The manufacturer of Zosyn states Lactated Ringer's Solution is compatible only with reformulated Zosyn containing EDTA and is compatible with co-administration via a Y-site. Trissel's IV compatibility database notes the older formulation without the added components (most generic products) is incompatible with Lactated Ringer's. Thus, the newer formulation is the only form of the drug mixed with this diluent. A study that tested the physical compatibility of Lactated Ringer's found compatib...
Wyeth, the manufacturer of Zosyn, states Lactated Ringer's Solution is compatible only with reformulated Zosyn containing EDTA and is compatible with co-administration via a Y-site. Many generic formulations (e.g., Apotex) do not contain EDTA. [1, 2]
Trissel's IV compatibility database notes the older formulation without the added components (most generic products) is incompatible with Lactated Ringer's. Ensure that the newer formulation is the only form of the drug mixed with Lactated Ringer's. [3]
A 2019 study that tested the physical compatibility of Lactated Ringer's with 94 medications found incompatibilities with ciprofloxacin, cyclosporine, diazepam, ketamine, lorazepam, nitroglycerin, phenytoin, and propofol after 4 hours at room temperature. This study surprisingly found compatibility with ceftriaxone, amphotericin B, and piperacillin-tazobactam, which all previously were thought to be incompatible with LR (See Tables 1 and 2). [4] The study utilized a formulation of...
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A search of the published medical literature revealed
2 studies investigating the researchable question:
Can piperacillin and tazobactam (Zosyn) be infused with Lactated Ringers?
Level of evidence
B - One high-quality study or multiple studies with limitations
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[1] ZOSYN IN GALAXY CONTAINERS (tazobactam sodium and piperacillin sodium injection, solution). Prescribing information. Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.; 2023.
[2] PIPERACILLIN AND TAZOBACTAM injection, powder, for solution. Prescribing information. Apotex Corp.; 2024.
[3] Zosyn in LR Trissel's IV Compatibility [Database] Lexicomp. Available from: https://online.lexi.com/lco/action/ivcompatibility/trissels. Accessed May 14, 2024.
[4] Vallée M, Barthélémy I, Friciu M, et al. Compatibility of Lactated Ringer's Injection With 94 Selected Intravenous Drugs During Si...