, Kitson TM "Inactivation of aldehyde dehydrogenase by a putative metabolite of cefamandole." Infection 14 (1986): 44-7
  3. Freundt KJ, Schreiner E, Christmann-Kleiss U "Cefamandole: a competitive inhibitor of aldehyde dehydrogenase." Infection 13 (1985): 91
  4. McMahon FG "Disulfiram-like reaction to a cephalosporin." JAMA 243 (1980): 2397
  5. Reeves DS, Davies AJ "Antabuse effect with cephalosporins." Lancet 2 (1980): 540
  6. Brown KR, Guglielmo BJ, Pons VG, Jacobs RA "Theophylline elixir, moxalactam, and a disulfiram reaction." Ann Intern Med 97 (1982): 621-2
  7. Umeda S, Arai T "Disulfiram-like reaction to moxalactam after celiac plexus alcohol block." Anesth Analg 64 (1985): 377
  8. Foster TS, Raehl CL, Wilson HD "Disulfiram-like reaction associated with a parenteral cephalosporin." Am J Hosp Pharm 37 (1980): 858-9

  Show all 12 sourcesShow fewer sources

  9. "Product Information. Zefazone (cefmetazole)." Pharmacia and Upjohn (2002):
  10. "Product Information. Cefobid (cefoperazone)." Roerig Division (2002):
  11. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals (2002):
  12. "Product Information. Mandol (cefamandole)." Lilly, Eli and Company (2001):

• Diseases requiring dialysis

  Moderate

  Most cephalosporin antibiotics are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis. Cefonicid, cefixime, and ceftriaxone are not significantly removed by hemodialysis.

  24 sources

  1. "Product Information. Ceclor (cefaclor)." Lilly, Eli and Company (2002):
  2. "Product Information. Duricef (cefadroxil)." Bristol-Myers Squibb (2002):
  3. "Product Information. Ancef (cefazolin)." SmithKline Beecham (2002):
  4. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc (2002):
  5. "Product Information. Monocid (cefonicid)." SmithKline Beecham (2002):
  6. "Product Information. Cefobid (cefoperazone)." Roerig Division (2002):
  7. "Product Information. Claforan (cefotaxime)." Hoechst Marion Roussel (2002):
  8. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals (2002):

  Show all 24 sourcesShow fewer sources

  9. "Product Information. Mefoxin (cefoxitin)." Merck & Co., Inc (2002):
  10. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn (2002):
  11. "Product Information. Cefzil (cefprozil)." Bristol-Myers Squibb (2002):
  12. "Product Information. Tazicef (ceftazidime)." SmithKline Beecham (2002):
  13. "Product Information. Cefizox (ceftizoxime)." Fujisawa (2002):
  14. "Product Information. Rocephin (ceftriaxone)." Roche Laboratories (2002):
  15. "Product Information. Keflex (cephalexin)." Dista Products Company (2002):
  16. "Product Information. Velosef (cephradine)." Apothecon Inc (2002):
  17. "Product Information. Keflin (cephalothin)." Lilly, Eli and Company (2002):
  18. "Product Information. Cefadyl (cephapirin)." Apothecon Inc (2002):
  19. "Product Information. Lorabid (loracarbef)." Lilly, Eli and Company (2002):
  20. "Product Information. Mandol (cefamandole)." Lilly, Eli and Company (2001):
  21. "Product Information. Cedax (ceftibuten)." Schering-Plough (2001):
  22. "Product Information. Maxipime (cefepime)." Bristol-Myers Squibb (2001):
  23. "Product Information. Omnicef (cefdinir)." Parke-Davis (2001):
  24. "Product Information. Spectracef (cefditoren)." TAP Pharmaceuticals Inc (2001):

• Heart Failure

  Moderate

  Parenteral cefoperazone sodium contains approximately 34 mg (1.5 mEq) of sodium per each gram of cefoperazone activity. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

  1 source

  1. "Product Information. Cefobid (cefoperazone)." Roerig Division (2002):

• Liver Diseases

  Moderate

  Cefoperazone is primarily eliminated by hepatobiliary excretion. In patients with impaired hepatic function and/or biliary obstruction, the half-life of cefoperazone is prolonged 2- to 4-fold but urinary excretion is increased. At usual dosages, adjustments are generally not necessary in either renal or hepatobiliary impairment. However, serum drug concentrations should be monitored if high dosages are used (i.e. > 4 g/day), and the dosage decreased accordingly if drug accumulation occurs. In patients with both hepatic and severe renal impairment, cefoperazone dosage should not exceed 1 to 2 grams per day without close monitoring of serum concentrations.

