capreomycin (Rx)

Brand and Other Names:Capastat
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 1g/vial
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Tuberculosis

1 g qDay (not to exceed 20 mg/kg/day), given IM or by IV infusion for 60-120 days

Maintenance dose: 1 g IM or IV infusion 2 or 3 times weekly; maintain therapy for tuberculosis for 12 to 24 months; 20 mg/kg/day maximum

Dosage Forms & Strengths

powder for injection

  • 1g/vial
more...

Tuberculosis (Off-label)

Per CTC/IDSA/ATS/AAP recommendation

<15 years old and <40 kg: 15-30 mg/kg IV/IM qDay; maximum 1 g/day for 2-4 months followed by 15-30 mg/kg given twice weekly; maximum 1 g/day

>15 years old and >40 kg: 15 mg/kg IV/IM; maximum 1 g/day for 2-4 months followed by 15 mg/kg 2-3 times/week; maximum 1 g/dose

Always used in conjunction with other antitubercular agents

Monitor: Renal function qWeek, serum potassium

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Interactions

Interaction Checker

and capreomycin

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >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

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            Warnings

            Black Box Warnings

            Use great caution in patients with renal insufficiency and pre-existing auditory impairment. Weigh the risk of additional cranial nerve VIII impairment or renal injury against the benefits of the therapy. Simulatneous administration with parenteral nonantituberculous agents with ototoxic potential (e.g., polymixin A sulfate, colisitin sulfate, amikacin, gentamicin, tobramycin, vancompycin, kanamycin, and neomycin) is not recommended.

            Coadministration with antituberculous agents like streptomycin is also not recommended since they have similar and sometimes irreversible effects in cranial nerve VIII.

            Safety in pregnancy has not been determined.

            Effectiveness in pediatric patients has not been established.

            Contraindications

            Hypersensitivity

            Pregnancy

            Cautions

            Renal impairment, auditory impairment, history of allergic rxns

            Risk of hypokalemia

            Risk of rare but potentially fatal toxic nephritis

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Half-life: 4-6 hr, prolonged in renal impairment

            Peak Plasma Time: 1-2 hr

            Excretion: urine

            Mechanism of Action

            Polypeptide antibiotic complex of 4 microbiologically active components, bacteriostatic

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            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

            Storage

            Reconstituted soln may be stored at 2-8°C for 24 hr

            Darkening or pale straw color development may occur over time, does NOT indicate loss of potency

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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