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No pharmacodynamic interaction studies have been performed with Numeta.
Numeta must not be administered simultaneously with blood through the same infusion tubing because of the risk of pseudoagglutination.
Olive and soybean oil have a natural content of vitamin K1 that may counteract the anticoagulant activity of coumarin (or coumarin derivatives including warfarin).
Due to the potassium content of Numeta special care should be taken in patients simultaneously treated with potassium sparing diuretics (e.g., amiloride, spironolactone, triamterene) or with ACE inhibitors, angiotensin II receptor antagonists, or the immunosuppressants tacrolimus and cyclosporine in view of the risk of hyperkalemia.
The lipids contained in this emulsion may interfere with the results of certain laboratory tests (for example, bilirubin, lactate dehydrogenase, oxygen saturation, blood hemoglobin) if the blood sample is taken before the lipids are eliminated. Lipids are generally eliminated after a period of 5 to 6 hours when no additional lipids are administered.
Please also refer to Incompatibilities under Cautions for Usage.
Numeta G13%E: As for other calcium-containing infusion solutions concomitant treatment with ceftriaxone and Numeta G13%E is contraindicated in preterm newborn infants (see Contraindications, Precautions and Incompatibilities under Cautions for Usage).
Numeta G16%E: As for other calcium-containing infusion solutions concomitant treatment with ceftriaxone and Numeta G16%E is contraindicated in term newborn infants (≤28 days of age), even if separate infusion lines are used (risk of fatal ceftriaxone-calcium salt precipitation in the neonate's bloodstream).
Numeta G16%E and Numeta G19%E: In patients of any age (including adults), ceftriaxone must not be mixed or administered simultaneously with any intravenous calcium-containing solutions, including Numeta, even via different infusion lines or at different infusion sites because of the risk of precipitation of ceftriaxone-calcium salt (see Precautions).
However, in patients older than 28 days of age ceftriaxone and calcium-containing solutions may be administered sequentially one after another if infusion lines at different sites are used or if the infusion lines are replaced or thoroughly flushed between infusions with physiological salt-solution to avoid precipitation.
