Adult Dosing
Pulmonary tuberculosis as a second line of treatment
- Initial: 1g IM/IV q24 hrs x 60-120 days (Max: 20 mg/kg/day)
- Maintenance: 1g IM/IV 2-3 qwk
Notes:
- Anti tuberculosis therapy should be maintained for 12-24 months
- For IV infusion dilute reconstituted capreomycin in 100 mL of 0.9% sodium chloride injection and administer over 60 mins
- For IM administration, give reconstituted capreomycin deep IM in to large muscle mass
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
- 80 mL/min: 10.4 mg/kg q24 hrs
- 60 mL/min: 8.16 mg/kg q24 hrs
- 50 mL/min: 7.01 mg/kg q24 hrs
- 40 mL/min: 5.87 mg/kg q24 hrs
- 30 mL/min: 4.72 mg/kg q24 hrs
- 20 mL/min: 3.58 mg/kg q24 hrs
- 10 mL/min: 2.43 mg/kg q24 hrs
- 0 mL/min: 1.29 mg/kg q24 hrs
Hepatic Dose Adjustment
- Hepatic impairment: Caution advised; dose adjustments not defined
- Should not be used in Pediatric patients
- Use with extreme caution in patients with renal insufficiency or preexisting auditory impairment [Black Box warnings]
- Avoid concomitant use with other ototoxic and nephrotoxic drugs [Black Box warnings]
- Perform assessment of vestibular function and audiometric measurement at baseline and at regular interval during capreomycin therapy
- Renal injury, with tubular necrosis, elevation of BUN or serum creatinine, and abnormal urinary sediment has occurred with capreomycin therapy. Carefully evaluate the renal function of the patients, if any evidence of decreasing renal function noted, reduce the dosage or completely withdraw the drug
- Large intravenous dose of capreomycin causes partial neuromuscular block
- Use cautiously in patients who have history of some form of allergy, particularly to drugs
- Monitor renal function at baseline and on weekly basis during the treatment
- Monitor serum electrolyte levels frequently during the treatment as it causes hypokalemia, hypomagnesemia and hypocalcemia
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Preexisting auditory impairment
- Elderly patients
Pregnancy Category:C
Breastfeeding: Infants showed developmental problems when exposed to capreomycin in breastmilk; however problems cannot be attributed to capreomycin alone, as mothers were also exposed to several other drugs during pregnancy and during breastfeeding. As capreomycin is not absorbed orally it is not likely to affect adversely the breastfed infant. Breastfeeding should not be discontinued if capreomycin is required by the mother. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 10th December 2010). However manufacturer advises caution when administering to a nursing woman because many drugs are excreted in human milk.
