📋 Indications & Clinical Dosage
*Gram-negative infections resistant to other antibacterials, including those caused by Pseudomonas aeruginosa, Acinetobacter baumanii and Klebsiella pneumonia:*
BY SLOW IV INJECTION, OR BY IV INF: Adult (body-weight up to 60 kg): 50,000-75,000 units/kg daily in 3 divided doses every 8 hrs.
Adult (body-weight 60 kg and above): 1-2 million units every 8 hrs, max 6 million units per day.
💊 Mode of Administration
By slow IV inj: To be administered into a totally implantable venous access device when giving via slow IV injection. By IV infusion:
Give intermittently in Sodium chloride 0.9%; dilute with 50ml infusion fluid and give over 30 minutes.
⛔ Contraindications
Myasthenia gravis
⚠️ Precautions & Warnings
Hepatic impairment, myasthenia gravis (muscle weakness may be increased), acute porphyrias. Reduce dose in renal impairment, monitor renal function monitor plasma colistimethate sodium concentration during parenteral treatment
🔄 Drug Interactions
Cephalosporins, aminoglycosides, other drugs with nephrotoxic or neurotoxic potential, neuromuscular blockers.
⚠️ Adverse Reactions / Side Effects
Apnoea, confusion, headache, muscle, weakness, nephrotoxicity, perioral paraesthesia, peripheral paraesthesia, psychosis, rash, slurred speech, vertigo, visual disturbances. Rare: Vasomotor instability
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated. Use only if potential benefit outweighs risk.
Lactation / Breastfeeding:
Contraindicated, avoid
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.