  9 sources

  1. Balant L, Dayer P, Rudhardt M, et al. "Cefoperazone: pharmacokinetics in humans with normal and impaired renal function and pharmacokinetics in rats." Clin Ther 3 (1980): 50-9
  2. Neu HC "A review and summary of the pharmacokinetics of cefoperazone: a new, extended-spectrum B-lactam antibiotic." Ther Drug Monit 3 (1981): 121-8
  3. Cochet B, Belaieff J, Allaz AF, et al. "Serum levels and urinary excretion of cefoperazone in patients with hepatic insufficiency." Infection 9 (1981): s37-9
  4. Bolton WK, Scheld WM, Spyker DA, Sande MA "Pharmacokinetics of cefoperazone in normal volunteers and subjects with renal insufficiency." Antimicrob Agents Chemother 19 (1981): 821-5
  5. Boscia JA, Korzeniowski OM, Snepar R, et al. "Cefoperazone pharmacokinetics in normal subjects and patients with cirrhosis." Antimicrob Agents Chemother 23 (1983): 385-9
  6. Greenfield RA, Gerber AU, Craig WA "Pharmacokinetics of cefoperazone in patients with normal and impaired hepataic and renal function." Rev Infect Dis 5 (1983): s127-36
  7. Saudek F, Moravek J, Modr Z "Cefoperazone pharmacokinetics in patients with liver cirrhosis: a predictive value of the ujoviridin test." Int J Clin Pharmacol Ther Toxicol 27 (1989): 82-7
  8. "Product Information. Cefobid (cefoperazone)." Roerig Division (2002):

  Show all 9 sourcesShow fewer sources

  9. Muder RR, Agarwala S, Mirani A, Gayowski T, Venkataramanan R "Pharmacokinetics of cefoperazone and sulbactam in liver transplant patients." J Clin Pharmacol 42 (2002): 644-50

• Liver Diseases

  Moderate

  Cases of hepatitis have been reported with the use of certain cephalosporins. Transient rise in AST, ALT, and alkaline phosphatase levels have also been observed. Caution and monitoring is recommended when these agents are prescribed to patients with hepatic disorders.

  20 sources

  1. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn
  2. "Product Information. Ceclor (cefaclor)." Lilly, Eli and Company (2002):
  3. "Product Information. Duricef (cefadroxil)." Bristol-Myers Squibb (2002):
  4. "Product Information. Ancef (cefazolin)." SmithKline Beecham (2002):
  5. "Product Information. Kefzol (cefazolin)." Lilly, Eli and Company (2002):
  6. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc (2002):
  7. "Product Information. Claforan (cefotaxime)." Hoechst Marion Roussel (2002):
  8. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals (2002):

  Show all 20 sourcesShow fewer sources

  9. "Product Information. Mefoxin (cefoxitin)." Merck & Co., Inc (2002):
  10. "Product Information. Cefzil (cefprozil)." Bristol-Myers Squibb (2002):
  11. "Product Information. Fortaz (ceftazidime)." Glaxo Wellcome (2002):
  12. "Product Information. Cefizox (ceftizoxime)." Fujisawa (2002):
  13. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome (2002):
  14. "Product Information. Zinacef (cefuroxime)." Glaxo Wellcome (2002):
  15. "Product Information. Keflex (cephalexin)." Dista Products Company (2002):
  16. "Product Information. Cedax (ceftibuten)." Schering-Plough (2001):
  17. "Product Information. Maxipime (cefepime)." Bristol-Myers Squibb (2001):
  18. "Product Information. Omnicef (cefdinir)." Parke-Davis (2001):
  19. "Product Information. Ceclor CD (cefaclor)." Dura Pharmaceuticals (2001):
  20. "Product Information. Spectracef (cefditoren)." TAP Pharmaceuticals Inc (2001):