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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]" /><meta name="citation_title" content="Ticarcillin" /><meta name="citation_publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="citation_date" content="2020/10/20" /><meta name="citation_pmid" content="31643377" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK548046/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Ticarcillin" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="DC.Date" content="2020/10/20" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK548046/" /><meta name="description" content="Ticarcillin is an extended-spectrum carboxypenicillin antibiotic and is used to treat moderate-to-severe infections due to susceptible organisms. Ticarcillin has been linked with idiosyncratic liver injury, but only rarely and as isolated case reports." /><meta name="og:title" content="Ticarcillin" /><meta name="og:type" content="book" /><meta name="og:description" content="Ticarcillin is an extended-spectrum carboxypenicillin antibiotic and is used to treat moderate-to-severe infections due to susceptible organisms. Ticarcillin has been linked with idiosyncratic liver injury, but only rarely and as isolated case reports." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK548046/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/livertox/Ticarcillin/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK548046/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="All Drug Records" href="/books/n/livertox/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" alt="Cover of LiverTox" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK548046_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK548046_dtls__"><div>Bethesda (MD): <a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>; 2012-.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/livertox/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Ticagrelor/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/TicarcillinClavulana/" title="Next page in this title">Next ></a></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK548046_"><span class="title" itemprop="name">Ticarcillin</span></h1><p class="small">Last Update: <span itemprop="dateModified">October 20, 2020</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="Ticarcillin.OVERVIEW"><h2 id="_Ticarcillin_OVERVIEW_">OVERVIEW</h2><div id="Ticarcillin.Introduction"><h3>Introduction</h3><p>Ticarcillin is an extended-spectrum carboxypenicillin antibiotic and is used to treat moderate-to-severe infections due to susceptible organisms. Ticarcillin has been linked with idiosyncratic liver injury, but only rarely and as isolated case reports.</p></div><div id="Ticarcillin.Background"><h3>Background</h3><p>Ticarcillin (tye" kar sil' in) is a fourth generation, extended-spectrum penicillin antibiotic which was previously used for moderate-to-severe infections caused by susceptible gram positive and gram negative agents. The extended spectrum of ticarcillin made it an appropriate agent in therapy of Pseudomonas aeruginosa. Ticarcillin also has extended activity against some Enterobacter and Proteus species. Ticarcillin has activity against most of the agents that are sensitive to natural penicillins, but is often less active. Ticarcillin is resistant to inactivation by many, but not all beta-lactamases. Ticarcillin was withdrawn from the market in the United States in 2004. Previously it was available in parenteral forms generically and under the name Ticar and is usually given in doses of 200 to 300 mg/kg per day in divided doses intravenously every 4 to 6 hours. Common side effects included nausea, diarrhea, dizziness, headache, rash and hypersensitivity reactions. Rare but potentially severe adverse events included severe hypersensitivity reactions, anaphylaxis and Stevens Johnson syndrome.</p></div><div id="Ticarcillin.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>Intravenous ticarcillin therapy has been associated with mild and transient serum aminotransferase elevations that were generally self-limited and only slightly more common with ticarcillin than with comparative antibiotics. Much more commonly reported were instances of anicteric hepatic injury from carbenicillin, a similar carboxypenicillin with extend coverage against Pseudomonas. Persons receiving high doses of intravenous carbenicillin not uncommonly (15% to 30%) developed serum aminotransferase elevations without jaundice, which promptly fell to normal with discontinuation or switching to another antibiotic. Recurrence is common with retreatment using carbenicillin, but not with ticarcillin. A similar phenomenon occurs with intravenous oxacillin. Rare instances of idiosyncratic, clinically apparent cholestatic liver injury have been reported in persons receiving ticarcillin in combination with clavulanate, some of which resemble the rare idiosyncratic reactions that can occur with many penicillins and which resemble the cholestatic liver injury that occurs after amoxicillin/clavulanate.</p><p><a class="def" href="/books/n/livertox/glossary/def-item/glossary.likelihood-score/">Likelihood score</a>: D (possible rare cause of clinically apparent liver injury).</p></div><div id="Ticarcillin.Mechanism_of_Injury"><h3>Mechanism of Injury</h3><p>The cause of the idiosyncratic liver injury associated with ticarcillin use was probably hypersensitivity or allergy. No cases of rechallenge or reexposure have been reported.</p></div><div id="Ticarcillin.Outcome_and_Management"><h3>Outcome and Management</h3><p>There have been too few cases of ticarcillin related liver injury to assess the prognosis and outcome. Patients with ticarcillin induced hepatitis should avoid reexposure to other penicillins and should take cephalosporins with caution.</p><p>References to the safety and potential hepatotoxicity of ticarcillin are provided in the drug record on Ticarcillin-Clavulanate.</p><p>Drug Class: Antiinfective Agents, <a href="/books/n/livertox/PenicillinFourthGen/">Penicillins (Fourth Generation)</a></p><p>Other Drugs in the Class: <a href="/books/n/livertox/Piperacillin/">Piperacillin</a>, <a href="/books/n/livertox/PiperacillinTazob/">Piperacillin-Tazobactam</a>, <a href="/books/n/livertox/TicarcillinClavulana/">Ticarcillin-Clavulanate</a></p></div></div><div id="Ticarcillin.PRODUCT_INFORMATION"><h2 id="_Ticarcillin_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><p>
