This drug may cause dizziness, confusion, or visual disturbance, if affected, do not drive or operate machinery.
Monitor serum creatinine, BUN, urine output; signs of neurotoxicity or bronchospasm.
Symptoms: Muscular weakness, apnoea. Resp arrest and acute renal failure may also occur. Management: Supportive treatment, including mannitol diuresis. May be removed by prolonged haemodialysis or peritoneal dialysis.
Additive nephrotoxic/neurotoxic effects w/ aminoglycosides, amphotericin B, bacitracin, capreomycin, cefazedone, methoxyflurane, polymyxin B, vancomycin. May prolong the effect of non-depolarising muscle relaxants (e.g. tubocurarine). May diminish therapeutic effect w/ Na picosulfate.
Description: Colistimethate Na is an inactive prodrug which is hydrolysed to colistin. Colistin acts as a cationic detergent which penetrates and disrupts the bacterial cytoplasmic membrane, causing leaking of intracellular substances and cell death. Pharmacokinetics: Absorption: Time to peak plasma concentration: 2-3 hr (IM). Distribution: Widely distributed, except in CNS and in synovial, pleural, and pericardial fluids; crosses placenta and enters breast milk. Plasma protein binding: 50%. Metabolism: Undergoes hydrolysis to the active substance colistin. Excretion: Mainly via urine, as unchanged drug. Elimination half-life: 2-3 hr.
Anon. Colistimethate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/06/2017.Buckingham R (ed). Colistimethate Sodium. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/06/2017.Colistimethate Sodium Injection (Par Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/06/2017.Joint Formulary Committee. Colistimethate Sodium. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/06/2017.McEvoy GK, Snow EK, Miller J et al (eds). Colistimethate Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 06/06/2017.