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The frequency of anaphylactoid reactions including flushing, histamine like response, hypotension, wheezing, dyspnea, urticaria, and pruritus may increase with the concomitant administration of anesthetic agents, it can be minimized by the administration of the drug as a 60-minute infusion prior to anesthetic induction.
Concurrent and/or sequential systemic or topical use of other potentially neurotoxic and/or nephrotoxic drugs, such as amphotericin B, aminoglycosides, bacitracin, polymyxin B, colistin, viomycin, or platinum antitumor drugs (cisplatin, nedaplatin, etc) may increase adverse reactions, so it should be administered with caution.
Change of international normalized ratio (INR) in patients taking anticoagulant with antibiotics including the drug concomitantly increased anticoagulant activity has been reported. Infectious disease (accompanied with inflammatory process) and age and general condition of patients are risk factors. Although interaction of the drug with warfarin has not been established through clinical trials, INR monitoring should be performed and if necessary, the dosage of oral anticoagulant should be properly adjusted. Some kinds of antibiotics, especially fluoroquinolones, macrolides, cyclins, cotrimoxazole and some cephalosporins showed severe cases.
