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Avycaz Dosage

Generic name: CEFTAZIDIME 2g, AVIBACTAM SODIUM 0.5g
Dosage form: powder, for solution

Medically reviewed on February 26, 2018.

2.1 Recommended Dosage

The recommended dosage of AVYCAZ is 2.5 grams (ceftazidime 2 grams and avibactam 0.5 grams) administered every 8 hours by intravenous (IV) infusion over 2 hours in patients 18 years of age and older in patients with normal renal function. For treatment of cIAI, metronidazole should be given concurrently. The guidelines for dosage of AVYCAZ in patients with creatinine clearance [CrCl] greater than 50 mL/min are listed in Table 1.

Table 1. Dosage of AVYCAZ 2.5 grams (ceftazidime 2 grams and avibactam 0.5 grams) by Indication
Infection Dosage Frequency Infusion Time
(hours)
Duration of Treatment
Complicated Intra-abdominal
Infections [used in combination with
metronidazole]
2.5 grams Every 8 hours 2 5 to 14 days
Complicated Urinary Tract
Infections including Pyelonephritis
2.5 grams Every 8 hours 2 7 to 14 days
Hospital-acquired Bacterial
Pneumonia and Ventilator-associated
Bacterial Pneumonia
2.5 grams Every 8 hours 2 7 to 14 days

2.2 Dosage Adjustments in Patients with Renal Impairment

The recommended AVYCAZ dosage in patients with varying degrees of renal function is presented in Table 2. For patients with changing renal function, monitor CrCl at least daily and adjust the dosage of AVYCAZ accordingly [see Warnings and Precautions (5.1), Use in Specific Populations (8.6) and Clinical Pharmacology (12.3)].

Table 2. Dosage of AVYCAZ in Patients with Renal Impairment
Estimated Creatinine
Clearance (mL/minute)
a
Recommended Dosage Regimen for AVYCAZ (ceftazidime and avibactam)b
31 to 50 AVYCAZ 1.25 grams (ceftazidime 1 gram and avibactam 0.25 grams) intravenously every 8 hours
16 to 30 AVYCAZ 0.94 grams (ceftazidime 0.75 grams and avibactam 0.19 grams) intravenously every 12
hours
6 to 15c AVYCAZ 0.94 grams (ceftazidime 0.75 grams and avibactam 0.19 grams) intravenously every 24
hours
Less than or equal to 5c AVYCAZ 0.94 grams (ceftazidime 0.75 grams and avibactam 0.19 grams) intravenously every 48
hours

a As calculated using the Cockcroft-Gault formula
b All doses of AVYCAZ are administered over 2 hours
c Both ceftazidime and avibactam are hemodialyzable; thus, administer AVYCAZ after hemodialysis on hemodialysis days

2.3 Preparation of the AVYCAZ Solution for Administration

AVYCAZ is supplied as a dry powder, which must be constituted and subsequently diluted, using aseptic technique prior to intravenous infusion.

a) Constitute the powder in the AVYCAZ vial with 10 mL of one of the following solutions:
● sterile water for injection, USP
● 0.9% of sodium chloride injection, USP (normal saline)
● 5% of dextrose injection, USP
● all combinations of dextrose injection and sodium chloride injection, USP, containing up to 2.5% dextrose, USP, and 0.45% sodium chloride, USP,
or
● lactated Ringer’s injection, USP

b) Mix gently. The constituted AVYCAZ solution will have an approximate ceftazidime concentration of 0.167 grams/mL and an approximate avibactam concentration of 0.042 grams/mL. The final volume is approximately 12 mL. The constituted solution is not for direct injection. The constituted solution must be diluted before intravenous infusion.

c) Prepare the required dose for intravenous infusion by withdrawing the appropriate volume determined from Table 3 from the constituted vial.

