Tigecycline


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Complicated intra-abdominal infections; Complicated skin and skin structure infections; Community-acquired pneumonia 100 mg as a single dose, then 50 mg 12 hrly.
Dosage Details
Intravenous
Community-acquired pneumonia
Adult: Initially, 100 mg as a single dose followed by 50 mg 12 hrly for 7-14 days. Infuse dose over 30-60 min.

Intravenous
Complicated intra-abdominal infections, Complicated skin and skin structure infections
Adult: 100 mg as a single dose, followed by 50 mg 12 hrly for 5-14 days. Infuse dose over 30-60 min.
Renal Impairment
No dosage adjustment needed.
Hepatic Impairment
Mild to moderate: No dosage adjustment. Severe: 100 mg as a single dose, then 25 mg 12 hrly.
Reconstitution
Reconstitute 50 mg vial w/ 5.3 mL of NaCl 0.9% inj or dextrose 5% inj or Lactate Ringer's inj to achieve a concentration of 10 mg/mL. For IV bag infusion: Further dilute a 5 mL reconstituted soln w/ 100 mL of IV bag for infusion. For a 100 mg dose: Reconstitute two 50 mg vials and dilute 10 mL of the reconstituted soln in 100 mL of IV infusion soln. For a 50 mg dose: Further dilute a 5 mL reconstituted soln w/ 100 mL of NaCl 0.9% inj or dextrose 5% inj. Concentration of infused soln should not exceed 1 mg/mL. The reconstituted soln should be yellow to orange only.
Incompatibility
Y-site: Amphotericin B, amphotericin B lipid complex, diazepam, omeprazole , esomeprazole or any IV soln that may result in a pH above 7.
Contraindications
Hypersensitivity. Hospital-acquired pneumonia and ventilator-associated pneumonia. Use during tooth development.
Special Precautions
Hypersensitivity to tetracyclines. Use tigecycline in situations when alternative treatments are not suitable. Patients w/ complicated intra-abdominal infections secondary to clinically apparent intestinal perforation. Hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Nausea, vomiting, diarrhoea, abdominal pain, anorexia, headache, dizziness, jaundice, abscess, dyspepsia, acidosis, hypoproteinemia, thrombophlebitis, photosensitivity, inj site reactions, pruritus, rash, overgrowth of nonsusceptible organisms (e.g. fungi), Clostridium-difficile associated diarrhoea, prolonged prothrombin time (PT) and aPTT increased ALT, AST, alkaline phosphatase and bilirubin.
Potentially Fatal: Sepsis or septic shock. Anaphylaxis and anaphylactoid reactions. Acute pancreatitis. Fatal colitis. Liver impairment w/ fatal liver failure.
IV/Parenteral: D
Drug Interactions
Increased warfarin serum levels. May decrease efficacy of oral contraceptives.
Action
Description: Tigecycline is a glycylcycline antibiotic which prevents protein synthesis of the susceptible bacteria by binding to its 30s ribosomal subunit. It is generally considered as bacteriostatic agent; w/ bactericidal activity against S. pneumonia and L. pneumophilia. Tigecycline antibacterial activity covers facultative gm+ve (including MRSA, vancomycin-susceptible Enterococcus faecalis) and gm-ve bacteria, and anaerobic bacteria.
Pharmacokinetics:
Absorption: Bioavailability: 100%.
Distribution: Widely distributed; crosses the placenta. Volume of distribution: 7-9 L/kg. Plasma protein binding: 71-89%.
Metabolism: Not extensively metabolised, resulting in trace amount of glucuronide, N-acetyl metabolite and tigecycline epimer.
Excretion: Via faeces: 60% (mainly as unchanged drug); urine: 33% (approx 22% as unchanged drug). Elimination half-life: 42 hr (following multiple doses).
Storage
Unopened vial: Store between 20-25°C. Reconstituted soln: 24 hr at room temperature (up to 6 hr in vial). IV infusion bag diluted w/ NaCl 0.9% inj or dextrose 5% inj: 48 hr between 2-8°C.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Tigecycline 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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