- March 15, 2022
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Brand Name :
Coly-Mycin M
Synonyms :
colistimethate
Class :
Antibiotics, Miscellaneous
Dosage Forms & Strengths
Solution for injection
150mg
Indicated for gram-negative infection
2.5-5 mg/kg each day intravenously or intramuscularly in 2-4 divided dose, based on infection severity
Do not exceed the dose of more than 5 mg/kg each day
50-75mg can be inhaled as normal saline through nebulizer 2-3 times daily
Dosage Forms & Strengths
Solution for injection
150mg
Indicated for gram-negative infection
2.5-5 mg/kg each day intravenously or intramuscularly in 2-4 divided dose, based on infection severity
Do not exceed the dose of more than 5 mg/kg each day
50-75mg can be inhaled as normal saline through nebulizer 2-3 times daily
For neonates, in the treatment of ventilator-associated pneumonia, administer 4mg/kg in each dose through inhalation
Refer to the adult dosing
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased nephrotoxic effect when combined with colistimethate
neomycin/polymyxin B/bacitracin topical
may have an increased nephrotoxic effect when combined with colistimethate
may have an increased nephrotoxic effect when combined with colistimethate
may have an increased nephrotoxic effect when combined with colistimethate
may have an increased nephrotoxic effect when combined with colistimethate
may have an increased nephrotoxic effect when combined with colistimethate
polymyxin B/bacitracin topical
may have an increased nephrotoxic effect when combined with polymyxin b
may increase the nephrotoxic effect of aminoglycosides
may have an increased nephrotoxic effect when combined with colistimethate
may increase the nephrotoxic effect of colistimethate
neomycin/polymyxin B/gramicidin ophthalmic
may increase the nephrotoxic effect of Polymyxin B
may have an increased nephrotoxic effect when combined with colistimethate
may have an increased nephrotoxic effect when combined with bacitracin
colistimethate increases the neuromuscular blocking effect of mecamylamine
may have an increased neuromuscular-blocking effect when combined with mecamylamine
colistimethate increases the nephrotoxicity of bacitracin
may have an increased nephrotoxic effect when combined with netilmicin
may have an increased nephrotoxic effect when combined with colistimethate
it may diminish the excretion rate when combined with gadofosveset, resulting in an enhanced serum level
May increase the nephrotoxicity of aminoglycoside antibiotics
May increase the nephrotoxicity of aminoglycoside antibiotics
may have an increased neuromuscular-blocking effect when combined with colistimethate
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
Actions and Spectrum
Actions:
colistimethate, also known as colistin or polymyxin E, exerts its antibiotic activity by disrupting the integrity of bacterial cell membranes, leading to cell death. The drug targets Gram-negative bacteria, including those resistant to many other antibiotics.
Spectrum:
colistimethate primarily targets Gram-negative bacteria, including those resistant to many other antibiotics. It is effective against bacteria such as Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae, which are known to cause severe hospital-acquired infections—colistimethate works by disrupting the integrity of the bacterial cell membrane, leading to cell death.
Frequency not defined
chest tightness
cough
decreased urine
difficult swallowing
fast heartbeat
fever
dizziness
drowsiness
hives, itching, skin rash
nausea or vomiting
increased thirst
loss of appetite
Black Box Warning:
None
Contraindication/Caution:
Contraindications:
Cautions:
Pregnancy consideration:
Pregnancy Category: C
Breastfeeding warnings:
colistimethate is excreted in small amounts in breast milk; hence, utilize it cautiously.
Pregnancy category:
Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: No data is available for the drug under this category.
Pharmacology:
colistimethate, or colistin methanesulfonate, is an antibiotic medication used to treat severe bacterial infections, particularly those caused by multidrug-resistant Gram-negative bacteria. It belongs to a class of antibiotics known as polymyxins. colistimethate is not absorbed well from the gastrointestinal tract and is typically administered through inhalation or intravenous routes for systemic infections.
Pharmacodynamics:
The effectiveness of colistimethate is influenced by factors such as the concentration of the drug at the infection site, the susceptibility of the specific bacterial strain, and the interaction between colistin and the bacterial cell membrane. Achieving an appropriate therapeutic concentration of colistin is crucial for achieving bactericidal effects.
Pharmacokinetics:
Absorption
When administered intravenously, colistimethate is hydrolyzed by enzymes in the body to form colistin, its active component. This active colistin is then distributed throughout the body to exert its antibacterial effects.
Distribution
Colistin, the active form of colistimethate, is distributed widely throughout the body, including tissues and fluids. However, the penetration into specific tissues, such as the central nervous system, is limited due to the hydrophilic nature of colistin.
Metabolism
colistimethate is a prodrug that undergoes hydrolysis by endogenous enzymes to form colistin. The conversion of colistimethate to colistin is essential for the drug to exert its antibacterial effects.
Elimination and excretion
Colistin is eliminated from the body primarily through renal excretion. The kidneys play a crucial role in clearing colistin from the bloodstream. Due to this elimination route, colistin exposure can lead to nephrotoxicity, particularly in patients with impaired renal function. It’s important to monitor kidney function during treatment with colistimethate.
Administration:
Patient information leaflet
Generic Name: colistimethate
Pronounced as: koe-LIS-ti-METH-ate
Why do we use colistimethate?
colistimethate, also known as colistin or polymyxin E, is used in clinical practice for specific situations where infections caused by multidrug-resistant Gram-negative bacteria have proven difficult to treat with other antibiotics. It is considered a “last-resort” antibiotic due to its limited spectrum of activity, potential toxicity, and the development of bacterial resistance.
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Founded in 2014, medtigo is committed to providing high-quality, friendly physicians, transparent pricing, and a focus on building relationships and a lifestyle brand for medical professionals nationwide.
MASSACHUSETTS – USA
60 Roberts Drive, Suite 313,
North Adams, MA 01247
MAHARASHTRA – INDIA
7, Shree Krishna, 2nd Floor,
Opp Kiosk Koffee,
Shirole Lane, Off FC Road,
Pune 411004, Maharashtra
