Adult Dosing
Complicated skin and skin structure infections
- 7.5 mg/kg IV q12 hr for 7 days
Infective endocarditis due to severe VREF infection
- 7.5 mg/kg IV q8 hr for 8 weeks
Pediatric Dosing
Complicated skin and skin structure infections
- >12 yrs: 7.5 mg/kg IV q12 hr for 7 days
Infective endocarditis due to severe VREF infection
- >12 yrs: 7.5 mg/kg IV q8 hr for 8 weeks
Note: Safety and effectiveness in pediatrics <12 yrs of age have not been established
[Outline]
See Supplemental Patient Information
- Inhibition of CYP P4503A4 mediated metabolism of cyclosporin A, midazolam, nifedipine and terfenadine is associated with this drug. Perform therapeutic level monitoring of cyclosporine when cyclosporine is used concurrently with this drug. Increased plasma concentrations of drugs metabolized by CYP4503A4 could result in increased or prolongation of therapeutic effect and/or increase adverse reactions on concurrent administration with this combination drug; exercise caution and monitor effects as co-administration possess a narrow therapeutic window. Avoid concomitant medications metabolized by the cytochrome P450 3A4 enzyme as prolongation of QTc interval may occur. Elevated plasma concentrations of nifedipine (repeated oral doses) and midazolam may occur on concurrent administration with this drug
- Plasma concentration of astemizole, terfenadine, delavirdine, nevirapine, indinavir, ritonavir, vinca alkaloids (e.g., vinblastine), docetaxel, paclitaxel, midazolam, diazepam, dihydropyridines (e.g., nifedipine), verapamil, diltiazem, HMG-CoA reductase inhibitors (e.g., lovastatin), cisapride, cyclosporine, tacrolimus, methylprednisolone, carbamazepine, quinidine, lidocaine, disopyramide may increase on concurrent administration with this combination drug
- Clostridium difficile associated diarrhea (CDAD) which may range from mild diarrhea to fatal colitis has been reported. It can occur during therapy or >2mo after discontinuation. Consider diagnosis if diarrhea presents after antibiotic administration
- Clostridium difficile associated diarrhea which may vary in severity from mild to fatal colitis, has been reported with use of all antibiotics. Maintain appropriate fluid and electrolyte levels, protein supplementation, along with antibiotics for C. difficile as needed
- To reduce the development of drug-resistant bacteria, use only to treat infections proven or strongly suspected to be caused by susceptible bacteria. Obtain susceptibility tests before starting therapy
- Antibiotic may alter colon flora, leading to C. difficile overgrowth. C. difficile produces toxins A and B which contribute to CDAD. Hypertoxin producing strains cause increased morbidity and mortality since these infections can be refractory to antibiotic therapy and may require colectomy
- If CDAD is suspected/confirmed, discontinue use
- Overgrowth of nonsusceptible organisms may occur; take appropriate measures on occurrence of superinfections
- Flush the vein with 5% Dextrose in Water solution for minimizing venous irritation following completion of a peripheral infusion. Avoid flushing with saline or heparin after administration as concerns for incompatibility exists. On occurrence of moderate-severe venous irritation following peripheral administration of dalfopristin/quinupristin diluted in 250 mL of Dextrose 5% in water, consider increasing the infusion volume to 500-750 mL, changing the infusion site, or infusing by a peripherally inserted central catheter (PICC) or a central venous catheter
- Safety for IV bolus use for this drug is not established
- Possibility for occurrence of arthralgia, myalgia and hyperbilirubinemia exists
Cautions: Use cautiously in
- Hepatic impairment
- Hyperbilirubinemia
- Venous irritation
- Superinfections
- Concurrent use of other drugs metabolized by the cytochrome P450 3A4 enzyme
Supplemental Patient Information
- Advise patients contact their clinician on development of watery and bloody stools accompanied with or without stomach cramps and fever
Pregnancy Category:B
Breastfeeding: Manufacturer advises caution.
US Trade Name(s)
US Availability
Synercid (dalfopristin/quinupristin)
- PWDR for INJ: 350 mg/150 mg (10 mL vial)
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
Synercid (dalfopristin/quinupristin)
- PWDR for INJ: 350 mg/150 mg (10 mL vial)
[Outline]
