Tazpen Special Precautions

Bleeding manifestations have occurred in some patients receiving piperacillin. These reactions have sometimes been associated with abnormalities of coagulation tests such as clotting time, platelet aggregation and prothrombin time and are more likely to occur in patients with renal failure. If bleeding manifestations occur, the antibiotic should be discontinued and appropriate therapy instituted.
The possibility of the emergence of resistant organisms that might cause superinfections should be kept in mind, particularly during prolonged treatment. If this occurs, appropriate measures should be taken.
As with other penicillins, patients may experience neuromuscular excitability or convulsions if higher than recommended doses are given intravenously (particularly in the presence of renal failure).
Leucopenia and neutropenia may occur, especially during prolonged therapy. Therefore, periodic assessment of haematopoietic function should be performed.
For patients with renal impairment and/or hepatic insufficiency, measurement of serum levels of piperacillin is advisable to provide guidance for adjusting dosage.
The theoretical sodium content of each 4.5 g vial of TAZPEN is 216 mg sodium (9.39 mmol), which may increase a patient's overall sodium intake. This should be considered when treating patients requiring restricted salt intake. Periodical electrolyte determinations should be made in patients with low potassium reserves and the possibility of hypokalaemia should be kept in mind with patients who have potentially low potassium reserves and who are receiving cytotoxic therapy or diuretics.
Periodical assessment of organ system functions including renal, hepatic and haematopoietic during prolonged therapy is advisable.