Capreomycin
Pronouncation: (CAP-ree-oh-MY-sin)Class: Antituberculosis agent
Trade Names:
Capastat Sulfate
- Powder for injection 1 g (as sulfate)/vial
Pharmacology
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Interferes with protein synthesis.
Pharmacokinetics
Absorption
The T max is 1 to 2 h following IM administration.
Elimination
Approximately 52% of capreomycin is excreted unchanged in the urine within 12 h.
Indications and Usage
Treatment of tuberculosis concomitantly with other antituberculous agents.
Contraindications
Standard considerations.
Dosage and Administration
AdultsIV/IM 1 g/day (max, 20 mg/kg/day) for 60 to 120 days, followed by 1 g IV or IM 2 or 3 times weekly.
General Advice
- Reconstitute following manufacturer's instructions.
- Inspect reconstituted solution visually before administration. Do not administer if solution is cloudy, discolored, or contains particulate matter. Reconstituted solution may acquire a pale straw color and darken with time, but this is not associated with loss of potency.
- For IM administration, give reconstituted capreomycin by deep IM injection into large muscle mass.
- For IV infusion, dilute reconstituted capreomycin in 100 mL of sodium chloride 0.9% injection and infuse prescribed dose over 60 min.
- Do not add other medications to IV container.
Storage/Stability
Store powder for injection at controlled room temperature (59° to 86°F). Reconstituted solution may be stored for up to 24 h in refrigerator (36° to 46°F).
Drug Interactions
Aminoglycosides (eg, streptomycin)May increase the risk of respiratory paralysis and renal function impairment.
Nondepolarizing neuromuscular blocking agents (eg, tubocurarine)Neuromuscular blockade may be enhanced.
Laboratory Test Interactions
None well documented.
Adverse Reactions
EENT
Ototoxicity; hearing loss.
Genitourinary
Nephrotoxicity.
Hematologic
Leukocytosis; leukopenia; eosinophilia; thrombocytopenia.
Hepatic
Decreased bromosulfophthalein excretion; abnormal liver function tests.
Miscellaneous
Hypersensitivity (including febrile reactions, urticaria, maculopapular rash); pain; induration and excessive bleeding at injection site; sterile abscesses.
Precautions
MonitorIM injection sitesAssess IM injection sites for pain, bleeding, induration, or evidence of abscess formation. Inform health care provider if noted and significant. Mycobacterial studies/Susceptibility testsAssess mycobacterial studies and susceptibility tests before and periodically throughout therapy to detect possible resistance. |
Pregnancy
Category C.
Lactation
Undetermined.
Children
Safety and efficacy not established.
Renal Function
Dosage reduction is necessary.
Special Risk Patients
Use with great caution in patients with preexisting renal insufficiency or auditory impairment.
Hypokalemia
May occur during therapy.
Nephrotoxicity
Renal injury with tubular necrosis, elevation of BUN or serum creatinine, and abnormal urinary sediment may occur.
Ototoxicity
May occur; perform audiometric measurements and assess vestibular function prior to therapy and at regular intervals during treatment.
Patient Information
- Advise patient that medication will be prepared and administered by a health care provider in a health care setting.
- Review dosing schedule and prescribed length of therapy with patient. Emphasize to patient that treatment will be lengthy.
- Instruct patient to report the following symptoms to health care provider: ringing in the ears, vertigo (feeling of whirling motion), dizziness, hearing loss, itching, rash, pain, lumps, bleeding at injection site.
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More Capreomycin resources:
Capreomycin - Includes detailed dosage instructions.
