Doripenem


Generic Medicine Info
Indications and Dosage
Intravenous
Complicated intra-abdominal infections
Adult: 500 mg 8 hrly infused over 1 hr for 5-14 days. May switch to an appropriate oral therapy, after at least 3 days of parenteral therapy upon evidence of clinical improvement.

Intravenous
Complicated urinary tract infections, Pyelonephritis
Adult: 500 mg 8 hrly infused over 1 hr for 10 days. May switch to an appropriate oral therapy, after at least 3 days of parenteral therapy upon evidence of clinical improvement. Duration can be extended up to 14 days for patients w/ concurrent bacteraemia.
Renal Impairment
CrCl Dosage
11-29 250 mg 12 hrly.
30-50 250 mg 8 hrly.
Reconstitution
Reconstitute 500 mg vial w/ 10 mL of sterile water for inj or NaCl 0.9% inj to form a susp containing 50 mg/mL. Further dilute the reconstituted vial w/ 100 mL of NaCl 0.9% or dextrose 5% inj, gently shake until clear. For a 250 mg dose, contents of the reconstituted vial should be withdrawn and added to 100 mL NaCl 0.9% infusion bag or dextrose 5% inj. Remove and discard 55 mL from the infusion bag to leave the remaining soln.
Incompatibility
Diazepam, K phosphates, propofol.
Contraindications
Hypersensitivity to doripenem, other carbapenem antibacterial agents; history of anaphylactic reaction to β-lactams (e.g. penicillins, cephalosporins).
Special Precautions
Patient w/ known or suspected CNS disorders (e.g. brain lesions, history of seizures). Not intended for treatment of any type of pneumonia. Renal impairment. Pregnancy and lactation.
Adverse Reactions
Headache, nausea, diarrhoea, rash, pruritus, phlebitis, elevated hepatic enzymes, oral candidiasis, anaemia, vulvomycotic infection, thrombocytopenia, neutropenia.
Potentially Fatal: Hypersensitivity reactions (e.g. anaphylaxis), Clostridium difficile-associated colitis.
IV/Parenteral: B
Monitoring Parameters
Monitor renal function and for signs of anaphylaxis during 1st dose. Consider haematologic assessment during prolonged therapy.
Drug Interactions
Increased plasma concentration w/ probenecid. May decrease plasma levels of valproic acid thus, increasing the risk of seizures.
Action
Description: Doripenem is a synthetic broad-spectrum carbapenem β-lactam antibiotic w/ potent in vitro antibacterial activity against aerobic and anaerobic gm+ve and gm-ve bacteria including Pseudomonas aeruginosa. It inhibits bacterial cell wall synthesis by binding to several penicillin-binding proteins, which in turn inhibits the final transpeptidase step of peptidoglycan synthesis in bacterial cell walls.
Pharmacokinetics:
Distribution: Widely distributed into body tissues and fluids. Volume of distribution: 16.8 L. Plasma protein binding: <10%.
Metabolism: Primarily metabolised via hydrolysis of its β-lactam ring by dehydropeptidase I to a microbiologically inactive open-ringed metabolite (doripenem-M1).
Excretion: Mainly excreted in the urine by tubular secretion and glomerular filtration (approx 70% as unchanged drug, approx 15% as metabolite); faeces (<1%). Elimination half-life: Approx 1 hr.
Storage
Reconstituted susp may be held for 1 hr prior to dilution in infusion bag. Following dilution of the susp w/ NaCl 0.9%, stability is 8 hr at room temperature or 24 hr between 2-8°C. Stability of soln when diluted w/ dextrose 5% inj is 4 hr at room temperature or 24 hr between 2-8°C.
MIMS Class
Other Beta-Lactams
References
Anon. Doripenem. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/05/2014.

Buckingham R (ed). Doripenem. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 05/05/2014.

Doribax Powder, for Solution (Shionogi Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 05/05/2014.

Label Changes for Antibacterial Doribax (doripenem) Describing Increased Risk of Death for Ventilator Patients with Pneumonia. U.S. FDA. https://www.fda.gov/. Accessed 05/05/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Doripenem. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 05/05/2014.

Disclaimer: This information is independently developed by MIMS based on Doripenem 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 © 2021 MIMS. All rights reserved. Powered by MIMS.com
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