gigabac
Generic Name
Colistin Methanesulfonate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| gigabac 45 miu injection | ৳ 1,000.00 | N/A |
Description
Overview of the medicine
A potent polymyxin antibiotic used to treat serious infections caused by multidrug-resistant Gram-negative bacteria, especially Pseudomonas aeruginosa and Acinetobacter baumannii. Administered intravenously.
Uses & Indications
Dosage
Adults
9 MIU loading dose, followed by 4.5 MIU every 12 hours (total daily dose 9 MIU), adjusted based on renal function.
Elderly
Dosage adjustment may be required based on renal function.
Renal_impairment
Significantly reduced dosage is required. Consult dosing guidelines.
How to Take
For intravenous use, dilute the reconstituted solution in 0.9% sodium chloride or 5% dextrose solution and infuse slowly over 30-60 minutes.
Mechanism of Action
Colistin is a cationic polypeptide that interacts with the bacterial outer membrane, displacing divalent cations (e.g., Mg2+, Ca2+) and disrupting the membrane's integrity. This leads to increased permeability, leakage of intracellular components, and ultimately bacterial cell death.
Pharmacokinetics
Onset
Active colistin levels are achieved within a few hours after administration of CMS.
Excretion
Primarily renal (glomerular filtration).
Half life
CMS: 2-3 hours; active Colistin: 3-5 hours.
Absorption
Colistin Methanesulfonate (CMS) is a prodrug. After IV administration, it is gradually hydrolyzed to active colistin. Poorly absorbed orally.
Metabolism
CMS is hydrolyzed to active colistin in vivo, primarily in the kidneys.
Side Effects
Contraindications
- Hypersensitivity to colistin or polymyxins
- Myasthenia Gravis (relative contraindication due to neuromuscular blocking effects)
Drug Interactions
Aminoglycosides
Increased risk of nephrotoxicity and neurotoxicity.
Neuromuscular blockers
Increased risk of neuromuscular blockade.
Other nephrotoxic drugs (e.g., NSAIDs, Cyclosporine, Amphotericin B)
Increased risk of nephrotoxicity.
Storage
Store below 25°C. Protect from light. Do not freeze.
Overdose
Symptoms include acute renal failure, neurotoxicity (e.g., paresthesia, dizziness, slurred speech, apnea). Management is supportive; hemodialysis may be considered for severe cases.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs risk. Excreted in breast milk; exercise caution.
Side Effects
Contraindications
- Hypersensitivity to colistin or polymyxins
- Myasthenia Gravis (relative contraindication due to neuromuscular blocking effects)
Drug Interactions
Aminoglycosides
Increased risk of nephrotoxicity and neurotoxicity.
Neuromuscular blockers
Increased risk of neuromuscular blockade.
Other nephrotoxic drugs (e.g., NSAIDs, Cyclosporine, Amphotericin B)
Increased risk of nephrotoxicity.
Storage
Store below 25°C. Protect from light. Do not freeze.
Overdose
Symptoms include acute renal failure, neurotoxicity (e.g., paresthesia, dizziness, slurred speech, apnea). Management is supportive; hemodialysis may be considered for severe cases.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs risk. Excreted in breast milk; exercise caution.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Hospitals, Pharmacies
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Ongoing studies for optimized dosing and efficacy in specific populations.
Lab Monitoring
- Renal function (serum creatinine, BUN) before and during treatment
- Urine output
- Electrolytes
Doctor Notes
- Crucial for multi-drug resistant Gram-negative infections, often as a last-resort antibiotic.
- Dose must be meticulously calculated and adjusted based on creatinine clearance.
- Close monitoring of renal function, electrolytes, and neurological status is mandatory.
Patient Guidelines
- Report any signs of kidney problems (e.g., decreased urine) or neurological symptoms (e.g., numbness, dizziness) immediately.
- Complete the full course of treatment as prescribed, even if symptoms improve.
- Do not share this medication with others.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or blurred vision; advise caution when driving or operating machinery.
Lifestyle Advice
- Maintain good hydration during treatment.
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