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Coly Mycin M (colistimethate) Disease Interactions

There are 3 disease interactions with Coly Mycin M (colistimethate):

Major

Polymyxin Antibiotics (Includes Coly Mycin M) ↔ Neurotoxicity

Severe Potential Hazard, Moderate plausibility

Applies to: Botulism, CNS Disorder, Myoneural Disorder

Parenteral use of polymyxin antibiotics may be associated with dose-related neurotoxic effects such as dizziness, drowsiness, confusion, irritability, nystagmus, muscle weakness, circumoral paresthesia, numbness of the extremities, slurred speech, ataxia, coma, and seizures. In addition, respiratory paralysis may occur as a result of neuromuscular blockade, particularly in patients with neuromuscular disease (e.g., myasthenia gravis, parkinsonian syndrome, botulism) or hypocalcemia and in patients receiving general anesthetics or neuromuscular blocking agents. Therapy with polymyxin antibiotics should be administered cautiously in patients at risk for neurotoxicity. The normally recommended dosages should not be exceeded in such patients, and renal function and serum drug concentrations should be monitored frequently during therapy to avoid excessive drug accumulation.

References

  1. "Product Information. Aerosporin (polymyxin B sulfate)." Glaxo Wellcome, Research Triangle Pk, NC.
  2. "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis, Morris Plains, NJ.
  3. "Multum Information Services, Inc. Expert Review Panel"
Major

Polymyxin Antibiotics (Includes Coly Mycin M) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Parenteral use of polymyxin antibiotics may be associated with dose-related neuro- and nephrotoxic effects. Neurotoxicity may manifest as dizziness, drowsiness, confusion, irritability, nystagmus, muscle weakness, circumoral paresthesia, numbness of the extremities, slurred speech, ataxia, coma, seizures, and respiratory paralysis. Nephrotoxicity is usually evidenced by albuminuria, cellular casts, azotemia, increased serum concentrations of creatinine and BUN, and elevated drug levels without an increase in dose. Although mild nephrotoxicity is generally reversible following discontinuation of the drug, renal failure and acute tubular necrosis have occurred. Therapy with polymyxin antibiotics should be administered cautiously at reduced dosages in patients with renal impairment, since they may be at increased risk for neuro- and nephrotoxicity due to drug accumulation. To minimize the risk of toxicity, the usual dosage should not be exceeded, use with other neuro- and nephrotoxic agents should be avoided, and serum drug concentrations should be periodically determined and dosage adjusted to maintain desired levels. Renal function should be closely monitored, and the dosage reduced or therapy withdrawn if toxicity develops. Diminishing urinary output, rising BUN or serum creatinine, and/or signs of respiratory paralysis are indications for discontinuing therapy.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  2. "Product Information. Aerosporin (polymyxin B sulfate)." Glaxo Wellcome, Research Triangle Pk, NC.
  3. "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis, Morris Plains, NJ.
Moderate

Antibiotics (Includes Coly Mycin M) ↔ Colitis

Moderate Potential Hazard, Low plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
View all 47 references

Coly Mycin M (colistimethate) drug Interactions

There are 74 drug interactions with Coly Mycin M (colistimethate)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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