Colistimethate (Colistin)

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

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

See package insert.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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