Brand and Other Names:Synercid
- Classes: Streptogramins
Dosing & Uses
Dosage Forms & Strengths
powder for injection
Dosage Forms & Strengths
powder for injection
Safety & efficacy < 16 years old has not been established
Serious - Use Alternative
Significant - Monitor Closely
Local pain (40-44%)
Inflammation at infusion site (38-42%)
Local edema (17-18%)
Infusion site reaction (12-13%)
Vomiting (3% to 4%)
incr LDH (3%)
Incr CPK (2%)
Incr GGT (2%)
Black Box Warnings
Approved for serious or life-threatening VREF bacteremia. Marketed under FDA accelerated program.
Hypersensitivity to drug, or other streptogramins (eg, pristinamycin, virginiamycin)
Not active against E. faecalis
Pregnancy & Lactation
Pregnancy Category: B
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.
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
Feces (75-77% as unchanged drug & metabolites)
Enzymes Inhibited: CYP3A4
Mechanism of Action
Inhibits protein synthesis at bacterial ribosome
Quinupristin & dalfopristin act synergistically
Solution: NaCl-containing diluents
Y-site: aztreonam, ciprofloxacin, fenoldopam, fluconazole, haloperidol, metoclopramide, KCl
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
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
Refrigerate unopened vials
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