Tazocin

Tazocin belongs to a large group of drugs with antimicrobial and antiparasitic properties. In this group a subgroup of antibiotics is distinguished, among which there is also Tazocin.

Among the antibiotics is a group of beta-lactam antibiotics, in which a subgroup of penicillins is located. The drug Tazocin belongs to this penicillin subgroup.

Indications Tazocin

Indications for use of the drug Tazocin for patients of the adult age group and children of twelve years are as follows:

1. The drug is indicated for use in the presence of infections with a medium and severe character of leakage, which are caused by microorganisms that have a sensitivity to the active substances of the drug.

These infections include:

• infectious diseases of a bacterial nature that affect the upper and lower respiratory tract; of pneumonia, it is possible to use the drug only for moderate-level diseases that did not cause pepicillin-resistant beta-lactamase-suppressing strains of Haemophilus influenzae, and also have a sensitivity to piperacillin microorganisms that form beta-lactamase related to enzymes that destroy penicillin and its derivatives;
• infectious diseases of organs that are located in the abdominal cavity; to them manifestations of a complicated appendicitis - an inflammatory process in the blind process of the small intestine, peritonitis - an inflammatory process in the peritoneum;
• infectious diseases of the skin, relating also to soft tissues, uncomplicated and complicated; to similar problems include displays of a cellulitis - fibrous inflammatory process of a hypodermic fat; various abscesses (abscesses); symptoms of infected trophic ulcers (which, for example, suffer patients who have a history of diabetic angiopathy - damage to the walls of blood vessels due to increased levels of sugar in the blood);
• infectious diseases of organs located in the small pelvis; these include infectious diseases of the urinary system with a complicated or uncomplicated character; diseases of the gynecological nature - which also include manifestations of endometritis and adnexitis that appear in the postpartum period;
• bacterial infectious diseases that occur in patients with symptoms of neutropenia (a decrease in the number of neutrophils in the blood serum) - are used in a joint application with aminoglycosides;
• bacterial septicemia - certain forms of the disease, which is characterized by the infection of human blood with the help of bacteria;
• infectious lesions of the bone system affecting the bones and joints of the patient;
• various diseases caused by mixed microorganisms of aerobic and anaerobic origin;
• therapy of conditions with a heavy nature of the course of the infectious-inflammatory nature, the causative agent of which has not yet been identified.

2. For patients from the age of two to twelve years, the drug Tazocin is changed as follows:

• with intra -obdominal infections (diseases of infectious nature caused by microorganisms living in the gastrointestinal tract and penetrating into other cavities of the peritoneum);
• in infectious diseases that occur in conjunction with neutropenia (combinatorial use of the medication Tazocine and aminoglycosides is recommended).

[1], [2], [3]

Release form

For the medicament Tazocin the following form of release is typical:

The drug belongs to the group of solid dosage forms - it is produced in the form of powder lyophilized or a mass of porous consistency, with which the solution for infusions is prepared. The color of the powder varies from almost white to pure white.

The active substances of the medicine are:

• piperacillin sodium - 2084.9 milligrams (in the amount of piperacillin monohydrate two thousand milligrams);
• tazobactam sodium - 268.3 million (in the amount of tazobactam two hundred and fifty milligrams).

The auxiliary components include:

• sodium citrate dihydrate - 110.22 milligrams (in the amount of citric acid - seventy-two milligrams);
• disodium edetate dihydrate - half milligram.

One bottle of medicament Tazocin includes active substances:

• four grams of piperacillin and half a gram of tazobactam;
• or piperacillin sodium - 4169.9 mgg and tazobactam sodium - 536.6 mg;
• or when recalculating piperacillin monohydrate - four thousand milligrams and on tazobactam - five hundred milligrams.

One bottle of Tazocin medication includes excipients:

• sodium citrate dihydrate - 220.43 milligrams or when recalculating for citric acid - one hundred and forty-four milligrams;
• disodium edetate dihydrate - one milligram.

It is possible to produce vials of Tazocin medication, in which the active substances contain:

• piperacillin - two grams;
• tazobactam - two hundred and fifty milligrams.

