capreomycin (Capastat)

Introduction

Tradename: Capastat sulfate.

Indications

• treatment of tuberculosis in conjunction with at least one other anti-tuberculous agent

Contraindications

hypersensitivity to capreomycin Warnings:

• use with caution in patients with renal insufficiency
• use with caution in patients with hearing impairment

pregnancy category = ?

safety in lactation = ?

Dosage

• 15 mg/kg/day up to 1 g/day for 60-120 days, then
• 15 mg/kg 2-3 times/week

Injection: 100 mg/mL. 10 mL.

Dosage adjustment in renal failure

• consult manufacturer's guidelines

Pharmacokinetics

• 1/2 life: 4-6 hours with normal renal function
• elminated unchanged in the urine

elimination via kidney

Monitor

• renal function tests
• audiometry

Adverse effects

• common (> 10%)
  • ototoxicity (auditory) (11%)
  • nephrotoxicity (36%)
• less common (1-10%)
  • eosinophilia
• uncommon (< 1%)
  • vertigo, fever, rash, leukocytosis, thrombocytopenia, pain, induration, bleeding at injection site, tinnitus

Drug interactions

• increased toxicity when concurrently administered with other nephrotoxic or ototoxic agents:
  • streptomycin
  • vancomycin
  • aminoglycosides
• increased effect or duration of non-depolarizing neuromuscular blocking agents

• drug interaction(s) anticonvulsants with anti-bacterial agents
• drug interaction(s) of antibiotics with warfarin

Test interactions

• hypokalemia
• increased BUN
• leukocytosis
• thrombocytopenia

More general terms

• anti-tuberculous agent

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3000502
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2547
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3032400
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3034057
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3032940