PI = Prescribing Information / SUV = Single Use Vial / SDV = Single Dose Vial / MDV = Multi Dose Vial / N/A: Not Applicable / LF: Latex Free / PF: Preservative. Medscape – Indication-specific dosing for colistimethate sodium, Coly Mycin M ( colistin), frequency-based adverse effects, comprehensive interactions. Drug Information on Coly Mycin M (colistimethate) includes drug pictures, side effects, drug interactions, directions for use, symptoms of overdose, and what to.
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Send the page ” ” to a friend, relative, colleague or yourself. We do not record any personal information entered above. Polypeptide parenteral foly off-label as nebulized solution for inhalation Used for acute or chronic multidrug-resistant gram-negative infections Copy reserved for when no other therapies available. The authors caution in the use of a loading dose of greater than mg of colistin base activity due to a lack of information and the potential impact of large loading doses on renal function.
In this study, CrCl was derived based on the Jelliffe equation; however, other means e. The body weight used should be the lower of either ideal or actual body weight. This may mcyin the potential for nephrotoxicity; therefore, the authors suggest using this maintenance dose formula in patients with good renal function only if the target Css,avg is low.
The manufacturer recommends colistimethate sodium equivalent to 2. Alternatively, colistimethate sodium equivalent to 2.
Coly Mycin M Uses, Side Effects & Warnings –
For continuous IV infusion, administer one-half of the total daily dose IV bolus over 3 to 5 minutes, then 1 to 2 hours later give the remainder of the daily dose by continuous IV infusion over 22 to 23 hours. In obese patients, base the dose on ideal body weight. A study of 60 patients with nosocomial infections caused by Pseudomonas aeruginosa or Acinetobacter baumannii receiving colistimethate sodium at doses equivalent to 2.
Another study of 60 patients with multi-drug resistant gram-negative infections showed a favorable response in Time-kill ,ycin with heteroresistant Acinetobacter baumannii and Pseudomonas aeruginosa also show that bacterial regrowth can occur within 6 hours after the dose, suggesting that dosage regimens of every 8 hours myin be superior to less frequent administration.
Because of the emergence of heteroresistance, combination therapy may be warranted in patients with Acinetobacter mycib.
Coly-Mycin M | Par Sterile Products
Limited data suggest that colistimethate sodium equivalent to 5 to 20 mg colistin base activity intrathecally or intraventricularly once or twice daily may be effective. Clinical practice guidelines recommend colistimethate sodium equivalent to 10 mg colistin base activity intraventricularly once daily. Several single patient cases and multi-patient case series report patients as either successfully treated or with sterile CSF cultures post colistimethate sodium treatment.
Treatment consisted of intrathecal or intraventricular colistimethate sodium alone or in conjunction with additional IV therapy. Patients were treated myxin to 24 days and showed no adverse events related to therapy. Case reports have shown colistimethate sodium equivalent to 1 to 5 mg colistin base activity intrathecally or intraventricularly once daily may be effective; additionally, doses of colistimethate sodium equivalent up to 5 mg colistin base activity intrathecally or intraventricularly twice daily have been used.
A year-old boy was treated with colistimethate sodium equivalent to 5 cily colistin base activity intraventricularly twice daily for 20 days for Acinetobacter baumannii ventriculitis. The patient expired 43 days after therapy ended due to cardiac arrest; however, postmortem showed no evidence of infection. Another year-old boy received colistimethate sodium equivalent to 5 mg base activity intraventricularly once daily for 21 days to successfully treat a multidrug-resistant Pseudomonas aeruginosa ventriculitis.
A 4-year old boy was treated for Acinetobacter baumannii bacteremia and meningitis initially with IV amikacin and intrathecal colistimethate sodium equivalent to 1 mg colistin base j daily, which was increased to 2 mg and then 4 mg daily. The dose was reduced to colistimethate sodium equivalent to 2 mg colistin base activity intrathecally daily after a CSF leukocytosis developed. The meningitis resolved, but functional recovery was poor.
The FDA-approved dosage is myin sodium equivalent to 2. Nebulized use of colistimethate sodium has been possibly associated with the death of a cystic fibrosis CF patient. To avoid this toxicity, colistimethate sodium should be administered promptly after being mixed. Limited data suggest that colistimethate sodium equivalent to 75 to mg of colistin base activity nebulized and inhaled every 12 hours may be effective.
Limited data suggest that colistimethate sodium equivalent to 75 mg of colistin base activity nebulized and inhaled every 12 hours may be effective. For patients with suspected MRSA, add linezolid or vancomycin. Reserve colistin use for VAP due to multidrug resistant gram-negative infections where alternative agents are not available.
For VAP due to gram-negative bacilli that are susceptible to only polymyxins, add inhaled colistin to systemic therapy. The FDA-approved dosage is 2. Clinical practice guidelines recommend adding inhaled colistin to systemic therapy for VAP due to gram-negative bacilli that are susceptible to only polymyxins. Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.
