Indications
Dorinem 500 Injection is used for:
Intra-abdominal infections, Bacterial infections, Septicemia, Nosocomial pneumonia, Urinary tract infections, Pyelonephritis
Adult Dose
Intravenous
Complicated intra-abdominal infections
Adult: 500 mg 8 hrly infused over 1 hr for 5-14 days. May switch to an appropriate oral therapy, after at least 3 days of parenteral therapy upon evidence of clinical improvement.
Complicated urinary tract infections; Pyelonephritis
Adult: 500 mg 8 hrly infused over 1 hr for 10 days. May switch to an appropriate oral therapy, after at least 3 days of parenteral therapy upon evidence of clinical improvement. Duration can be extended up to 14 days for patients w/ concurrent bacteraemia.
Child Dose
<18 years: Safety and efficacy not established
Renal Dose
Renal impairment:
CrCl (ml/min)
30-50 250 mg every 8 hr by IV infusion over 1 hr
11-29 250 mg every 12 hr by IV infusion over 1 hr
Administration
Reconstitution:
Reconstitute 500 mg vial w/ 10 mL of sterile water for inj or NaCl 0.9% inj to form a susp containing 50 mg/mL. Further dilute the reconstituted vial w/ 100 mL of NaCl 0.9% or dextrose 5% inj, gently shake until clear. For a 250 mg dose, contents of the reconstituted vial should be withdrawn and added to 100 mL NaCl 0.9% infusion bag or dextrose 5% inj. Remove and discard 55 mL from the infusion bag to leave the remaining soln.
IV Administration
Infuse over 1 hr
Contra Indications
Hypersensitivity; anaphylactic reactions to beta-lactams.
Precautions
May decrease serum concentration of valproic acid to below therapeutic range thus increasing risk of breakthrough seizure; consider alternative antimicrobial agents or additional anti-seizure medications if concurrent usage is necessary. Prolonged use may result in Clostridium difficile-associated diarrhoea (CDAD). May cause development of drug-resistant bacteria when used in the absence of proven or strongly suspected bacterial infection. Renal impairment. Safety and efficacy have not been established in patients <18 yr old.
Lactation: unknown if excreted in breast milk; use caution
Pregnancy-Lactation
Pregnancy Category: B
Lactation: unknown if excreted in breast milk; use caution
Interactions
Increased plasma concentration w/ probenecid. May decrease plasma levels of valproic acid thus, increasing the risk of seizures.
Side Effects
Side effects of Doripenem :
>10%
Headache (4-16%), Nausea (4-12%), Diarrhea (6-11%)
1-10%
Anemia (2-10%), Phlebitis (4-8%), Rash (1-5%), Pruritus (3%), Transaminases elevated (1-2%), Oral candidiasis (1%), Renal impairment/failure (1%)
Potentially Fatal: Anaphylaxis, toxic epidermal necrolysis, Stevens-Johnson Syndrome, interstitial pneumonia, seizure.
Mode of Action
Doripenem is a broad-spectrum carbapenem with potent in vitro antibacterial activity against aerobic and anaerobic gram-positive and gram-negative bacteria including Pseudomonas aeruginosa. It inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins; which in turn inhibits the final transpeptidase step of peptidoglycan synthesis in bacterial cell walls.
Note
Dorinem 500 500mg/vial Injection generic name is Doripenem. Dorinem 500 500mg/vial Injection is manufactured by ACI LimitedDorinem 500 is availble in all over Bangladesh.
Mes BD drug index information on Dorinem 500 Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.