Gigabac
Generic Name
Colistimethate Sodium
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| gigabac 1 miu injection | ৳ 400.00 | N/A |
Description
Overview of the medicine
Gigabac 1 MIU Injection contains Colistimethate Sodium, a prodrug of colistin, which is a polymyxin antibiotic. It is used to treat serious infections caused by multi-drug resistant Gram-negative bacteria.
Uses & Indications
Dosage
Adults
Intravenous (IV) administration: Usually 4.5-9 MIU per day, divided into 2-3 doses, depending on the severity of infection and renal function. A loading dose of 9 MIU may be given.
Elderly
Dosage adjustment may be necessary based on renal function.
Renal_impairment
Significant dosage reduction is required in patients with renal impairment. Consult specific guidelines for creatinine clearance levels.
How to Take
Administer as a slow intravenous infusion over 30 to 60 minutes. Do not administer as a bolus injection. For inhalation, use a suitable nebulizer.
Mechanism of Action
Colistin acts as a cationic detergent, disrupting the outer and inner cell membranes of Gram-negative bacteria, leading to leakage of intracellular contents and bacterial death.
Pharmacokinetics
Onset
Onset of action is relatively rapid after intravenous administration.
Excretion
Both CMS and colistin are primarily excreted by the kidneys. Renal impairment significantly prolongs the elimination half-life.
Half life
The half-life of active colistin is approximately 2 to 3 hours in patients with normal renal function.
Absorption
Colistimethate Sodium (CMS) is poorly absorbed from the gastrointestinal tract. After parenteral administration, it is slowly hydrolyzed to active colistin.
Metabolism
CMS is a prodrug and is slowly converted to its active form, colistin, in vivo. The exact metabolic pathways are not fully elucidated.
Side Effects
Contraindications
- Hypersensitivity to colistimethate sodium or any other polymyxin antibiotic.
Drug Interactions
Neuromuscular blocking agents (e.g., rocuronium, succinylcholine)
Colistimethate Sodium can potentiate the effects of neuromuscular blockers, leading to prolonged respiratory depression or paralysis. Monitor closely for signs of respiratory compromise.
Nephrotoxic drugs (e.g., aminoglycosides, NSAIDs, ciclosporin, tacrolimus)
Concomitant use with other nephrotoxic agents may increase the risk of nephrotoxicity. Avoid co-administration if possible or monitor renal function closely.
Storage
Store at controlled room temperature (20°C to 25°C), protect from light. Reconstituted solution should be used immediately or stored as per specific guidelines.
Overdose
Symptoms of overdose include acute renal failure, neuromuscular blockade, apnea, and respiratory arrest. Management is supportive, including mechanical ventilation if necessary. Hemodialysis may not be effective in removing colistin.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Colistin is excreted into breast milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to colistimethate sodium or any other polymyxin antibiotic.
Drug Interactions
Neuromuscular blocking agents (e.g., rocuronium, succinylcholine)
Colistimethate Sodium can potentiate the effects of neuromuscular blockers, leading to prolonged respiratory depression or paralysis. Monitor closely for signs of respiratory compromise.
Nephrotoxic drugs (e.g., aminoglycosides, NSAIDs, ciclosporin, tacrolimus)
Concomitant use with other nephrotoxic agents may increase the risk of nephrotoxicity. Avoid co-administration if possible or monitor renal function closely.
Storage
Store at controlled room temperature (20°C to 25°C), protect from light. Reconstituted solution should be used immediately or stored as per specific guidelines.
Overdose
Symptoms of overdose include acute renal failure, neuromuscular blockade, apnea, and respiratory arrest. Management is supportive, including mechanical ventilation if necessary. Hemodialysis may not be effective in removing colistin.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Colistin is excreted into breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when stored unopened and unreconstituted, as per manufacturer's instructions.
Availability
Hospitals, retail pharmacies (with prescription)
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA) for specific indications
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Ongoing clinical trials focus on optimizing dosing strategies, evaluating efficacy in various infection types, and exploring combination therapies to combat antimicrobial resistance.
Lab Monitoring
- Regular monitoring of renal function (serum creatinine, blood urea nitrogen, urine output)
- Electrolyte levels (especially potassium, magnesium, calcium)
- Liver function tests (if clinically indicated)
Doctor Notes
- Colistimethate Sodium should be considered a last-resort antibiotic for serious MDR Gram-negative infections.
- Careful dose adjustment is crucial in renal impairment; monitor creatinine clearance and adjust dose accordingly.
- Educate patients on potential neurotoxic symptoms (paresthesia, dizziness) and emphasize immediate reporting.
Patient Guidelines
- Report any unusual symptoms, especially numbness, tingling, or muscle weakness, to your doctor immediately.
- Ensure you complete the full course of treatment, even if you feel better, to prevent recurrence and resistance.
- Maintain good hydration throughout the treatment period.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or vertigo. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a balanced diet and adequate fluid intake to support overall health during antibiotic treatment.
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