Drug information of Capreomycin
Cyclic peptide antibiotic similar to viomycin. It is produced by Streptomyces capreolus.
Mechanism of effect
Little is known about capreomycin's exact mechanism of action, but it is thought to inhibit protein synthesis by binding to the 70S ribosomal unit. Capreomycin also binds to components in the bacterial cell which result in the production of abnormal proteins.
These proteins are necessary for the bacteria's survival. Therefore the production of these abnormal proteins is ultimately fatal to the bacteria.
Capreomycin is a member of the aminoglycoside family of antibiotics. These antibiotics have the ability to kill a wide variety of bacteria, including bacteria responsible for causing tuberculosis (TB).
Half-life: 4-6 hr, prolonged in renal impairment
Peak Plasma Time: 1-2 hr
1 g qDay (not to exceed 20 mg/kg/day), given IM or by IV infusion for 60-120 days
Maintenance dose: 1 g IM or IV infusion 2 or 3 times weekly; maintain therapy for tuberculosis for 12 to 24 months; 20 mg/kg/day maximum
<15 years old and <40 kg: 15-30 mg/kg IV/IM qDay; maximum 1 g/day for 2-4 months followed by 15-30 mg/kg given twice weekly; maximum 1 g/day
>15 years old and >40 kg: 15 mg/kg IV/IM; maximum 1 g/day for 2-4 months followed by 15 mg/kg 2-3 times/week; maximum 1 g/dose
InteractionsSuccinylcholine , Kanamycin , Meglumine Compound , Cidofovir , Succinylcholine Chloride , Dofetilide , novafen , Atracurium , Cis atracurium , Vecuronium , Pancuronium , Amphotericin B Deoxycholate , Neomycin , Rocuronium , Rapacuronium , abobotulinumtoxinA , Tubocurarine , IncobotulinumtoxinA , Netilmicin , Diatrizoate (Amidotrizoic acid) , Plazomicin , Ioxaglate , Iothalamate Meglumine , Blonanserin
Renal impairment, auditory impairment, history of allergic rxns
Risk of hypokalemia
Risk of rare but potentially fatal toxic nephritis
Black Box Warnings
Use great caution in patients with renal insufficiency and pre-existing auditory impairment. Weigh the risk of additional cranial nerve VIII impairment or renal injury against the benefits of the therapy. Simulatneous administration with parenteral nonantituberculous agents with ototoxic potential (e.g., polymixin A sulfate, colisitin sulfate, amikacin, gentamicin, tobramycin, vancompycin, kanamycin, and neomycin) is not recommended.
Coadministration with antituberculous agents like streptomycin is also not recommended since they have similar and sometimes irreversible effects in cranial nerve VIII.
Safety in pregnancy has not been determined.
Effectiveness in pediatric patients has not been established.
Points of recommendation
Have blood work checked as you have been told by the doctor. Talk with the doctor.
Have a hearing test before starting capreomycin and while you take capreomycin.
Do not use longer than you have been told. A second infection may happen.
Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using capreomycin while you are pregnant.
Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.