Yonex IM/IV Injection

Colistin (Colistimethate Sodium)

68 mg

Healthcare Pharmaceuticals Ltd.

Pack size	2 MIU
Dispensing mode
Source
Agent
Retail Price	700.00 AED

Available as:

150 mg - Injection 34 mg - IM/IV Injection

Indications

Yonex IM/IV 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

Yonex 68 mg IM/IV Injection manufactured by Healthcare Pharmaceuticals Ltd.. Its generic name is Colistin (Colistimethate Sodium). Yonex is availble in Bangladesh. Farmaco BD drug index information on Yonex IM/IV 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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