Capreomycin

Indications

Capreomycin is used for: Tuberculosis

Adult Dose

Parenteral Tuberculosis Adult: 1 g daily, by deep IM inj or IV infusion, for 2-4 mth, then 2-3 times wkly for the remainder of the therapy. Max: 20 mg/kg/day.

Child Dose

Renal Dose

Administration

IV Preparation Dissolve 1 g powder with 2, 2.15, 2.63, 3.3, or 4.3 mL of NS or SWI Allow 2-3 min to dissolve IV/IM Administration IM: deep IM into large muscle mass IV: dilute with 100 mL NS & infuse over 1 hr

Contra Indications

Hypersensitivity to capreomycin and other aminoglycosides.

Precautions

Patient w/ pre-existing auditory impairment. Renal impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor auditory, vestibular and renal function at baseline and during therapy; frequent assessment of serum electrolytes (e.g. Ca, Mg, K) and liver function.

Pregnancy-Lactation

Pregnancy Category: C Lactation: excretion in milk unknown; use with caution

Interactions

Additive and sometimes irreversible toxic effects w/ other parenteral anti-TB agents (e.g. streptomycin, viomycin). Increased risk of nephrotoxicity and ototoxicity w/ other non-antituberculosis drugs (e.g. polymyxin A sulfate, amikacin, gentamicin, tobramycin, vancomycin, kanamycin, neomycin).

Adverse Effects

Side effects of Capreomycin : >10% Nephrotoxicity, incr BUN (36%) Hearing loss (11% subclinical; 3% clinical) 1-10% Eosinophilia (dose related, >5%) <1% Incr LFTs Inj site pain/induration Leukopenia Maculopapular rash Urticaria

Mechanism of Action

Capreomycin is a cyclic polypeptide antimicrobial. It is bacteriostatic against various Mycobacteria, particularly those that have become resistant to primary anti-TB drugs.