Capreomycin
Synonym :
Capastat
Mechanism :
It is a bacteriostatic drug used as a second line drug in combination with other antibiotics in the treatment of tuberculosis. It is available as an intramuscular injection and not used frequently in the pediatric age group.
Indication :
- Drug resistant tuberculosis
Contraindications :
Simultaneous administration of Capreomycin with parenteral antitubercular with ototoxic potential (e.g. amikacin, polymyxin A sulfate, colistin sulfate, tobramycin, vancomycin).
Coadministration with antituberculosis drugs like streptomycin, as they can have irreversible and similar effects on VIII Cranial nerve.
Dosing :
15 mg/kg IM/IV once every day
max: 1 g/day.
Adverse Effect :
Tinnitus, hearing loss, vertigo, leukopenia, hypokalemia, transient proteinuria, cylindruria, nitrogen retention, rashes, fever, nephrotoxicity, eosinophilia.
Interaction :
Live Typhoid vaccine: May render the vaccine ineffective.
Live BCG vaccine: May render the vaccine ineffective.
Neuromuscular blocking agents: Can increase the action of the neuromuscular blocking agents.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | 1 g every 48 hours |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Dialysed. Dose as in GFR<10 mL/ min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended unless renal dysfunction is present.