CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

Oral: 200–400 mg daily, increased if necessary to 400 mg twice dailyIV: 200–400 mg twice daily

PHARMACOKINETICS

  • Molecular weight                           :361.4
  • %Protein binding                           :25
  • %Excreted unchanged in urine     : 65–80
  • Volume of distribution (L/kg)       :1.5–2.5
  • half-life – normal/ESRD (hrs)      :4–6/15–60

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : 200–400 mg once daily
  • 10 to 20     : 200–400 mg once daily
  • <10           : 200 mg once daily

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not significantly 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      :Dialysed. Dose as in GFR=10–20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Analgesics: increased risk of convulsions with NSAIDs
  • Anticoagulants: effect of acenocoumarol and warfarin enhanced
  • Antimalarials: manufacturer of artemether with lumefantrine advises avoid concomitant use
  • Ciclosporin: increased risk of nephrotoxicityTheophylline: possibly increased risk of convulsions

    ADMINISTRATION

    Reconstition

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    Route

    Oral, IV

    Rate of Administration

    200 mg over 30 minutes

    Comments

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