Accordingly, the number of auxiliary components when packaged into these bottles is reduced by half, compared with the above packing.

Medication Tazocin is available for the number of active substances - two grams of piperacillin and two hundred and fifty milligrams of tazobactam:

• in bottles made of colorless glass (type I). The capacity of each bottle corresponds to thirty milliliters. The vials are sealed with a stopper made of butyl rubber material. From above the stopper is rolled up with the help of an aluminum cap, in which there is a gray plastic tear-off cap. The surface of the cap can be smooth or contain an engraved inscription "Wyeth".
• in a cardboard box containing twelve bottles, where a cardboard separator is installed between two rows of bottles.
• In addition, the package contains instructions for the use of the drug.

Medication Tazocin is available for the amount of active substances - four grams of piperacillin and five hundred milligrams of tazobactam:

• in bottles made of colorless glass (type I). The capacity of each bottle corresponds to seventy milliliters. The vials are sealed with a stopper made of butyl rubber material of gray color. From above the stopper is rolled up with the help of an aluminum cap, in which there is a violet plastic tear-off cap. The surface of the cap can be smooth or contain an engraved inscription "Wyeth".
• in a cardboard box containing twelve bottles, where a cardboard separator is installed between two rows of bottles.
• In addition, the package contains instructions for the use of the drug.

[4], [5], [6], [7], [8]

Pharmacodynamics

Pharmacodynamics of the drug Tazocin is as follows:

One of the active components of the drug, piperacillin monohydrate, is a semisynthetic bactericidal antibiotic with a wide spectrum of action. This substance is active against many gram-positive and gram-negative aerobic and anaerobic microorganisms.

The properties of piperacillin include the ability to inhibit the synthesis of membranes of cell walls of microorganisms.

Tazobactam is a sulfonic derivative of trialomethylpenicillanic acid. The properties of tazobactam include the possibility of potent inhibition of numerous beta-lactamases (which include varieties of plasmid and chromosomal beta-lactamases). These beta-lactamases in many cases stimulate the resistance of the microorganism to preparations of the pericillin group and cephalosporin group (which include the third generation cephalosporins). Tazobactam, as a component of the drug Tazocin allows you to strengthen the antimicrobial action of the drug and promotes the expansion of the spectrum of action of piperacillin. This is due to the inclusion of tazobactam in many microorganisms that produce beta-lactamases, which in the usual cases are resistant to the action of piperacillin and other beta-lactam antibiotics.

Summarizing the properties of Tazocin, it can be said that this combinatorial medicine has characteristics of an antibiotic with a broad spectrum of action and a drug that promotes the inhibition of beta-lactamases.

The drug Tazocin is active against gram-negative bacteria, which develop only in the presence of oxygen. These include beta-lactamase-producing and non-beta-lactamase-producing strains of microorganisms. These include the E. Coli, the genus Citrobacterium (including Citrobacter freundii, Citrobacter diversus), the genus Klebsiella (including the Klebsiella Oxytoca, Klebsiella pneumonia), the genus Enterobacteria (including enterobacter cloacae, Enterobacter aerogenes), Proteus vulgaris, Proteus mirabilis, Providencia rettgery, Providencia stuartii , Plesiomonas shigelloides, Morganella morganii, Serratia spp. (including Serratia marcescens, Serratia liquifaciens), Salmonella, Shigella, Pseudomonas aeruginosa and other pseudomonas (including pseudomonad cepacia and pseudomonad fluorescens), Xanthamonas maltophilia, gonococcus, meningococcus, Moraxella spp. (including Branhamella catarrhalis), Acinetobacter spp., Haemophilus parainfluenzae, Pasteurella multocida, Yersinia, Campylobacter, Gardnerella vaginal.

Also in vitro, there was an increase in the effectiveness of the combined use of piperacillin and tazobactam together with aminoglycosides with respect to multiresistant Pseudomonas aeruginosa.

