Capreomycin

CLINICAL USE

Antibacterial agent in combination with other drugs:

Tuberculosis that is resistant to first-line drugs

DOSE IN NORMAL RENAL FUNCTION

Deep IM injection: 1 g daily (not more than 20 mg/kg) for 2–4 months, then 1 g 2–3 times each week

PHARMACOKINETICS

Molecular weight :668.7

%Protein binding :No data

%Excreted unchanged in urine : 50

Volume of distribution (L/kg) :0.37–0.42

half-life – normal/ESRD (hrs) :2/55.5

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : 1 g every 48 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 :Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsIncreased risk of nephrotoxicity and ototoxicity with aminoglycosides and vancomycin

ADMINISTRATION

Reconstition

Dissolve in 2 mL of sodium chloride 0.9% or water for injection. 2–3 minutes should be allowed for complete dissolution

Route

Deep IM injection

Rate of Administration

–

Comments

–

OTHER INFORMATION

Nephrotoxic Check potassium levels as hypokalaemia may occur

Desired steady state serum capreomycin level is 10 micrograms/mLDose should not exceed 1 g/day in renal failure

Capreomycin sulphate 1 000 000 Units approximately equivalent to capreomycin base 1 g

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