Quinupristin + Dalfopristin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Vancomycin-resistant Enterococcus faecium 7.5 mg/kg (equiv to quinupristin 2.25 mg/kg and dalfopristin 5.25 mg/kg) 8 hrly for at least 7 days. Complicated skin and skin structure infection 7.5 mg/kg (equiv to quinupristin 2.25 mg/kg and dalfopristin 5.25 mg/kg) 12 hrly for at least 7 days.
Dosage Details
Intravenous
Complicated skin and skin structure infections
Adult: 7.5 mg/kg (equivalent to quinupristin 2.25 mg/kg and dalfopristin 5.25 mg/kg) every 12 hr for at least 7 days, duration depends on site and severity of infection. To be infused over 60 minutes.

Intravenous
Vancomycin-resistant Enterococcus faecium
Adult: 7.5 mg/kg (equivalent to quinupristin 2.25 mg/kg and dalfopristin 5.25 mg/kg) every 8 hr for at least 7 days, duration depends on site and severity of infection. To be infused over 60 minutes.
Hepatic Impairment
Dosage adjustment may be required.
Reconstitution
Single dose vial: Reconstitute with 5% dextrose in water or sterile water for inj. Swirl gently (without shaking) to dissolve. Allow the solution to sit for a few minutes until all the foam has disappeared. Resulting solution should be clear and yield a concentration of 100 mg/mL. Based on patient's wt, reconstituted solution should be added to 250 mL of 5% dextrose in water for peripheral admin (may increase to 500 mL or 750 mL to limit venous irritation). An infusion volume of 100 mL may be used for central line infusions.
Incompatibility
Incompatible with saline.
Contraindications
Severe hepatic impairment. Hypersensitivity.
Special Precautions
Hepatic impairment and predisposition to cardiac arrhythmias.
Adverse Reactions
Nausea, vomiting, diarrhoea, headache, arthralgia, myalgia, asthenia, rash, pruritus, anaemia, leucopenia, eosinophilia, raised urea and creatinine; inj-site reactions on peripheral venous administration; less frequently oral candidiasis, stomatitis, constipation, abdominal pain, anorexia, peripheral oedema, hypotension, chest pain, arrhythmias, dyspnoea, hypersensitivity reactions (including anaphylaxis and urticaria), insomnia, anxiety, confusion, dizziness, paraesthesia, hypertonia, hepatitis, jaundice, pancreatitis, gout; also reported, thrombocytopenia, pancytopenia, electrolyte disturbances.
Potentially Fatal: Pseudomembranous colitis.
Overdosage
Signs may include dyspnoea, emesis, tremors and ataxia. Careful observation and supportive treatment are recommended.
Drug Interactions
Increased risk of ventricular arrhythmias when used with drugs that prolong QT interval eg. astemizole, cisapride and terfenadine. May increase the serum levels of ciclosporin, nifedipine, midazolam and tacrolimus.
Action
Description: Quinupristin/Dalfopristin works synergistically to inhibit bacterial protein synthesis by binding at different sites on the 50S subunit of the bacterial ribosome. Quinupristin works by inhibiting peptide chain elongation in the late phase of protein synthesis while dalfopristine works by inhibiting the peptidyl transferase in the early phase of protein synthesis.
Pharmacokinetics:
Distribution: Plasma protein binding: 55-78% (quinupristin) and 11-26% (daflopristine).
Metabolism: Rapidly metabolised in the liver.
Excretion: Biliary excretion is probably the primary route for faecal elimination. 75-77% of a dose is excreted faecally. Half-life of quinupristin and its metabolites: about 3 hr, half-life of daflopristin and its metabolites: about 1 hr.
Storage
Unopened vial: Store at 2-8°C (36-46°F). Reconstituted solution should be diluted within 30 minutes. Stability of the diluted solution prior to the infusion is established as 5 hr at room temperature or 54 hr if refrigerated at 2-8°C (36-46°F). Do not freeze solution.
Disclaimer: This information is independently developed by MIMS based on Quinupristin + Dalfopristin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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