Capreomycin


Concise Prescribing Info
Indications/Uses
TB.
Dosage/Direction for Use
Adult : IV/IM 1 g/day for 2-4 mth, then 2 or 3 times/wk for the remainder of the therapy. Max: 20 mg/kg/day.
Dosage Details
Parenteral
Tuberculosis
Adult: 1 g daily, by deep IM inj or IV infusion, for 2-4 mth, then 2-3 times wkly for the remainder of the therapy. Max: 20 mg/kg/day.
Child: 15-30 mg/kg daily. Max: 1 g/day.
Renal Impairment
Dose reduction needed based on CrCl.
Reconstitution
Add 2 mL, 2.15 mL, 2.63 mL, 3.3 mL or 4.3 mL of NaCl 0.9% or sterile water for inj to the vial labelled as containing 1 g to provide soln containing approx 370 mg, 350 mg, 300 mg, 250 mg or 200 mg per mL. Allow 2-3 min for the drug to completely dissolve. For IV infusion, further dilute w/ 100 mL of NaCl 0.9% inj.
Contraindications
Hypersensitivity to capreomycin and other aminoglycosides.
Special Precautions
Patient w/ pre-existing auditory impairment. Renal impairment. Childn. Pregnancy and lactation.
Adverse Reactions
Ototoxicity; hypokalaemia, hypocalcaemia, hypomagnesaemia and an electrolyte disturbance resembling Bartter's syndrome; leukocytosis, leucopenia, eosinophilia; hypersensitivity reactions (e.g. urticaria, photosensitivity, maculopapular rash) associated w/ fever; abnormal LFT results; partial neuromuscular blockade; pain, induration, excessive bleeding and sterile abscess on inj site.
Potentially Fatal: Nephrotoxicity, neuromuscular blockade or resp paralysis.
IM/IV/Parenteral: C
MonitoringParameters
Monitor auditory, vestibular and renal function at baseline and during therapy; frequent assessment of serum electrolytes (e.g. Ca, Mg, K) and liver function.
Overdosage
Symptoms: Hypokalaemia, hypocalcaemia, hypomagnesaemia and an electrolyte disturbance resembling Bartter's syndrome; nephrotoxicity (e.g. acute tubular necrosis) and ototoxicity (e.g. dizziness, tinnitus, vertigo, loss of high-tone acuity). Management: Symptomatic and supportive treatment. May administer activated charcoal to reduce absorption.
Drug Interactions
Additive and sometimes irreversible toxic effects w/ other parenteral anti-TB agents (e.g. streptomycin, viomycin). Increased risk of nephrotoxicity and ototoxicity w/ other non-antituberculosis drugs (e.g. polymyxin A sulfate, amikacin, gentamicin, tobramycin, vancomycin, kanamycin, neomycin).
Action
Description: Capreomycin is a cyclic polypeptide antimicrobial. It is bacteriostatic against various Mycobacteria, particularly those that have become resistant to primary anti-TB drugs.
Pharmacokinetics:
Absorption: Poorly absorbed from the GI tract. Time to peak plasma concentration: 1-2 hr (IM).
Excretion: Via urine (approx 50%, as unchanged drug) by glomerular filtration w/in 12 hr.
Chemical Structure

Chemical Structure Image
Capreomycin

Source: National Center for Biotechnology Information. PubChem Database. Capreomycin, CID=135483770, https://pubchem.ncbi.nlm.nih.gov/compound/Capreomycin (accessed on Jan. 21, 2020)

Storage
Store between 15-30°C. Reconstituted soln: Store between 2-8°C, stable for 24 hr.
MIMS Class
References
Anon. Capreomycin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 16/10/2014.

Buckingham R (ed). Capreomycin Sulfate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 16/10/2014.

Capastat Sulfate Injection, Powder for Solution (Akorn). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 16/10/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Capreomycin Sulfate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 16/10/2014.

Disclaimer: This information is independently developed by MIMS based on Capreomycin 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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