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Tigecycline Dosage

Applies to the following strength(s): 50 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for Intraabdominal Infection

100 mg IV initial dose, followed by 50 mg IV every 12 hours
Duration of therapy: 5 to 14 days

Approved indication: For the treatment of complicated intraabdominal infections due to susceptible isolates of Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, K pneumoniae, Enterococcus faecalis (vancomycin-susceptible isolates), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus anginosus group (includes S anginosus, S intermedius, and S constellatus), Bacteroides fragilis, B thetaiotaomicron, B uniformis, B vulgatus, Clostridium perfringens, and Peptostreptococcus micros

Usual Adult Dose for Skin or Soft Tissue Infection

100 mg IV initial dose, followed by 50 mg IV every 12 hours
Duration of therapy: 5 to 14 days

Comments:
-Tigecycline is not for the treatment of diabetic foot infections; clinical trial failed to show its non-inferiority.

Approved indication: For the treatment of complicated skin and skin structure infections due to susceptible isolates of E coli, E faecalis (vancomycin-susceptible isolates), S aureus (methicillin-susceptible and -resistant isolates), S agalactiae, S anginosus group (includes S anginosus, S intermedius, and S constellatus), S pyogenes, E cloacae, K pneumoniae, and B fragilis

Usual Adult Dose for Skin and Structure Infection

100 mg IV initial dose, followed by 50 mg IV every 12 hours
Duration of therapy: 5 to 14 days

Comments:
-Tigecycline is not for the treatment of diabetic foot infections; clinical trial failed to show its non-inferiority.

Approved indication: For the treatment of complicated skin and skin structure infections due to susceptible isolates of E coli, E faecalis (vancomycin-susceptible isolates), S aureus (methicillin-susceptible and -resistant isolates), S agalactiae, S anginosus group (includes S anginosus, S intermedius, and S constellatus), S pyogenes, E cloacae, K pneumoniae, and B fragilis

Usual Adult Dose for Pneumonia

100 mg IV initial dose, followed by 50 mg IV every 12 hours
Duration of therapy: 7 to 14 days

Comments:
-Tigecycline is not for the treatment of hospital-acquired or ventilator-associated pneumonia; greater mortality and decreased efficacy reported in comparative clinical trial.

Approved indication: For the treatment of community-acquired bacterial pneumonia due to susceptible isolates of S pneumoniae (penicillin-susceptible isolates), including cases with concurrent bacteremia, Haemophilus influenzae (beta-lactamase negative isolates), and Legionella pneumophila

Usual Pediatric Dose for Intraabdominal Infection

Proposed for complicated infections:
8 to 11 years: 1.2 mg/kg IV every 12 hours
Maximum dose: 50 mg/dose

12 to 17 years: 50 mg IV every 12 hours

Comments:
-Tigecycline should not be used unless no alternative antibacterial agents are available.
-Safety and efficacy of the suggested regimens have not been evaluated due to the increase in mortality observed in tigecycline-treated adult patients.
-Proposed doses based on exposures seen in pharmacokinetic trials (small numbers of pediatric patients included).

Usual Pediatric Dose for Skin and Structure Infection

Proposed for complicated infections:
8 to 11 years: 1.2 mg/kg IV every 12 hours
Maximum dose: 50 mg/dose

12 to 17 years: 50 mg IV every 12 hours

Comments:
-Tigecycline should not be used unless no alternative antibacterial agents are available.
-Safety and efficacy of the suggested regimens have not been evaluated due to the increase in mortality observed in tigecycline-treated adult patients.
-Proposed doses based on exposures seen in pharmacokinetic trials (small numbers of pediatric patients included).

Usual Pediatric Dose for Pneumonia

Proposed for community-acquired bacterial pneumonia:
8 to 11 years: 1.2 mg/kg IV every 12 hours
Maximum dose: 50 mg/dose

12 to 17 years: 50 mg IV every 12 hours

Comments:
-Tigecycline should not be used unless no alternative antibacterial agents are available.
-Safety and efficacy of the suggested regimens have not been evaluated due to the increase in mortality observed in tigecycline-treated adult patients.
-Proposed doses based on exposures seen in pharmacokinetic trials (small numbers of pediatric patients included).

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Mild to moderate liver dysfunction (Child-Pugh A and B): No adjustment recommended.
Severe liver dysfunction (Child-Pugh C): 100 mg IV initial dose, followed by 25 mg IV every 12 hours; caution recommended

Precautions

Consult WARNINGS section for dosing related precautions.

Dialysis

Hemodialysis: No adjustment recommended.
Peritoneal dialysis: Data not available

Other Comments

Administration advice:
-Reserve tigecycline for situations when alternative therapies are not suitable.
-Duration of therapy should be guided by the severity and site of the infection and clinical and bacteriological progress of the patient.
-Administer IV infusions over 30 to 60 minutes through a dedicated line or through a Y-site.
-If same IV line used for sequential infusion of several drugs, flush the line before and after tigecycline infusion; the manufacturer's product information should be consulted.

Storage requirements:
-Prior to reconstitution: Should be stored at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F)
-After reconstitution: Tigecycline may be stored at room temperature (not to exceed 25C [77F]) for up to 24 hours (up to 6 hours in the vial and the remaining time in the IV bag); if storage conditions exceed 25C (77F), tigecycline should be used immediately. Alternatively, tigecycline mixed with 0.9% Sodium Chloride Injection, USP or 5% Dextrose Injection, USP may be stored refrigerated at 2C to 8C (36F to 46F) for up to 48 hours after immediate transfer of reconstituted solution into the IV bag.

Reconstitution/preparation techniques:
-The manufacturer's product information should be consulted.

IV compatibility:
-Compatible IV solutions: 0.9% Sodium Chloride Injection, USP, 5% Dextrose Injection, USP, Lactated Ringer's Injection, USP
-Compatible drugs/diluents (when used with 0.9% Sodium Chloride Injection, USP or 5% Dextrose Injection, USP): Amikacin, dobutamine, dopamine hydrochloride (HCl), gentamicin, haloperidol, Lactated Ringer's, lidocaine HCl, metoclopramide, morphine, norepinephrine, piperacillin-tazobactam (EDTA formulation), potassium chloride, propofol, ranitidine HCl, theophylline, tobramycin
-Incompatible drugs: Amphotericin B, amphotericin B lipid complex, diazepam, esomeprazole, omeprazole

General:
-Appropriate specimens should be obtained for bacteriological examination to isolate and identify causative organisms and determine susceptibility to tigecycline; may start tigecycline as empiric monotherapy before test results are known.
-Each vial contains 100 mg lactose monohydrate.

Monitoring:
-General: For superinfection (during therapy); treatment response in patients with severe liver dysfunction
-Hepatic: For worsening hepatic function in patients who develop abnormal liver function tests during therapy

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