For intravenous injection, each vial should be dissolved in 6.7 ml of one of the solvents described above and administered for at least 3 npp steroid minutes.
On the part of the cardiovascular system: blood pressure reduction.
On the part of the gastrointestinal tract: diarrhea, nausea, vomiting, pseudomembranous colitis.
Allergic Reactions: Hypersensitivity, manifested as maculopapular rash, and urticaria and pruritus, Stevens-Johnson syndrome , anaphylactic shock.
From the hematopoietic system: decrease in the number of neutrophils. Long-term treatment may develop reversible neutropenia, a decrease in hemoglobin and hematocrit. There transient eosinophilia, thrombocytopenia, leukopenia, hypoprothrombinemia.
Laboratory tests: transient increase in “liver” transaminases, alkaline phosphatase and bilirubin in the blood serum, hypercreatininemia, hematuria. In some patients during treatment showed a positive Coombs. When using Benedict or Fehling’s solution can be observed false-positive reaction for glucose in urine.
The local reaction observed after intramuscular injection of transient stinging and pain at the injection site. When administered intravenously through a catheter may develop phlebitis at the injection site.
Other: headache, fever, pain during the injection, fever, vasculitis.
Information on acute toxicity of npp steroid cefoperazone sodium and sulbactam sodium in humans is limited. It is necessary to take into account the fact that a high concentration of beta-lactam antibiotics in the cerebrospinal fluid can cause neurological disorders, including seizures. Treatment: symptomatic, dialysis is effective, particularly in patients with impaired renal function.
Interaction with other drugs
Solutions cefoperazone / sulbactam and aminoglycosides should not be directly mixed, given pharmaceutical incompatibility between them. When combination therapy is carried out, the drug is administered by two consecutive infusions using the separate secondary catheters, and catheter primary solution is well washed between doses of drugs. Intervals between administration throughout the day should be as large as possible.
At the use of ethanol during treatment with cefoperazone and for up to 5 days after the administration of development disulfiramopodobnyh effects characterized by “tides”, sweating, headache and tachycardia. In patients who need artificial feeding (orally or parenterally) should avoid the use of solutions containing ethanol.
risk of hypersensitivity reactions, including those leading to npp steroid death, higher in patients with a history of hypersensitivity reactions were observed many allergens. If you have an allergic reaction, you must stop the drug and prescribe appropriate therapy.
In severe anaphylactic reactions must be an urgent injection of adrenalin. Assign oxygen, intravenous steroids and ensure the airway, including intubation.
Changes in dose may be required in cases of severe biliary obstruction, severe liver disease and impaired renal function, combined with any of these conditions.
In patients with impaired liver function and concomitant renal impairment is necessary monitoring of serum concentrations of cefoperazone and correction of the dose if necessary. If the regular monitoring of serum concentrations of cefoperazone in such cases is not carried out, its daily dose should not exceed 2 g npp steroid.