Drug information of Capreomycin

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.

Pharmacodynamic

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).

Pharmacokinetics

Half-life: 4-6 hr, prolonged in renal impairment

Peak Plasma Time: 1-2 hr

Excretion: urine

Drug indications

tuberculosis

Dosage

Adult

Tuberculosis

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

Pediatric

Tuberculosis (Off-label)

<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

Drug contraindications

pregnancy , Hypersensitivity

Alerts

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.

Pregnancy level

C


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