Colistimethate (colistin (as colistimethate sodium))

Dosage of colistimethate sodium commercially available in the US is expressed in terms of colistin.

Dosage of colistimethate sodium preparations commercially available in some other countries (e.g., United Kingdom, Greece) may be expressed in terms of colistimethate sodium, in terms of colistin, or as international units. The fact that dosages reported in published clinical studies or case reports may vary depending on the country of origin and the preparation used should be considered.

Although not the dosage convention in the US, it has been suggested that dosage of colistimethate sodium should preferably be expressed in terms of international units to avoid confusion. When expressed in terms of international units, each mg of colistin base has a potency of 30,000 international units and each mg of colistimethate sodium has a potency of 12,500 international units.

In patients with renal impairment, dosage of colistimethate sodium should be decreased in proportion to the degree of renal impairment.

Dosage for Adults with Renal Impairment

Creatinine Clearance (mL/minute) IM or IV Dosage (of Colistin) 80 or greater 2.5-5 mg/kg daily given in 2-4 divided doses 50-79 2.5-3.8 mg/kg daily given in 2 divided doses 30-49 2.5 mg/kg daily given as a single dose or in 2 divided doses 10-29 1.5 mg/kg given once every 36 hours

No dosing information is available for this tab.

No dosing information is available for this tab.

No dosing information is available for this tab.

Since nephrotoxic and/or neurotoxic effects may be additive, concurrent or sequential use of colistimethate sodium and other drugs with similar toxic potentials (e.g., aminoglycosides, amphotericin B, capreomycin, methoxyflurane (no longer commercially available in the US), polymyxin B sulfate, vancomycin) should be avoided, if possible.

Neuromuscular blocking agents (e.g., tubocurarine, succinylcholine, ether, decamethonium (no longer commercially available in the US), gallamine (no longer commercially available in the US), decamethonium) and other drugs (e.g., sodium citrate) potentiate neuromuscular blockade induced by colistimethate sodium and these drugs should be used with extreme caution in patients receiving colistimethate sodium.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Safe use of colistimethate sodium during pregnancy has not been established. When colistimethate sodium was given to rabbits during organogenesis in an IM dosage of 4.15 or 9.3 mg/kg (0.25 or 0.55 times, respectively, the maximum daily human dosage based on mg/m2), talipes varus occurred in 2.6 or 2.9% of fetuses, respectively. In addition, increased resorption occurred at the 9.3 mg/kg dosage. The drug was not teratogenic when the same dosages were used in rats (0.13 or 0.3 times the maximum daily human dosage, respectively, based on mg/mm2). There are no adequate and controlled studies to date using colistimethate sodium in pregnant women, and the drug should be used during pregnancy only when the potential benefits justify the possible risks to the fetus.

It is not known whether colistimethate sodium is distributed into milk, but colistin sulfate has been detected in milk. Therefore, colistimethate sodium should be used with caution in nursing women.

No enhanced messaging available.