Table 3. Preparation of AVYCAZ Doses
AVYCAZ (ceftazidime and avibactam) Dose Volume to Withdraw from Constituted Vial for Further Dilution to
50 to 250 mL
2.5 grams (2 grams and 0.5 grams) 12 mL (entire contents)
1.25 grams (1 gram and 0.25 grams) 6 mL
0.94 grams (0.75 grams and 0.19 grams) 4.5 mL

d) Before infusion, dilute the withdrawn volume of the constituted AVYCAZ solution further with the same diluent used for constitution of the powder (except sterile water for injection), to achieve a total volume between 50 mL (ceftazidime 0.04 grams/mL and avibactam 0.01 grams/mL) to 250 mL (ceftazidime 0.008 grams/mL and avibactam 0.002 grams/mL) in an infusion bag. If sterile water for injection was used for constitution, use any of the other appropriate constitution diluents for dilution.

e) Mix gently and ensure that the contents are dissolved completely. Visually inspect the diluted AVYCAZ solution (for administration) for particulate matter and discoloration prior to administration (the color of the AVYCAZ infusion solution for administration ranges from clear to light yellow).

f) Use the diluted AVYCAZ solution in the infusion bags within 12 hours when stored at room temperature.

g) The diluted AVYCAZ solution in the infusion bags may be stored under refrigeration at 2 to 8°C (36 to 46°F) up to 24 hours following dilution and used within 12 hours of subsequent storage at room temperature.

2.4 Drug Compatibility

The AVYCAZ solution for administration at the range of diluted concentrations of ceftazidime 0.008 g/mL and avibactam 0.002 g/mL to ceftazidime 0.04 g/mL and avibactam 0.01 g/mL is compatible with the more commonly used intravenous infusion fluids in infusion bags (including Baxter® Mini-Bag Plus) such as:

  • 0.9% sodium chloride injection, USP
  • 5% dextrose injection, USP
  • all combinations of dextrose injection and sodium chloride injection, USP, containing up to 2.5% dextrose, USP, and 0.45% sodium chloride, USP
  • lactated ringer's injection, USP, and
  • Baxter® Mini-Bag Plus containing 0.9% sodium chloride injection or 5% dextrose injection

Intravenous Line Compatibility

Simulated Y-site compatibility of AVYCAZ admixed with other drug products in a 1:1 volume ratio at room temperature was evaluated by visual inspection, and measurement of turbidity and particulate matter at 0, 1 and 4 hours after mixing. Compatible drugs with the corresponding compatible diluent (i.e., 0.9% Sodium Chloride Injection, 5 % Dextrose Injection or Lactated Ringer’s Injection) are listed in Tables 4, 5, 6 and 7 below. Any drug products not listed in the tables below should not be co-administered with AVYCAZ through the same intravenous line (or cannula).

Table 4. Compatible Drugs for use with 0.9% Sodium Chloride, 5% Dextrose or Lactated Ringer’s Injection as Diluents
Daptomycin
Dexmedetomidine H Cl
Dopamine HCl
Furosemide
Gentamicin Sulfate
Imipenem-cilastatin
Magnesium Sulfate
Norepinephrine Bitartrate
Phenylephrine HCl
Vasopressin
Vecuronium Bromide
Table 5. Compatible Drugs for use with 0.9% Sodium Chloride or 5% Dextrose Injection as Diluents
Ertapenem Sodium
Potassium Phosphate
Sodium Glycerophosphate
Table 6. Compatible Drugs for use with 5% Dextrose or Lactated Ringer’s Injection as Diluents
Heparin Sodium
Linezolid
Tobramycin Sulfate
Table 7. Compatible Drugs for use with One Compatible Diluent only
Meropenem (0.9% Sodium Chloride Injection diluent only)
Sodium Bicarbonate (5% Dextrose Injection diluent only
Tedizolid Phosphate (5% Dextrose Injection diluent only)
Potassium Chloride (Lactated Ringer’s Injection diluent only)

2.5 Storage of Constituted Solutions

Upon constitution with appropriate diluent, the constituted AVYCAZ solution may be held for no longer than 30 minutes prior to transfer and dilution in a suitable infusion bag.

Following dilution of the constituted solutions with the appropriate diluents, AVYCAZ solutions in the infusion bags are stable for 12 hours when stored at room temperature.

Following dilution of the constituted solutions with the appropriate diluents, AVYCAZ solutions in the infusion bags may also be refrigerated at 2 to 8°C (36 to 46°F) for up to 24 hours; and then should be used within 12 hours of subsequent storage at room temperature.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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