Medication Tazocin is active against gram-positive bacteria (a microorganism that can exist in the absence of oxygen) that produce or do not produce beta-lactamase. These include strains of the following microorganisms: streptococci (including pneumococci, streptococci pyrrolidonylpeptidase - streptococcus group A, Streptococcus bovis - streptococcus group D, streptococcus agalactia - streptococcus group B, Sfreptococcus viridance - green streptococcus, streptococcus group C and group G); enterococci (including fecal enterococcus, Enterococcus faechtm); Staphylococci - Staphylococcus aureus, which shows sensitivity to methylcillin, saprophytic staphylococcus, epidermal staphylococcus (coagulase-negative forms); coryneform bacteria, listeria, Nocardia spp.

Medication Tazocin is active against anaerobic bacteria that produce and do not produce beta-lactamase. These include bacteroides (bacteroids of the species bivius, bacteroids of the species bivius, bacteroids of the species of disuens, bacteroids of the species of capillosus, bacteroids of the species melaninogenicus, bacteroides of the oralis species, bacteroids of the species of the fragilis, bacteroids of the species vulgatus, the bacteroids of the species distasonis, the bacteroids of the ovatus species, the bacteriides of the species of theaiotaomicron, species of asaccharolyticus), bacteria of the species Peptosfreptococcus, bacteria of the species Fusobacterium, bacteria of the genus Clostridium (including Clostridium difficile, Clostridium parfringens), bacteria of the species Veilonella spp., bacteria of the species Actynomyces spp.

[9], [10], [11], [12], [13],

Pharmacokinetics

The pharmacokinetics of the drug Tazocin is as follows:

The mechanism of distribution of the drug.

• the maximum amount of the drug in the blood serum is reached immediately after the end of intravenous administration.
• piperacillin, introduced together with tazobactam, is similar in blood concentration to that in the blood of piperacilin, administered as monotherapy.
• Piperacilin and tazobactam are bound by proteins in about thirty percent; while the active substances do not interact with protein binding.
• active components - piperacillin and tazobactam - are susceptible to a wide distribution in tissues and body fluids, including the intestinal epithelium, the epithelium of the gallbladder (and bile), the lung epithelium, in the female genitalia (including the uterus, ovaries, fallopian tubes), and the bone system.
• the average level of active substances in various tissues - from fifty to one hundred percent of the content of the drug in the blood serum.
• There is no information on the possibility of penetration of active components through the blood-brain barrier.

The mechanism of biotransformation of the active substances of the preparation is as follows:

• in the course of metabolism, piperacillin is transformed into a substance that has a lower level of activity, namely, a desethyl derivative;
• in the course of metabolism tazobactam is transformed into a substance of an inactive metabolite.

The mechanism of excretion of the drug Tazocin from the body is as follows:

• active substances - piperacillin and tazobactam - can be excreted by the kidneys; in this process, glomerular filtration and tubular secretion are involved.
• piperacillin can be excreted at a rapid pace in the same form as was injected into the body; Sixty-eight percent of the amount consumed is in the urine and is excreted with it.
• tazobactam and derivatives of its metabolism can be quickly excreted by renal function; eighty percent of the amount consumed is in the same form in the body in the urine, and the rest of the tazobactam is in the metabolic form.
• excretion from the body of piperacillin, tazobactam and desethylpiperacillin is also possible with the help of bile.
• if a single and repeated administration of a medicament is prescribed in healthy patients, the half-life of active substances from blood serum ranged from 0.7 to 1.2 hours; This process did not depend on the amount of medication and the time of its introduction into the body.
• if the clearance of creatinine T1 / 2 is reduced, then the amount of time for half-elimination of the drug from the body increases.

If there is a violation of renal function, the pharmacokinetics of the drug Tazocin is manifested as follows:

• as mentioned above, with a decrease in creatine clearance, the half-life of active substances is elongated.
• if the creatine clearance drops less than twenty milliliters per minute, then the half-life of the active substances increases - piperacillin twice, and tazobactam - four times - in comparison with patients with normal renal function.
• in the process of hemodialysis, thirty to fifty percent of piperacillin can be removed, as well as five percent of the tazobactam in a metabolic form.