The following recommendations are based on an interim study of critically-ill patients. Creatinine clearance CrCl was derived based on the Jelliffe equation; however, other means e. Cockroft-Gault may be used to estimate CrCl which would then be normalized to a body surface area of 1. The colistin Css,avg target should be based on the MIC, site of infection, and severity j infection. Maintenance dose in patients not receiving renal replacement therapy: Start the suggested maintenance dose 24 hours after the administration of the loading dose.
The following are recommendations from US prescribing information. Intrathecal, intraventricular, and oral routes do not require adjustment; inhalation therapy may or may not need adjustment. No dosage adjustment is needed. Colistimethate sodium equivalent to 2. Colistimethate sodium equivalent to mycun. An interim study of critically-ill patients demonstrated that both colistimethate sodium and colistin are efficiently cleared during intermittent hemodialysis. In this study, dosing recommendations for patients receiving intermittent hemodialysis assumes a CrCl of zero.
Coly Mycin M
A loading dose is recommended with the maintenance dose starting 24 hours after the initial load. The body weight used should be the lower or either ideal of actual body weight. On hemodialysis days, a supplemental dose in mg of colistin base activity should be used.
It is recommended that the dialysis session take place toward the end of the regularly scheduled dosing interval. Continuous hemodialysis Colistimethate sodium and colistin base are cleared during continuous renal mhcin therapy.
In an interim study of critically-ill patients, cloy recommendations for patients receiving continuous renal replacement therapy CRRT include a loading dose with the maintenance dose starting 24 hours after the initial load. Peritoneal dialysis Case reports indicate that colistimethate sodium given intraperitoneally is absorbed, but concentrations are not consistent with systemic use; limited drug is removed during peritoneal dialysis. Dosing recommendations based on current peritoneal dialysis practices are not available; monitor patients closely.
The term colistin can describe two distinct products, colistin sulfate colistin base or colistimethate sodium.
There are differences in the basic chemistry, pharmacology, pharmacokinetics, and clinical applications of these two formulations. If the term colistin is used, then the information described applies to both products.
However, the terms colistin sulfate or colistimethate sodium will be used whenever there are specific differences between the drugs. To avoid errors in dosing and administration, colistimethate sodium or colistin should only be prescribed and administered in colistin base activity.
Parenteral vials contain colistimethate sodium equivalent to mg colistin base activity based on microbiological standardization per vial approximately mhcin or 5 million International Units of colistimethate sodium. Colistimethate sodium is used for parenteral administration, given via intravascular IM injection, IV injection, or IV infusionintrathecal or intraventricular administration. Visually inspect parenteral drug products for particulate matter and discoloration prior to administration, whenever solution and container permit.
Do not administer if particulate matter or discoloration is present. Vials are for single use only. Reconstitution, preparation, and administration for intravenous IV injection: If not used immediately, the reconstituted solution can be stored in the refrigerator or at room temperature for up to 7 days. Slowly inject the dose IV over a period of 3 to 5 minutes.
Reconstitution, preparation, and administration for intravenous IV infusion: For continuous IV infusion: Administer one-half the daily dose as an IV bolus injection over 3 to 5 minutes. Dilute the other half of the daily dose in 0.
Colly 1 to 2 hours after the IV bolus, administer the remaining daily dose over 22 to 23 hours. Use the diluted solution within 24 hours of preparation.
For intermittent IV infusion: Colistin is not FDA-approved for intermittent IV infusion, but intermittent dosing, over 9 to minutes, has been used. Colistin in not FDA-approved for intrathecal administration. Reconstitute vial with 45 mL of sterile 0. Swirl gently to avoid frothing. Administer 10 mg 3 mL via lumbar puncture after the removal of greater or equal volume of cerebrospinal fluid CSF.
Reconstitute vial with 30 mL of sterile 0. Administer 5 to 10 mg 1 to 2 mL via lumbar puncture after the removal of greater or equal volume of CSF. Reconstitute vial with Administer 20 mg 3 mL via lumbar puncture after the removal of greater or equal volume of CSF. Reconstitute vial with 15 mL of sterile 0.
Administer 10 to 20 mg 1 to 2 mL via lumbar puncture after the removal of greater or equal volume of CSF. Colistin is not FDA-approved for intraventricular administration. Administer 10 mg 3 mL via external ventricular drain clamped for 1 to 3 hours after the removal of greater or equal volume of CSF.
Administer 5 to 10 mg 1 to 2 mL via external ventricular drain clamped for 1 to 3 hours after the removal of greater or equal volume of CSF. Administer 20 mg 3 mL via external ventricular drain clamped for 1 to 3 hours after the removal of greater or equal volume of CSF. Administer 10 to 20 mg 1 to 2 mL via external ventricular drain clamped for 1 to 3 hours after the removal of greater or equal volume of CSF.
Colistin is not FDA-approved for inhalation administration. Vials for injection containing colistimethate sodium equivalent to mg colistin base activity are used off-label for nebulization.
Using vials for injection: Reconstitute vial with 2 to 4 mL of Sterile Water for Injection, swirling gently to avoid frothing.