Colistimethate Injection
Colistin (Colistimethate Sodium)
1 MIU/Vial
ZAS Corporation
| Pack size | 1's Pack |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 800.00 AED |
Available as:
Indications
Colistimethate Injection is used for:
Bowel sterilization, gastrointestinal tract infections, respiratory tract infections
Adult Dose
Oral
Bowel sterilisation; Gastrointestinal infections
Adult: As colistin sulfate: 1.5-3 MIU tid.
Child: As colistin sulfate: <15 kg: Not suitable; 15-30 kg: 0.75-1.5 MIU tid.
Parenteral
IV/IM
Severe Gram-negative infections
Adult: As colistimethate Na (strength expressed in terms of colistin base): 2.5-5 mg/kg/day in 2-4 divided doses.
Max: 5 mg/kg/day.
Inhalation
Adjunct to antimicrobial therapy in resp infections As colistimethate Na: 1-2 million units twice daily.
Max: 2 million units 3 times/day for up to 3 mth in frequent recurrent infections.
Inhalation
Management of chronic pulmonary infections due to Pseudomonas aeruginosa in patients with cystic fibrosis
By Inhalation of Nebulised Solution
Adult: 1–2 million units 2–3 times a day, for specific advice on administration using nebulisers.
Maximum 6 million units per day
BY Inhalation of Powder
Adult: 1.66 million units twice daily
Child Dose
Oral
Susceptible Infections
Dosage expressed in terms of colistin base
<12 years old: Safety and efficacy not established
Bowel sterilisation; Gastrointestinal infections
Child: As colistin sulfate: <15 kg: Not suitable; 15-30 kg: 0.75-1.5 MIU tid.
Parenteral
Severe Gram-negative infections
Child: IV, IM 2.5–5 mg base/kg/day based on IBW q8h
Up to 5–7 mg base/kg/day
By Inhalation of Nebulised Solution
Child 2–17 years: 1–2 million units 2–3 times a day, for specific advice on administration using nebulisers;
Maximum 6 million units per day
Renal Dose
Renal Impairment
CrCl >80 mL/min: No dosage adjustment required
CrCl 50-79 mL/min: 2.5-3.8 mg/kg/day IV/IM divided q12hr
CrCl 30-49 mL/min: 2.5 mg/kg/day IV/IM qDay or divided q12hr
CrCl 10-29 mL/min: 1.5 mg/kg IV/IM q36hr
Administration
Reconstitution: Reconstitute 150 mg vial w/ 2 mL sterile water for inj. Reconstituted soln provides colistimethate Na at a concentration equivalent to 75 mg/mL colistin base.
IV/IM Administration
IM or
IV push: half of daily dose injected over 3-5 min q12 hr
IV infusion: half of daily dose injected over 3-5 min; other half mixed with compatible IV solution and administered 1-2 hr later at 5-6 mg/hr
Contra Indications
Hypersensitivity. Anuria; porphyria; myasthenia gravis. Pregnancy and lactation.
Precautions
Do not exceed 5 mg/kg/day (as colistin base) with normal renal function
Not indicated for infections by Proteus or Neisseria (most strains are resistant)
Risk of nephrotoxicity, neurotoxicity; discontinue if elevated BUN/creatinine
Risk of respiratory arrest in myasthenia gravis or concomitant anesthetics or neuromuscular blocking drugs
Risk of C. difficile-associated pseudomembranous colitis
Sedative effects may impair driving, operating machinery
Colistimethate sodium preferred for treatment of lower urinary tract infections because of higher urinary concentrations, including polymyxin B; use in combination with other antibiotics depending on susceptibilities
MONITORING REQUIREMENTS
Monitor serum creatinine and BUN regularly while on treatment.
When used by inhalation: Measure lung function before and after initial dose of colistimethate sodium and monitor for bronchospasm; if bronchospasm occurs in a patient not using a bronchodilator, repeat test using a bronchodilator before the dose of colistimethate sodium.
Pregnancy-Lactation
Pregnancy Category: C
Lactation: unknown; use caution
Interactions
Certain other antibiotics (aminoglycosides and polymyxin) have also been reported to interfere with the nerve transmission at the neuromuscular junction. Based on this reported activity, they should not be given concomitantly with Colistin Parenteral except with the greatest caution.
Curariform muscle relaxants (e.g., tubocurarine) and other drugs, including ether, succinylcholine, gallamine, decamethonium and sodium citrate, potentiate the neuromuscular
blocking effect and should be used with extreme caution in patients being treated with Colistin Parenteral.
Sodium cephalothin may enhance the nephrotoxicity of Colistin Parenteral. The concomitant use of sodium cephalothin and Colistin Parenteral should be avoided.
Potentially Fatal: Potentiates action of curariform muscle relaxants. Potentiates nephrotoxicity of aminoglycosides and cephalothin.
Contraindicated (0)
Serious (13)
amphotericin B deoxycholate
atracurium
bacitracin
cholera vaccine
cidofovir
cisatracurium
microbiota oral
neomycin PO
pancuronium
rapacuronium
rocuronium
succinylcholine
vecuronium
Adverse Effects
Side effects of Colistin (Colistimethate Sodium) :
1-10%
Dizziness,Paresthesia, tingling sensation
<1%
Neurotoxicity,Nephrotoxicity,Acute respiratory failure (inhalation route),Respiratory tract paralysis
Potentially Fatal: Acute tubular necrosis, neurotoxicity; nephrotoxicity. The neuromuscular blockade is potentially fatal, when associated with use of curariform muscle relaxants.
Mechanism of Action
Colistin sulfate is a polymyxin antibiotic which is active against aerobic gram-negative bacteria including most enterobacteria except Proteus, Providentia and Serratia. Susceptible organisms include P. aeruginosa, Legionella spp, H. influenzae, Acinetobacter, V. cholera, Salmonella, Shigella and Pasteurella.
Colistin sulfate is used orally while colistimethate sodium is used parenterally or via inhalational route.
Note
Colistimethate 1 MIU/Vial Injection manufactured by ZAS Corporation. Its generic name is Colistin (Colistimethate Sodium). Colistimethate is availble in Bangladesh.
Farmaco BD drug index information on Colistimethate Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.
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