If peritoneal dialysis is performed, six percent of piperacillin and twenty-one percent of tazobactam can be withdrawn; Eighteen percent of tazobactam is excreted from the body in a metabolic form.

When the hepatic functioning is disturbed, the pharmacokinetic characteristics of the medicament are manifested in the following:

• the time intervals of the half-life of the active substances are increased.
• and there is no need to adjust the applied amounts of the medicament.

[14], [15], [16], [17], [18]

Dosing and administration

There is a recommendation that concerns a preliminary study of the patient's microflora: before using this medication, it is necessary to determine the presence or absence of sensitivity of microorganisms that provoked the disease to the active components of the drug.

The method of administration and dose of Tazocin is as follows:

The drug Tazocin is intended for intravenous administration at a slow pace in a jet for a period of at least three to five minutes. Alternatively, the drug may be administered by a drop route in a time interval of twenty to thirty minutes.

The dosage of the use of Tazocine and the duration of the course of therapy depend on the severity of the infectious disease, the location of the infectious focus, and on the dynamic characteristics of the process of changing the clinical and bacteriological pattern of the disease. The determination of the dosage of the drug is also influenced by the degree of sensitivity of the microorganisms to the active substances of the medicament.

The use of the drug for adults and children aged from twelve years with normal functioning of the kidneys is as follows:

• the amount of the drug per day is a dose of twelve grams of piperacillin and one and a half grams of tazobactan;
• the above-mentioned daily dose of active substances should be divided into several administration steps every six to eight hours;
• The daily amount of active components of the drug is determined based on the severity of the disease; Also, the localization of infection in the patient's body is also important;
• the maximum daily amount of the drug is eighteen grams of piperacillin and 2.25 grams of tazobactan; while the daily dose of active substances should be divided into several methods for administration.

The method of application of the drug Tazocin for children from two to twelve years is as follows:

• with the presence of neutropenia in patients with pediatric patients with normal kidney function and body weight of not less than fifty kilograms - a single dose of Tazocin is ninety milligrams (eighty milligrams of piperacillin and ten milligrams of tazobactam) per kilogram of the child's body weight;
• the above dose of the drug is administered every six hours along with the required amount of aminoglycosides;
• for patients of child age with a body weight of fifty kilograms, the amount of the drug is equal to the dose of the drug for an adult organism, which is administered to a sick child together with aminoglycosides;
• in the presence of intra-abdominal infections in patients of child age with a body weight of up to forty kilograms and normal renal function, the corresponding amount of the drug is one hundred milligrams of piperacillin and twelve and a half milligrams of tazobactam per kilogram;
• the above amount of the drug is administered to the patient every eight hours;
• Children of child age, having a body weight of forty kilograms and normal renal function, take the same amount of the drug as adult patients.

The drug is administered for a period of five to fourteen days. It must be taken into account that the use of the medication should continue for at least forty-eight hours after the symptoms of the disease cease to exist.

In case of impaired renal function, Tazocine is used as follows:

• patients with renal insufficiency or patients on hemodialysis should receive an adjusted amount of the drug; this adjustment applies to the frequency of administration of the drug;

The recommended amount of medication for adult and pediatric patients with a body weight of more than fifty kilograms, with renal insufficiency as follows:

• with a creatinine clearance above 40 ml per minute - the dose of the drug in the adjustment is not affected;
• with the clearance of creatine from twenty to forty ml per minute - the amount of piperacillin is twelve grams, and the amount of tazobactam is one and a half grams per day; the drug is administered every eight hours in the amount of four grams of piperacillin and five hundred milligrams of tazobactam;
• when the creatinine clearance is less than twenty ml per minute, the amount of piperacillin per day is eight grams with the amount of tazobactam per gram; More active substances are injected every twelve hours in the amount of four grams of piperacillin and five hundred milligrams of tazobactam.

Patients who are on hemodialysis should receive the maximum daily dose of the drug in eight grams of piperazillin and one gram of tazobactam. At the same time, it must be taken into account that hemodialysis is capable of removing from thirty to fifty percent of piperacillin within four hours. In this case, it is necessary to assign one additional dose in the amount of two grams of piperacillin and two hundred fifty grams of tazobactam after each hemodialysis session.

