Zosyn Reconstitution in Normal Saline
Yes, Zosyn (piperacillin/tazobactam) can be reconstituted and diluted in normal saline (0.9% sodium chloride injection). This is explicitly approved according to FDA labeling and supported by stability data.
FDA-Approved Reconstitution and Dilution
Normal saline is listed as an approved diluent for both reconstitution and further dilution of piperacillin/tazobactam. 1
Reconstitution Options
- Sodium Chloride Injection (0.9%) is specifically listed as an acceptable diluent for reconstituting conventional vials 1
- Bacteriostatic Sodium Chloride Injection is also approved for reconstitution 1
- Each gram should be reconstituted with at least 5 mL of suitable diluent 1
Intravenous Dilution
- 0.9% Sodium Chloride is explicitly listed as an approved intravenous solution for further dilution 1
- Reconstituted solution may be diluted to the desired volume (e.g., 50 or 100 mL) in normal saline 1
- Normal Saline with KCl 40 mEq is also listed as an acceptable intravenous admixture 1
Stability in Normal Saline
Piperacillin/tazobactam demonstrates excellent stability when reconstituted and diluted in 0.9% sodium chloride. 2
Storage Stability
- 72 hours at 4°C (refrigerated) - all concentrations remain stable 2
- At least 30 hours at 25°C (room temperature) - maintains stability 2
- 24 hours or more at 32°C - remains stable 2
- At least 24 hours at 37°C - stable at body temperature 2
Practical Considerations
- Pharmacy vials should be used immediately after reconstitution 1
- Discard unused portions after 24 hours at room temperature (20-25°C) or 48 hours if refrigerated (2-8°C) 1
- Vials should not be frozen after reconstitution 1
Administration Methods
Multiple administration routes are compatible with normal saline dilution:
Intermittent IV Infusion
- Infuse diluted solution over approximately 30 minutes 1
- During infusion, discontinue the primary intravenous solution 1
IV Bolus
- Reconstituted solution should be injected slowly over 3 to 5 minutes to avoid vein irritation 1
Y-Site Compatibility
- Piperacillin/tazobactam in 0.9% sodium chloride is stable during Y-site administration with various medications 3
- Concentrations of 40 mg/mL piperacillin plus 5 mg/mL tazobactam and 80 mg/mL piperacillin plus 10 mg/mL tazobactam in normal saline were stable for up to 4 hours during simulated Y-site administration 3
Common Pitfalls to Avoid
- Do not use glucose-containing solutions for certain combinations - while normal saline is safe, be aware that some drug combinations may have specific diluent requirements 4
- Monitor for precipitation with high-concentration combinations - when using extended-infusion dosing schemes with high concentrations (33.75-90 mg/mL), normal saline remains compatible 5
- Ensure proper storage conditions - temperature significantly affects stability, particularly for extended storage periods 2