Colistimethate Sodium 1,000,000IU/ 1 MU Inj. (Polymyxin E)
Trade Name
Prescriber Category
:
:
Colomycin
A*
Department
Antimicrobial Restriction
:
:
ID, ANAES/ICU
Red Category (ID/Anaes)
INDICATION (BLUE BOOK / UKK)
Intravenous administration for the treatment of serious infections caused by Gram negative bacteria, when more commonly used systemic antibacterial agents may be contraindicated or may be ineffective because of bacterial resistance.
DOSING FOR ADULTS GUIDE [DIAMS HSgB]
Loading dose:
9 million units IV (regardless the body weight)
OR
Weight based (IBW):
> 75 kg: 9 million units IV
61-74 kg: 8 million units IV
51-60 kg: 7 million units IV
< 50 kg: 6 million units IV
Follow by:
Maintenence dose:
4.5 million units IV q12h
(to be administer 12-24h after loading dose)
RENAL DOSE ADJUSTMENT IN ADULTS GUIDE [DIAMS HSgB]
CrCl 50-59 ml/min:
4 million units IV q12h
CrCl 40-49 ml/min:
3.5 million units IV q12h
CrCl 30-39 ml/min:
3 million untis IV q12h
CrCl 10-29 ml/min:
2.5 million units IV q12h
CrCl <10 ml/min:
2 million units IV q12h
HD:
Dose on non-dialysis days: 2 million units IV q12h
Dose on dialysis days: 2 million units IV q12h plus supplemental dose post-HD
Example of supplemental dose as below:
a) 1.2 million units IV (if 3 hours HD session)
b) 1.6 million units IV (if 4 hours HD session)
*Note: Supplemental dose can be served together with the next regular dose
IV TO PO GUIDE [DIAMS HSgB]
N/A
EXTENDED INFUSION GUIDE [DIAMS HSgB]
In-progress
SPECIAL MONITORING & PRECAUTION GUIDE [DIAMS HSgB]
In-progress
ALTERNATIVE DOSING (BLUE BOOK / HSgB DRUG LIST)
A minimum of 5 days treatment is generally recommended. For the treatment of respiratory exacerbations in cystic fibrosis patients, treatment should be continued up to 12 days. Children and adults (including elderly): Up to 60kg: 50,000 units/kg/day to a maximum of 75,000 units/kg/day. The total daily dose should be divided into three doses given at approximately 8-hour intervals. Over 60kg: 1-2 million units three times a day. The maximum dose is 6 million units in 24 hours. Renal impairment: In moderate to severe renal impairment, excretion of colistimethate sodium is delayed. Dosage in Renal Impairment (for over 60 kg body weight): - Mild (CrCl 20-50 ml/min): 1-2 million units every 8 hr. - Moderate (CrCl 10-20 ml/min): 1 million units every 12-18 hr. - Severe (CrCl <10 ml/min): 1 million units every 18-24 hr.