Capreomycin
Indications
Capreomycin is used for:
Tuberculosis
Adult Dose
Parenteral
Tuberculosis
Adult: 1 g daily, by deep IM inj or IV infusion, for 2-4 mth, then 2-3 times wkly for the remainder of the therapy. Max: 20 mg/kg/day.
Child Dose
Renal Dose
Administration
IV Preparation
Dissolve 1 g powder with 2, 2.15, 2.63, 3.3, or 4.3 mL of NS or SWI
Allow 2-3 min to dissolve
IV/IM Administration
IM: deep IM into large muscle mass
IV: dilute with 100 mL NS & infuse over 1 hr
Contra Indications
Hypersensitivity to capreomycin and other aminoglycosides.
Precautions
Patient w/ pre-existing auditory impairment. Renal impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor auditory, vestibular and renal function at baseline and during therapy; frequent assessment of serum electrolytes (e.g. Ca, Mg, K) and liver function.
Pregnancy-Lactation
Pregnancy Category: C
Lactation: excretion in milk unknown; use with caution
Interactions
Additive and sometimes irreversible toxic effects w/ other parenteral anti-TB agents (e.g. streptomycin, viomycin). Increased risk of nephrotoxicity and ototoxicity w/ other non-antituberculosis drugs (e.g. polymyxin A sulfate, amikacin, gentamicin, tobramycin, vancomycin, kanamycin, neomycin).
Side Effects
Side effects of Capreomycin :
>10%
Nephrotoxicity, incr BUN (36%)
Hearing loss (11% subclinical; 3% clinical)
1-10%
Eosinophilia (dose related, >5%)
<1%
Incr LFTs
Inj site pain/induration
Leukopenia
Maculopapular rash
Urticaria
Mode of Action
Capreomycin is a cyclic polypeptide antimicrobial. It is bacteriostatic against various Mycobacteria, particularly those that have become resistant to primary anti-TB drugs.