Patients aged 2 to 12 years with renal insufficiency, the drug is administered with caution, since the pharmacokinetic characteristics of piperacillin and tazobactam in children with impaired renal function have not been studied. There is no data on the quantities of the drug with simultaneous presence of renal dysfunction and neutropenia.

Patients aged 2 to 12 years with renal dysfunction are recommended to adjust the amount of the drug. It should be understood that the dose of Tazocin indicated for use is only a guideline for the necessary administration. Any patient of this group of patients should be constantly observed by the treating staff in order to identify the symptoms of drug overdose in time and take appropriate measures. Attention should be paid not only to the amount of medication for administration, but also to the interval between its use. The recommended doses of the drug and the time intervals between injections for children of a child with a body weight of less than fifty kilograms are as follows:

• with the clearance of creatine more than fifty ml per minute - the corresponding amount of Tazocin is one hundred and twelve and a half milligrams per kilogram of the child's body weight (meaning one hundred milligrams of piperacillin and twelve and a half milligrams of tazobactam); the drug is to be administered every eight hours;
• when the clearance is less than 50 ml per minute - the appropriate amount of Tazocine is the amount of the drug at seventy-eight and three-quarters of milligrams per kilogram of body weight (meaning seventy milligrams of piperacillin and eight and three-quarters of milligrams of tazobactam); the drug is to be administered every eight hours.

Do not need to adjust the amount of administration of the drug in case of abnormal liver function.

Older patients need to adjust the amount of the drug only in the case of impaired renal function.

There are the following recommended procedures that must be used to prepare a drug solution:

• It should be recalled that Tazocine is used only for intravenous administration;
• the drug must be dissolved in one of the solvents listed below;
• it is necessary to pay attention to the volumes of active components of the preparation and the solvent;
• the vial is rotated by circular movements until the contents of the vial dissolve - it is necessary to constantly turn the vial for five to ten minutes;
• The prepared solution is a liquid without color or with a light yellow color.

The dosage of the active ingredients in the preparation of the solution is as follows:

• two grams of piperacillin and two hundred and fifty grams of tazobactam per ten milliliters of solvent;
• four grams of piperacillin and five hundred milligrams of tazobactan per twenty grams of solvent.

Among the solvents that are compatible with Tazocin, the use of:

• 0.9% solution of sodium chloride,
• sterile water for injection,
• 5% dextrose solution,
• Ringer's lactate solution.

After preparation, the solution can be diluted to the desired volume to introduce the drug intravenously. For example, a dilution from fifty milliliters to one hundred and fifty milliliters is possible with one of the following solvents. Recommended use:

• 0.9% solution of sodium chloride,
• sterile water for injection (with a maximum amount of fifty milliliters),
• 5% dextrose solution,
• Ringer's lactate solution.

Use of the prepared solution should be for twenty four hours, if the solution is kept at a temperature not exceeding twenty-five degrees Celsius. The solution must be used for forty-eight hours if stored at a temperature of two to eight degrees Celsius.

[24], [25], [26]

Use Tazocin during pregnancy

Use of the drug Tazocine during pregnancy is as follows:

There is insufficient information on the combined use of piperacillin and tazobactam in Tazocine in women during pregnancy. This also applies to the separate use of these substances in this period.

Substances piperacillin and tazobactam are able to penetrate the placental barrier.

The drug can be administered to female patients during pregnancy only following strict indications and with a vital need.

The drug Tazocin is administered during pregnancy only if the expected benefit to the mother appears, which is much more significant than the risk of life threatening and fetal development.

The substance piperatsillin is able to enter into breast milk in small concentrations. Data on the ingestion of tazobactam in breast milk is not available due to the lack of knowledge of this problem.

Nursing women can use Tazobactam only if the effectiveness of the drug will significantly exceed the possible risk levels for the baby.

It is recommended to stop the process of breastfeeding for the period of use of the drug Tazobaktam.

