৳ 400/unit
Pack: ৳ 400
৳ 400/unit
Pack: ৳ 400
At a glance
Colistimethate Sodium is an antibiotic used for the treatment of acute or chronic infections caused by sensitive strains of certain gram-negative bacilli, particularly Pseudomonas aeruginosa infections.
Indications
- Acute or chronic infections caused by susceptible gram-negative bacilli
- Enterobacter aerogenes infections
- Escherichia coli infections
- Klebsiella pneumoniae infections
- Pseudomonas aeruginosa infections
Pharmacology
Colistimethate is a surface active agent which penetrates into and disrupts the bacterial cell membrane. Colistimethate is polycationic and has both hydrophobic and lipophilic moieties. It interacts with the bacterial cytoplasmic membrane, changing its permeability. This effect is bactericidal. There is also evidence that polymyxins enter the cell and precipitate cytoplasmic components, primarily ribosomes.
Dosage
Adult Dose (Maintenance): 9 MIU/day in 2-3 divided doses. A loading dose of 9 MIU should be administered in critically ill patients.
Pediatric Dose (≤40 kg): 75,000-150,000 IU/kg/day divided into 3 doses.
Pediatric Dose (>40 kg): >150,000 IU/kg/day has been reported in children with cystic fibrosis.
Renal Dose:
| Creatinine Clearance (ml/min) | Daily Dose |
|---|---|
| 50-30 | 5.5-7.5 MIU |
| 30-10 | 4.5-5.5 MIU |
| <10 | 3.5 MIU |
Hemodialysis Patients: Non-HD days: 2.25 MIU/day; HD days: 3 MIU/day (after HD session).
Side effects
Common Side Effects:
- Gastrointestinal upset
- Tingling of extremities and tongue
- Slurred speech
- Dizziness
- Vertigo
- Paresthesia
- Generalized itching
- Urticaria and rash
- Fever
Serious Side Effects:
- Increased BUN
- Elevated creatinine and decreased creatinine clearance
- Respiratory distress and apnea
- Nephrotoxicity
- Decreased urine output
Use in pregnancy
There are no adequate and well-controlled studies about the use of Colistimethate in pregnant women. Colistimethate is transferred across the placental barrier in humans. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Precautions & warnings
- Use with caution in patients with impaired renal function; reduce dosage accordingly.
- Use with caution in neonates, infants and children.
- Avoid concurrent use with aminoglycosides and polymyxin (interfere with nerve transmission at neuromuscular junction).
- Avoid use with muscle relaxants (tubocurarine, ether, succinylcholine, gallamine, decamethonium, sodium citrate).
Overdose effects
Overdose symptoms: Paresthesia, lethargy, confusion, dizziness, ataxia, nystagmus, disorders of speech, apnea (respiratory muscle paralysis), acute renal failure (decreased urine output, increased BUN and creatinine). Treatment: Discontinue therapy and institute general supportive measures.
Storage conditions
Before reconstitution: Store below 30°C. After reconstitution: Store at 2°C-8°C (Do not freeze) and use within 24 hours.