Sulperazon Caution For Usage

Special Precautions for Disposal and Other Handling: Reconstitution: (See Table 6).

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Sulbactam/cefoperazone has been shown to be compatible with these diluents: water for injection, 5% dextrose, normal saline, 5% dextrose in 0.225% saline, and 5% dextrose in normal saline. Cefoperazone is compatible at concentrations ranging from 10-250 mg/ml of diluent. Sulbactam is compatible at concentrations ranging from 5-125 mg/ml of diluent.
Lactated Ringer's Solution: Sterile Water for Injection should be used for reconstitution (see Incompatibilities - Lactated Ringer's Solution under Cautions for Usage). A two-step dilution is required using Sterile Water for Injection (shown in table as previously mentioned) further diluted with Lactated Ringer's Solution to a sulbactam concentration of 5 mg/ml (use 2 ml initial dilution in 50 ml or 4 ml initial dilution in 100 ml Lactated Ringer's Solution).
Lidocaine: Sterile Water for Injection should be used for reconstitution (see section 6.2 Incompatibilities - Lidocaine). For a concentration of cefoperazone of 250 mg/ml or larger, a two-step dilution is required using Sterile Water for Injection (shown in table above) further diluted with 2% lidocaine to yield solutions containing up to 125 mg cefoperazone and 125 mg sulbactam per ml in approximately a 0.5% lidocaine HCl solution.
Incompatibilities: Aminoglycosides: Solutions of sulbactam/cefoperazone and aminoglycosides should not be directly mixed, since there is a physical incompatibility between them. If combination therapy with sulbactam/cefoperazone and an aminoglycoside is contemplated (see Combination Therapy under Indications) this can be accomplished by sequential intermittent intravenous infusion provided that separate secondary intravenous tubing is used, and that the primary intravenous tubing is adequately irrigated with an approved diluent between doses. It is also suggested that doses of sulbactam/cefoperazone be administered throughout the day at times as far removed from administration of the aminoglycoside as possible.
Lactated Ringer's Solution: Initial reconstitution with Lactated Ringer's Solution should be avoided since these mixture has been shown to be incompatible. However, a two step dilution process involving initial reconstitution in water for injection will result in a compatible mixture when further diluted with Lactated Ringer's Solution (see Special Precautions for Disposal and Other Handling - Lactated Ringer's Solution under Cautions for Usage).
Lidocaine: Initial reconstitution with 2% lidocaine HCl solution should be avoided since this mixture has been shown to be incompatible. However, a two step dilution process involving initial reconstitution in water for injection will result in a compatible mixture when further diluted with 2% lidocaine HCl solution (see Special Precautions for Disposal and Other Handling - Lidocaine under Cautions for Usage).