Contraindications

Contraindications to the use of the drug Tazocin are as follows:

The presence of hypersensitivity to the active substances of the drug, including other penicillins, cephalosporins and carbopenemam. The patient's history (history of the disease) should contain data on the presence of allergic manifestations in response to the use of penicillins, cejalosporins and carbopenems.

In the presence of any allergic reactions not only to drugs of the penicillin group, the drug Tazocin should be administered with caution.

There is no information on the safe use of the drug for patients in the age group of up to two years. Therefore, the drug Tazocin is not assigned to patients younger than this age.

[19]

Side effects Tazocin

The following side effects of the drug have been identified with the use of Tazocine:

Manifestations of disorders of the gastrointestinal tract - symptoms of nausea, vomiting, diarrhea or constipation, stomatitis. There are symptoms of dyspepsia - difficulty or painful digestion with the presence of pain in the base of the stomach. Some patients experience the appearance of pseudomembranous colitis - intestinal colic, which are characterized by paroxysmal pains in the abdomen and separation of mucus from feces in large quantities.

There is a manifestation of jaundice. In some cases, the increased activity of "liver" transaminases (AST and ALT), as a temporary (transient) phenomenon. Perhaps the emergence of symptoms of hyperbilirubinemia, increased activity of alkaline phosphatase, increased activity of gamma-glutamyltransferase, signs of hepatitis.

The occurrence of allergic reactions - skin rash, skin itching, hives, erythema (redness of the skin in a limited area). Sometimes there are signs of bullous dermatitis and erythema multiforme (including signs of Stephen-Johnson syndrome). In rare cases, there are manifestations of toxic epidermal necrolysis. There may be anaphylactic (or anaphylactoid) reactions, up to anaphylactic shock.

There may be fungal superinfections.

Perhaps the appearance of disorders of the nervous system, which are manifested in the occurrence of headaches, insomnia, seizures.

In rare cases, there is a manifestation of symptoms of a hemopoiesis disorder - anemia may appear (hemoglobin in the blood), leukopenia (decrease in the number of leukocytes in the blood serum), the appearance of neutropenia (a decrease in the number of neutrophils in the blood), the occurrence of thrombocytopenia (a decrease in the number of platelets in the blood ), the appearance of eosinophilia (an increase in the number of eosinophils in the blood).

Perhaps the appearance of agranulocytosis - a decrease in blood neutrophils and leukocytes, which provokes an increase in the susceptibility of the patient's body to diseases of a fungal and bacterial nature. In some cases, there are symptoms of pancytopenia - a reduction in the number of all blood cells - red blood cells, platelets, white blood cells.

Sometimes there are symptoms of hypoalbuminemia - a decrease in the amount of albumin in the blood plasma. Perhaps the presence of symptoms of hypoglycemia - reducing the amount of glucose in the blood serum. There are signs of hypoproteinemia, characterized by a low content of protein components in the blood plasma. Perhaps the presence of symptoms of hypokalemia - a decrease in the concentration of potassium ions in the serum.

In some patients, there are signs of hypotension - low blood pressure. Perhaps the emergence of phlebitis - inflammatory processes of the walls of blood vessels (veins). There are also the appearance of thrombophlebitis - inflammatory processes in the walls of blood vessels (veins) in combination with thrombosis - the appearance of a thrombus that clogs the lumen of the vein. There may be sensations of "tides" of blood to the skin of the face.

Sometimes there are bleeding, including purpura, nosebleeds. The duration of bleeding may increase as compared to the period before the medication is applied (that is, the time for thromboplastin processes increases and the time of prothrombin processes increases).

Some patients may develop thrombocytosis - an increase in the number of platelets in the blood, which triggers thrombosis.

In patients who are prescribed Tazocin, there may be a false positive Coombs test (diagnostic examination of autoimmune blood diseases).

There are symptoms of arthralgia - pain in the joints, which are volatile.

It is possible to increase the amount of creatinine in the blood plasma. There are symptoms of interstitial nephritis and renal failure.

There may be an increased amount of urea in the blood plasma.

In some cases, there is an increase in body temperature, as well as the presence of local reactions - redness of the skin, tightening of the skin and soft tissues in the area of medication.

