Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

polymyxin B (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatric

Systemic Infections

IV: 15,000-25,000 units/kg/day divided q12hr; not to exceed 25,000 units/kg/day

IM: 25,000-30,000 units/kg/day divided q4-6hr

Intrathecal: 50,000 qDay for 3-4 days; then qDay or qODay for at least 2 weeks after CSF cultures are negative and normal for glucose content

Total daily dose not to exceed 2,000,000 units/day

Renal Impairment

CrCl >20 mL/minute: give 75-100% usual dose/day divided q12hr

CrCl 5-20 mL/minute: give 50% usual dose/day divided q12hr

CrCl <5 mL/minute: give 15% usual dose/day q12hr

Other Information

Monitor: renal function

Other Indications & Uses

Bacterial Septicemia due to P. aeruginosa, E. aerogenes, & K. pneumoniae, H. Influenzae Meningitis, UTI due to E. coli

Systemic Infections

Infants

  • IM: May receive up to 40,000 units/kg/day divided q6hr if renal function healthy
  • IV: May receive up to 40,000 units/kg/day divided q12hr;
  • Intrathecal: 20,000 units/day for 3-4 days; follow with 25,000 units qODay for at least 2 weeks after CSF cultures are negative and CSF (glucose) has returned to normal

Children

  • IM: 25,000-30,000 units/kg/day divided q12hr
  • IV: 15,000-25,000 units/kg/day divided q12hr; not to exceed 25,000 units/kg/day
  • Intrathecal: 50,000 qDay for 3-4 days; then qDay or qODay for at least 2 weeks after CSF cultures are negative and normal for glucose content

Renal Impairment

CrCl >20 mL/min: give 75-100% usual dose/day divided q12hr

CrCl 5-20 mL/min: give 50% usual dose/day divided q12hr

CrCl <5 mL/min: give 15% usual dose/day q12hr

Other Information

Monitor: renal function

Next

Interactions

Interaction Checker

polymyxin B and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            Frequency Not Defined

            Anaphylactoid reactions with dyspnea and tachycardia

            Eosinophilia

            Fever

            Nephrotoxicity

            Neurotoxicity

            Skin exanthemata

            Urticaria

            Previous
            Next

            Warnings

            Contraindications

            Hypersensitivity

            Cautions

            Oliguria, myasthenia gravis, pregnancy, renal disease

            Potential risk of nephrotoxicity and neurotoxicity

            May inhibit neuromuscular transmission

            Inactivated by strong acidic or alkaline solution

            Discontinue if diminished urine output, rise in SCr or BUN, or signs of respiratory paralysis appear

            Do not use IM routinely, particularly in peds, because of severe inj site pain

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy Category: B: use when benefits outweigh risks

            Lactation: use caution; no data

            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.

            more...
            Previous
            Next

            Pharmacology

            Distribution: wide, does not cross placenta or aqueous humor of eye; does not appear in CSF or synovial fluid

            Peak Plasma

            Time: IM: 2 hr

            Concentration: 20-40 KU IM dose: 1-8 mcg/mL

            Other Information

            Protein Bound: 79-92%

            Half-life elimination: 4.3-6 hr with normal renal function

            Metabolism: N/A

            Excretion: urine 60% (<1% as unchanged drug)

            Dialyzable: HD; no; PD: no

            Mechanism of Action

            Bactericidal; causes leakage of bacterial membrane by binding to phospholipids.

            Previous
            Next

            Administration

            IV Incompatibilities

            Additive: amphotericin B, chloramphenicol Na succinate, chlorothiazide, heparin, MgSO4

            Syringe: ampicillin(?)

            IV Compatibilities

            Additive: amikacin, ascorbic acid, colistimethate, diphenhyramine, erythromycin lactobionate, hydrocortisone Na succinate, kanamycin, pencillin G potassium, penicillin G Na, phenobarbital, ranitidine, vit B/C

            Syringe: penicillin G Na

            Y-site: esmolol

            IV/IM/IT Preparation

            IV: dilute 500,000 U in 300-500 mL D5W

            IM: reconstitute vial with 2 mL SWI , NS, or procaine HCl 1% solution

            Intrathecal (IT): reconstitute vial with10 mL NS; DO NOT use procaine HCl for IT

            IV/IM Administration

            IV: infuse over 60-90 min

            IM: give deep into upper outer quadrant of gluteal muscles

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            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.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.