DOSE IN NORMAL RENAL FUNCTION

3.2 g every 6–8 hours, increased to every 4 hours in severe infections

PHARMACOKINETICS

  • Molecular weight                           : Ticarcillin (as Na) 428.4, clavulanic acid 199.2
  • %Protein binding                           : Ticarcillin 50, clavulanic acid 25
  • %Excreted unchanged in urine     : Ticarcillin 85–90, clavulanic acid 40
  • Volume of distribution (L/kg)       : Ticarcillin 0.14–0.21, clavulanic acid 0.3
  • half-life – normal/ESRD (hrs)      : Ticarcillin 1.2/15, clavulanic acid 1/3–4

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    >30 3.2 g every 8 hours 10–30 1.6 g every 8 hours

  • <10           : 1.6 g every 12 hours

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                : Not dialysed. Dose as in GFR <10 mL/min
  • HD                     : Dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   : Dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD      : Unknown dialysability. Dose as in GFR=10–30 mL/min or 2.4 g every 6–8 hours1 CVVhd/ HDF Dialysed. 3.2 g every 6 hours1

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Anticoagulants: effects of coumarins are potentially enhanced Oral contraceptives: potentially reduced efficacy Methotrexate: reduced excretion thereby increasing risk of toxicity

    ADMINISTRATION

    Reconstition

    With 10 mL water for injection and add to 100 mL glucose 5%

    Route

    IV

    Rate of Administration

    30–40 minutes

    Comments

    Each 3.2 g of ticarcillin/clavulanic acid contains 16 mmol of sodium and 1 mmol of potassium

    OTHER INFORMATION

    CSM has advised that cholestatic jaundice may occur if treatment exceeds a period of 14 days and can present up to 6 weeks after treatment has been stopped. The incidence of cholestatic jaundice occurring with Timentin is higher in males than in females and is particularly prevalent in men over the age of 65 years

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