Doriject
Generic Name
Doripenem
Manufacturer
Eskayef Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| doriject 500 mg injection | ৳ 2,000.00 | N/A |
Description
Overview of the medicine
Doriject 500 mg Injection contains Doripenem, which is a broad-spectrum carbapenem antibiotic. It is used to treat serious bacterial infections in adults, including complicated intra-abdominal infections, complicated urinary tract infections, and hospital-acquired pneumonia.
Uses & Indications
Dosage
Adults
500 mg intravenously (IV) every 8 hours, infused over 1 hour, for 5-14 days depending on the type and severity of infection.
Elderly
No specific dose adjustment is required based on age alone; however, renal function should be monitored, and dosage adjusted accordingly for renal impairment.
Renal_impairment
Creatinine clearance (CrCl) 30-50 mL/min: 250 mg IV every 8 hours. CrCl 10-29 mL/min: 250 mg IV every 12 hours. End-stage renal disease (ESRD)/Hemodialysis: 250 mg IV every 24 hours (after dialysis on dialysis days).
How to Take
Doriject 500 mg is for intravenous infusion only. Reconstitute the vial with sterile water for injection, then dilute the reconstituted solution in 0.9% Sodium Chloride Injection or 5% Dextrose Injection to a final concentration of 1 mg/mL or 5 mg/mL. Administer the diluted solution over 1 hour.
Mechanism of Action
Doripenem works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located on the bacterial cell wall, which disrupts the peptidoglycan synthesis crucial for cell wall formation, leading to bacterial cell lysis and death.
Pharmacokinetics
Onset
Rapid, typically within minutes of infusion.
Excretion
Primarily excreted unchanged in the urine (around 70%) via glomerular filtration and tubular secretion. Non-renal clearance is negligible.
Half life
Approximately 1 hour in individuals with normal renal function.
Absorption
Administered intravenously, resulting in 100% systemic bioavailability. Peak plasma concentrations are achieved rapidly after a 1-hour infusion.
Metabolism
Minimally metabolized; primarily hydrolyzed in the kidney to an inactive ring-opened metabolite.
Side Effects
Contraindications
- Known serious hypersensitivity to doripenem or other carbapenem antibiotics
- Known serious hypersensitivity to other beta-lactam antibacterial drugs (e.g., penicillins or cephalosporins)
Drug Interactions
Probenecid
Probenecid interferes with the renal tubular secretion of doripenem, increasing its plasma concentration and half-life. Co-administration is not recommended.
Valproic Acid
Co-administration with carbapenems, including doripenem, may decrease valproic acid plasma levels, potentially leading to loss of seizure control. Monitor valproic acid levels and consider alternative antibacterial or anticonvulsant therapy.
Storage
Store intact vials at controlled room temperature 20°C to 25°C (68°F to 77°F). Protect from light. Do not freeze. Reconstituted and diluted solutions should be used immediately or stored as per specific stability guidelines.
Overdose
In the event of an overdose, Doriject should be discontinued, and general supportive treatment should be initiated. Doripenem can be removed by hemodialysis.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown a risk, but there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. Doripenem is excreted into human breast milk. Exercise caution when administering to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Refer to the product label for the exact expiry date.
Availability
Hospitals and Retail Pharmacies
Approval Status
Approved for severe bacterial infections
Patent Status
Likely off-patent for the active ingredient
Clinical Trials
Doripenem has undergone extensive clinical trials demonstrating its efficacy and safety in treating various severe bacterial infections, including cIAI, cUTI, and HAP/VAP, compared to other broad-spectrum antibiotics.
Lab Monitoring
- Renal function (creatinine, BUN) should be monitored, especially in elderly patients or those with pre-existing renal impairment.
- Liver function tests (ALT, AST, alkaline phosphatase) may be monitored periodically, especially during prolonged therapy.
- Complete Blood Count (CBC) for prolonged courses.
Doctor Notes
- Perform appropriate culture and susceptibility tests to isolate and identify the causative organisms and to determine their susceptibility to doripenem.
- Carefully monitor patients for signs of superinfection, especially CDAD, during and after therapy.
- Adjust dosage in patients with renal impairment based on CrCl to avoid accumulation and potential toxicity.
Patient Guidelines
- Inform your doctor immediately if you experience any signs of an allergic reaction (e.g., rash, itching, swelling, severe dizziness, trouble breathing).
- Complete the entire course of treatment as prescribed, even if you start to feel better, to prevent the return of the infection and development of drug resistance.
- Inform your doctor about all medications, supplements, and herbal products you are currently taking.
Missed Dose Advice
If a dose of Doriject is missed, administer it as soon as possible. However, if it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Doriject may cause dizziness or seizures in some patients. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Maintain good hydration during treatment.
- Avoid alcohol consumption during the course of treatment, as it may exacerbate side effects.
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