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Colistimethate Side Effects

Medically reviewed by Last updated on Apr 7, 2022.

For the Consumer

Applies to colistimethate: injection powder for solution

Side effects requiring immediate medical attention

Along with its needed effects, colistimethate may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking colistimethate:

Incidence not known

  • Blood in the urine
  • bluish lips or skin
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in the frequency or amount of urine
  • cough
  • decrease in amount of urine
  • difficulty with breathing or swallowing
  • dizziness
  • drowsiness
  • fast heartbeat
  • fever
  • hives, itching, skin rash
  • increased thirst
  • loss of appetite
  • nausea or vomiting
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • slurred speech
  • swelling of the feet or lower legs
  • tightness in the chest
  • tingling of the arms, legs, and tongue
  • troubled breathing
  • unusual tiredness or weakness

Get emergency help immediately if any of the following symptoms of overdose occur while taking colistimethate:

Symptoms of overdose

  • Dizziness
  • mood or mental changes
  • shakiness and unsteady walk
  • uncontrolled eye movements
  • unsteadiness, trembling, or other problems with muscle control or coordination
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

Side effects not requiring immediate medical attention

Some side effects of colistimethate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  • Diarrhea
  • dizziness or lightheadedness
  • feeling of constant movement of self or surroundings
  • redness of the skin
  • sensation of spinning
  • stomach cramps or pain
  • swelling, tenderness, or pain at the injection site

For Healthcare Professionals

Applies to colistimethate: compounding powder, injectable powder for injection

Nervous system

Nervous system side effects have included tingling of the tongue and extremities, slurred speech, dizziness, vertigo, paresthesia, confusion, psychosis, and seizures. Neuromuscular blockade may occur with overdoses.[Ref]


Respiratory side effects have included respiratory distress and apnea. Inhalation treatment has been associated with cough and bronchospasm. At least one case of fatal acute respiratory distress syndrome with nebulized colistimethate has been reported.[Ref]


Dermatologic side effects have included generalized itching, urticaria, and rash.[Ref]


Gastrointestinal side effects have included gastrointestinal upset, nausea, and vomiting.[Ref]


Hypersensitivity side effects have included rash, drug fever, and eosinophilia.[Ref]


Local side effects have included pain at the injection site.[Ref]


Musculoskeletal side effects have included muscular weakness.[Ref]


Other side effects have included fever.[Ref]


Renal side effects have included increases in blood urea nitrogen and serum creatinine, nephrotoxicity, decreased urine output, acute tubular necrosis, and hematuria.[Ref]


1. "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis (2001):

2. Hartzell JD, Neff R, Ake J, et al. "Nephrotoxicity Associated with Intravenous Colistin (Colistimethate Sodium) Treatment at a Tertiary Care Medical Center." Clin Infect Dis 48 (2009): 1724-8

3. Lindesmith LA, Baines RD Jr, Bigelow DB, Petty TL "Reversible respiratory paralysis associated with polymyxin therapy." Ann Intern Med 68 (1968): 318-27

4. McCoy KS "Compounded colistimethate as possible cause of fatal acute respiratory distress syndrome." N Engl J Med 357 (2007): 2310-1

Further information

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

Some side effects may not be reported. You may report them to the FDA.