Close
New

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

 

tigecycline (Rx)Brand and Other Names:Tygacil

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 50mg/vial
more...

Complicated Intra-abdominal Infections

Initial: 100 mg IV infusion, THEN

50 mg IV infusion q12hr for 5-14 days

Complicated Skin Infections

Initial: 100 mg IV infusion, THEN

50 mg IV infusion q12hr for 5-14 days

Community-Acquired Pneumonia

Initial: 100 mg IV infusion, THEN

50 mg IV infusion q12hr for 7-14 days

Acute Myeloid Leukemia (Orphan)

Orphan designation for treatment of acute myeloid leukemia

Tigecycline selectively targets leukemia cells and leukemic stem cells by inhibiting mitochondrial protein synthesis

Orphan sponsor

  • Stem Cell Therapeutics Corporation; 96 Skyway Avenue; Toronto, ON M9W 4Y9, Canada

Dosing Modifications

Renal impairment: Dose adjustment not necessary (minimum dialyzed through hemodialysis or peritoneal dialysis)

Hepatic impairment

  • Severe (Child-Pugh C): Maintenance 25 mg IV q12hr (following initial 100 mg)

Dosing Considerations

Not indicated for the treatment of diabetic foot infections; a clinical trial failed to demonstrate noninferiority

Not indicated for the treatment of hospital-acquired or ventilator-associated pneumonia; in a comparative clinical trial, greater mortality and decreased efficacy were reported in tigecycline-treated patients

Susceptible organisms

  • Complicated skin infections caused by Escherichia coli, Enterococcus faecalis (vancomycin-susceptible only), Staphylococcus aureus (MRSA and methicillin-susceptible), Streptococcus pyogenes, Streptococcus anginosus grp, Streptococcus agalactiae, or Bacteroides fragilis
  • Complicated intra-abdominal infections caused by E coli, Enterococcus faecalis (vancomycin-susceptible only), S aureus (methicillin-susceptible only), Citrobacter freundii, Enterobacter cloacae, Klebsiella pneumoniae, K oxytoca, B thetaiotaomicron, B uniformis, B vulgatus, Clostridium perfringens, Peptostreptococcus micros
  • Community-acquired pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, Legionella pneumophila

<18 years: Safety and efficacy not established

Next

Interactions

Interaction Checker

tigecycline 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

            >10%

            Nausea (29.5%)

            Vomiting (19.7%)

            Diarrhea (12.7%)

            1-10%

            Infection (8.3%)

            Fever (7.1%)

            Abd pain (6.8%)

            Headache (5.9%

            HTN (4.9%)

            Anemia (4.2%)

            Dizziness (3.5%)

            Dyspnea (2.9%)

            Pruritus (2.6%)

            Rash (2.4%)

            Hypotension (2.3%)

            Insomnia (2.3%)

            Postmarketing Reports

            Anaphylaxis/anaphylactoid reactions

            Acute pancreatitis

            Hepatic cholestasis and jaundice

            Severe skin reactions, including Stevens-Johnson Syndrome

            Symptomatic hypoglycemia in patients with or without diabetes mellitus

            Prolonged activated partial thromboplastin time (aPTT), prolonged prothrombin time (PT), eosinophilia, increased international normalized ratio (INR), thrombocytopenia

            Previous
            Next

            Warnings

            Black Box Warnings

            Increased mortality with use of tigecycline for FDA-approved indications, as well as for nonapproved indications, compared with other antibiotics

            FDA approved to treat complicated skin and skin structure infections (cSSSI), complicated intra-abdominal infections (cIAI), and community-acquired bacterial pneumonia (CABP); it is not approved for treatment of diabetic foot infection or for hospital-acquired or ventilator-associated pneumonia

            Analysis from 10 clinical trials for FDA-approved uses (cSSSI, cIAI, CABP), including trials conducted after the drug was approved, showed a higher risk of death among patients receiving tigecycline, compared with other antibacterial drugs: 2.5% (66/2640) vs. 1.8% (48/2628), respectively; the adjusted risk difference for death was 0.6%, with a corresponding 95% confidence interval (0.0%, 1.2%)

            Contraindications

            Documented hypersensitivity

            Cautions

            Severe hepatic impairment

            Pregnancy

            Caution in severe hepatic impairment (reduce dose); patients who develop abnormal liver function tests during therapy should be monitored for evidence of worsening hepatic function and evaluated for risk/benefit of continuing tigecycline therapy

            Use during tooth development may cause permanent discoloration of teeth

            May permit clostridia overgrowth, resulting in antibiotic-associated colitis; evaluate for Clostridium difficile if diarrhea occurs

            Avoid use in patients with known hypersensitivity to tetracyclines

            May have adverse effects similar to those of tetracyclines (eg, photosensitivity, pseudotumor cerebri, antianabolic action)

            Pancreatitis, including fatalities, reported; if pancreatitis suspected, consider stopping treatment

            Increased mortality risk with use of IV tigecycline (see Black Box Warnings)

            May cause fetal harm when administered to a pregnant woman

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy category: D

            Lactation: Not known whether distributed in breast milk; use 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.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            A glycylcycline antibiotic that is structurally similar to tetracycline antibiotics; inhibits bacterial protein translation by binding to 30S ribosomal subunit, and blocks entry of amino-acyl tRNA molecules in ribosome A site.

            Distribution

            Protein bound: 71-89%

            Vdss: 500-700 L

            Metabolism

            Not extensive

            Elimination

            Half-life: (single dose) 27 hr; (multiple dose) 42 hr

            Excretion: urine (33%); feces (59%)

            Previous
            Next

            Administration

            IV Incompatibilities

            Y-site: amphotericin B, chlorpromazine, methylprednisolone, voriconazole

            IV Compatibilities

            Solution: NS, D5W

            Y-site: dobutamine, dopamine, LR, KCl, theophylline, ranitidine, lidocaine

            IV Preparation

            Reconstitute each vial with 5.3 mL NS or D5W to achieve a conc of 10 mg/mL

            Gently swirl to dissolve

            Immediately withdraw 5 mL and add to a 100-mL infusion bag

            IV Administration

            Infuse over 30-60 min

            Through dedicated line or Y-site

            Storage

            Store vials at 20-25°C (68-77°F)

            May be stored in IV bag at room temp for up to 6 hr or refrigerated at 2-8°C for up to 24 hr

            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.