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quinupristin/dalfopristin (Rx)Brand and Other Names:Synercid

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

quinupristin/dalfopristin

powder for injection

  • (150mg/350mg)/10mL
more...

Vanco-resistant Enterococcus Faecium

7.5 mg/kg IV over 1 hr, q8hr 

Skin & Structure Infection, Complicated

7.5 mg/kg IV over 1 hr, q12hr, x7 days 

S. aureus (MSSA), S. pyogenes

Dosage Forms & Strengths

quinupristin/dalfopristin

powder for injection

  • (150mg/350mg)/10mL
more...

Safety & efficacy < 16 years old has not been established

Vanco-resistant Enterococcus Faecium

7.5 mg/kg IV over 1 hr, q8hr 

16 years old

Skin & Structure Infection, Complicated

7.5 mg/kg IV over 1 hr, q12hr, x7 days  

16 years old

S. aureus (MSSA), S. pyogenes

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Interactions

Interaction Checker

quinupristin/dalfopristin and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Local pain (40-44%)

            Inflammation at infusion site (38-42%)

            Hyperbilirubinemia (3-35%)

            Local edema (17-18%)

            Infusion site reaction (12-13%)

            1-10%

            Arthralgia (<1-8%)

            Nausea (3-5%)

            Myalgia (<1-5%)

            Vomiting (3% to 4%)

            Anemia (3%)

            Diarrhea (3%)

            incr LDH (3%)

            Rash (3%)

            Pain (2-3%)

            Headache (2%)

            Incr CPK (2%)

            Incr GGT (2%)

            Pruritus (2%)

            Thrombophlebitis (2%)

            Hyperglycemia (1%)

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            Warnings

            Black Box Warnings

            Approved for serious or life-threatening VREF bacteremia. Marketed under FDA accelerated program.

            Contraindications

            Hypersensitivity to drug, or other streptogramins (eg, pristinamycin, virginiamycin)

            Cautions

            Not active against E. faecalis

            Hepatic impairment

            Inhibits CYP3A4

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: unknown

            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...
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            Pharmacology

            Distribution: quinupristin: 0.45 L/kg; dalfopristin: 0.24 L/kg

            Protein Bound: moderate

            Half-life elimination: quinupristin: 0.85 hr; dalfopristin: 0.7 hr (mean elimination half-lives, including metabolites: 3 & 1 hr, respectively)

            Metabolism: to active metabolites via nonenzymatic reactions

            Excretion

            Feces (75-77% as unchanged drug & metabolites)

            Urine (15-19%)

            Other Information

            Enzymes Inhibited: CYP3A4

            Mechanism of Action

            Inhibits protein synthesis at bacterial ribosome

            Quinupristin & dalfopristin act synergistically

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            Administration

            IV Incompatibilities

            Solution: NaCl-containing diluents

            IV Compatibilities

            Y-site: aztreonam, ciprofloxacin, fenoldopam, fluconazole, haloperidol, metoclopramide, KCl

            IV Preparation

            Reconstitute 500 mg-containing vial with 5 mL of D5W or SWI to obtain 100 mg/mL solution

            Do not shake; swirl gently to dissolve while limiting foam formation

            Dilute reconstituted solution within 30 min

            Reconstituted solution should be added to at least 250 mL of D5W for peripheral administration (increase to 500 mL or 750 mL if necessary to limit venous irritation). Final conc NMT 2 mg/mL

            An infusion volume of 100 mL may be used for central line infusions

            Do not freeze solution

            IV Administration

            Flush with D5W before and after administration; incompatible with saline

            Complete infusion over 1 hr (toxicity may be increased with shorter infusion)

            If severe venous irritation occurs following peripheral administration of quinupristin/dalfopristin diluted in 250 mL D5W, consider increasing the infusion volume to 500 mL or 750 mL, changing the infusion site, or infusing by a peripherally inserted central catheter (PICC) or a central venous catheter

            Storage

            Refrigerate unopened vials

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            Images

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            Formulary

            FormularyPatient Discounts

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            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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