[20], [21], [22], [23]

Overdose

Drug overdose Tazocin is manifested in the following symptoms:

• From the gastrointestinal tract there are signs of nausea, vomiting, diarrhea.
• From the side of the nervous system there are signs of neuromuscular excitability and convulsions.

Treatment of drug overdose depends on clinical manifestations. The patient is given symptomatic therapy to remove the consequences of improper intake of medication.

To reduce the high level of piperacillin or tazobactam in the blood, it is possible to prescribe hemodialysis (a method of extrarenal blood purification).

[27], [28]

Interactions with other drugs

The following signs of interaction of the drug Tazocin with other drugs are revealed:

If Tazocin is prescribed for use in combination with probenecid, then T1 / 2 increases and there is a decrease in renal clearance and piperacillin and tazobactam. However, the maximum level of concentration of these substances in serum does not change.

During the studies, no data were obtained on the interaction of Tazocin and Vancomycin, since pharmacokinetic interaction between these drugs was not detected.

Piperazillin both in use alone and in conjunction with tazobactam, does not have a big impact on the pharmacokinetic processes of Tobramycin. This applies to patients who have a safe functioning of the kidneys, as well as patients with some mild and moderate renal dysfunction. With the use of Teoracimin, the pharmacokinetic processes associated with piperacillin, tazobactamomi with their metabolites did not have significant changes.

With the parallel use of Tazocine and Vercuronium bromide, neuromuscular blockade may occur for a long time period. This effect is observed with combinatorial administration of piperacillin and other non-depolarizing muscle relaxants.

Combinatorial use of Tazocin and Heparin, preparations with indirect anticoagulant action and other medications that affect the possibility of blood clotting (on the blood coagulation system, which includes the functioning of platelets) should be carefully. During the entire period of simultaneous treatment with these drugs, the level of blood clotting and the state of the body system responsible for this function should be constantly monitored.

Piperacillin has the property of delaying the excretion of methotrexate from the body. As a result, when combinatorial treatment with these substances, one must constantly monitor the level of methotrexate concentration in the blood plasma.

With the use of Tazocin, a false positive test result can be observed for glucose in the urine. For such a test, a method is used that allows the recovery of copper ions. In view of this fact, there are recommendations for conducting glucose tests using enzymatic glucose oxidation.

If mixing of solutions of Tazocine and aminoglycosides occurred, then their inactivation may occur. As a result, these drugs should be administered in a separate way. In cases where joint use is justified, solutions of Tazocine and aminoglycosides must be prepared separately. When introducing solutions of these drugs, only a V-shaped catheter is used. If all of the above conditions are met, Tazocine is allowed to be administered to the patient via a V-shaped catheter only with the following aminoglycosides - amikacin and gentamicin. The dose of aminoglycosides is determined based on the body weight of the patient, and the nature of the infection (serious or life threatening) and the functioning of the kidneys (the creatinine clearance rate) also has significance.

To use the drug Tazocin, you can not use a syringe or a dropper, in which there were other medicines. The exceptions are Gentamicin, Amikacin and the solvents mentioned in the previous paragraphs. This precaution is explained by the fact that there is no evidence of compatibility between Tazocine and other medications.

If it is necessary to use the drug Tazocin simultaneously with other drugs of the antibiotic group, these medications are administered to the patient in a strictly separate way.

The drug Tazocin has the property of chemical instability, as a result of which this drug is not used simultaneously with solutions that have sodium bicarbonate in their composition.

The drug Tazocin is not recommended to be added to blood preparations or hydrolysates of albumin.

[29], [30], [31], [32]

Storage conditions

Tazocin storage conditions are as follows:

The drug is stored at room temperature from fifteen to twenty degrees Celsius.

The drug should be kept in a dry and protected from light place, to which there is no access to direct sunlight.

Tazocine must be carefully hidden from the reach of children.

[33]

Shelf life

The shelf life of the drug Tazocin is thirty-six months from the date of release of the drug.

It is forbidden to use Tazocine for treatment after the expiration date of the preparation indicated on the package.

[34], [35]