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<b>REPRESENTATIVE TRADE NAMES</b>
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</p><p>Ticarcillin – Generic, Ticar®</p><p>
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<b>DRUG CLASS</b>
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</p><p>Antiinfective Agents</p><p>
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<a href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=ticarcillin" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">COMPLETE LABELING</a>
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</p><p>Product labeling at DailyMed, National Library of Medicine, NIH</p></div><div id="Ticarcillin.CHEMICAL_FORMULAS_AND_STRUCT"><h2 id="_Ticarcillin_CHEMICAL_FORMULAS_AND_STRUCT_">CHEMICAL FORMULAS AND STRUCTURES</h2><div id="Ticarcillin.Tc" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548046/table/Ticarcillin.Tc/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Ticarcillin.Tc_lrgtbl__"><table><thead><tr><th id="hd_h_Ticarcillin.Tc_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">DRUG</th><th id="hd_h_Ticarcillin.Tc_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CAS REGISTRY NO</th><th id="hd_h_Ticarcillin.Tc_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_Ticarcillin.Tc_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_Ticarcillin.Tc_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ticarcillin</td><td headers="hd_h_Ticarcillin.Tc_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135000353" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">34787-01-4</a>
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</td><td headers="hd_h_Ticarcillin.Tc_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">C15-H16-N2-O6-S2</td><td headers="hd_h_Ticarcillin.Tc_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135000353" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135000353" alt="image 135000353 in the ncbi pubchem database" /></a>
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</td></tr></tbody></table></div></div></div><div id="bk_toc_contnr"></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK548046</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/31643377" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">31643377</a></span></div><div style="margin-top:2em" class="bk_noprnt"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Ticagrelor/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/TicarcillinClavulana/" title="Next page in this title">Next ></a></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK548046/?report=reader">PubReader</a></li><li><a href="/books/NBK548046/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK548046" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK548046" style="display:none" title="Cite this Page"><div class="bk_tt">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. 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79(5B):62-6. </em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/3899005" ref="ordinalpos=1&linkpos=4&log$=relatedarticles&logdbfrom=pubmed">Ceftazidime versus tobramycin-ticarcillin in the treatment of pneumonia and bacteremia.</a><span class="source">[Antimicrob Agents Chemother. 1...]</span><div class="brieflinkpop offscreen_noflow">Ceftazidime versus tobramycin-ticarcillin in the treatment of pneumonia and bacteremia.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Cone LA, Woodard DR, Stoltzman DS, Byrd RG. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Antimicrob Agents Chemother. 1985 Jul; 28(1):33-6. </em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/6817707" ref="ordinalpos=1&linkpos=5&log$=relatedarticles&logdbfrom=pubmed">Effect of calcium, magnesium, and zinc on ticarcillin and tobramycin alone and in combination against Pseudomonas aeruginosa.</a><span class="source">[Antimicrob Agents Chemother. 1...]</span><div class="brieflinkpop offscreen_noflow">Effect of calcium, magnesium, and zinc on ticarcillin and tobramycin alone and in combination against Pseudomonas aeruginosa.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Zuravleff JJ, Yu VL, Yee RB, Zaphyr MK, Diven W, Taylor FB. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Antimicrob Agents Chemother. 1982 Nov; 22(5):839-43. </em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=31643377" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=31643377" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c8e1f9a68b6b5afc7b3f7e">Ticarcillin - LiverTox</a><div class="ralinkpop offscreen_noflow">Ticarcillin - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c8e1f8ab82281a804390d6">Ticagrelor - LiverTox</a><div class="ralinkpop offscreen_noflow">Ticagrelor - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c8e1f7b15b832ebc169853">Tibolone - LiverTox</a><div class="ralinkpop offscreen_noflow">Tibolone - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=4" href="/portal/utils/pageresolver.fcgi?recordid=67c8e1f6b15b832ebc169254">Tiagabine - LiverTox</a><div class="ralinkpop offscreen_noflow">Tiagabine - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=5" href="/portal/utils/pageresolver.fcgi?recordid=67c8e1f5a68b6b5afc7b1d2e">Thyroid Hormone - LiverTox</a><div class="ralinkpop offscreen_noflow">Thyroid Hormone - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
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