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The reconstituted solution of piperacillin/tazobactam containing EDTA may be further diluted to the desired volume (e.g., 50 mL to 150 mL) with one of the compatible solvents for intravenous use listed as follows: 0.9% Sodium chloride for injection, Sterile water for injection‡, Dextrose 5%, Dextran 6% in saline, Lactated Ringer's Injection, Hartmann's solution, Ringer's acetate, Ringer's acetate/malate.
‡ Maximum recommended volume of sterile water for injection per dose is 50 mL.
Whenever piperacillin/tazobactam is used concurrently with another antibiotic (e.g., aminoglycosides), the drugs must be administered separately. The mixing of piperacillin/tazobactam with an aminoglycoside in vitro can result in substantial inactivation of the aminoglycoside.
The mixing of β-lactam antibiotics with aminoglycosides in vitro can result in substantial inactivation of the aminoglycoside. However, amikacin and gentamicin were determined to be compatible with piperacillin/tazobactam in vitro in certain diluents at specific concentrations (see Dosage & Administration).
Piperacillin/tazobactam should not be mixed with other drugs in a syringe or infusion bottle since compatibility has not been established.
Because of chemical instability, piperacillin/tazobactam should not be used with solutions containing only sodium bicarbonate.
Piperacillin/tazobactam should not be added to blood products or albumin hydrolysates.
Special precautions for disposal and other handling: Directions for Reconstitution and Dilution for Use: Intravenous use only: Reconstitute each vial with the volume of solvent shown in the table as follows, using one of the compatible solvents for reconstitution. Swirl until dissolved.
When swirled constantly, reconstitution generally occurs within 5 to 10 minutes. (See Table 10).
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