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Colistimethate sodium (Colistin) - Coly-Mycin®

Usual Dosing (Adults)

DOSAGE AND ADMINISTRATION
Important:
Colistimethate for injection is supplied in vials containing colistimethate sodium equivalent to 150 mg colistin base activity per vial.

Reconstitution:
The 150 mg vial should be reconstituted with 2.0 mL Sterile Water for Injection, USP. The reconstituted solution provides colistimethate sodium at a concentration equivalent to 75 mg/mL colistin base activity.

During reconstitution swirl gently to avoid frothing.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. If these conditions are observed, the product should not be used.

Dosage---------------------------
Adults and pediatric patients – Intravenous or Intramuscular Administration:
Colistimethate for injection should be given in 2 to 4 divided doses at dose levels of 2.5 to 5 mg/kg per day for patients with normal renal function, depending on the severity of the infection.

In obese individuals, dosage should be based on ideal body weight.

The daily dose should be reduced in the presence of renal impairment. Modifications of dosage in the presence of renal impairment are presented in Table 1 below:

Renal Dosing

dialysis

TABLE 1. Suggested Modification of Dosage Schedules of Colistimethate for Injection for Adults with Impaired Renal function
Note: The suggested unit dose is 2.5 to 5 mg/kg; however, the time INTERVAL between injections should be increased in the presence of impaired renal function.
Renal Function Degree of Impairment
  Normal Mild Moderate Considerable
Plasma creatinine, mg/100 mL 0.7-1.2 1.3-1.5 1.6 -2.5 2.6- 4.0
         
Urea clearance, % of normal 80-100 40-70 25-40 10-25
         
Dosage        
Unit dose of Colistimethate
for injection , mg
100–150 75–115 66–150 100–150
Frequency, times/day 4 to 2 2 2 or 1 every 36 hr
Total daily dose, mg 300 150–230 133–150 100
Approximate daily dose, mg/kg/day 5 2.5–3.8 2.5 1.5
  Normal
0.7-1.2
Mild
1.3- 1.5
Moderate
1.6- 2.5
Considerable
2.6- 4.0
Summary: 2.5 - 5 mg/kg/day in 2 to 4 divided doses. 2.5 - 3.8 mg/kg/day in 2  divided doses. 1.6 - 2.5 mg/kg/day in 1 to 2 divided doses. ~1.5 mg/kg q36 hours

Hemodialysis

dialysis See package insert.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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