Colistimethate (CMS)
Form: Injection
Strength: 1 MIU
Generic Name: Colistimethate Sodium
Company: ZAS Corporation
MRP:৳ 650.0 (1 MIU vial)
Is Antibiotic: No
Indications
Colistimethate (CMS) is used to treat infections caused by certain bacteria, especially Pseudomonas aeruginosa. Colistimethate (CMS) is also effective against other gram-negative bacteria like Enterobacter aerogenes, Escherichia coli, and Klebsiella pneumoniae. Colistimethate (CMS) is not effective for infections caused by Proteus or Neisseria.
Pharmacology
Colistimethate (CMS) works by interacting with the bacterial cell membrane, making Colistimethate (CMS) more permeable, which kills the bacteria. Colistimethate (CMS) can also enter the bacteria and cause a buildup of cell components like ribosomes, further damaging the bacteria.
Dosage & Administration
Adults: The usual maintenance dose is 9 MIU per day, divided into 2-3 doses. For critically ill patients, a loading dose of 9 MIU is recommended.
Renal impairment: Dose adjustments are needed for patients with kidney problems.
- Creatinine clearance <50 ml/min: 5.5-7.5 MIU/day
- Creatinine clearance <30 ml/min: 4.5-5.5 MIU/day
- Creatinine clearance <10 ml/min: 3.5 MIU/day
For dialysis patients: On non-dialysis days, take 2.25 MIU/day. On dialysis days, take 3 MIU/day after the session.
Pediatric population: Dosage depends on the child’s weight, ranging from 75,000 to 150,000 IU/kg/day, divided into 3 doses.
Hepatic impairment: There is no specific data for liver disease, so caution is advised.
Interaction
Colistimethate (CMS) should not be taken with aminoglycosides, polymyxin, muscle relaxants like tubocurarine, ether, succinylcholine, gallamine, decamethonium, or sodium citrate. Colistimethate (CMS) should also not be used with Sodium Cephalothin.
Contraindications
Colistimethate (CMS) should not be used by patients who are allergic to Colistimethate (CMS) or any of its components.
Side Effects
Side effects may include upset stomach, tingling in the hands or tongue, slurred speech, dizziness, itching, rash, fever, kidney problems, breathing issues, and decreased urine output.
Pregnancy & Lactation
There is limited information on its safety during pregnancy. Colistimethate (CMS) should only be used if the potential benefits outweigh the risks. Colistimethate (CMS) is also unknown whether Colistimethate (CMS) passes into breast milk, so Colistimethate (CMS) should be used cautiously in breastfeeding women.
Precautions & Warnings
Colistimethate (CMS) should be used carefully in patients with kidney problems. If kidney function is impaired, the dosage may need to be reduced. Colistimethate (CMS) should also be used with caution in newborns, infants, and children.
Overdose Effects
Overdose can cause symptoms like tingling, confusion, dizziness, speech problems, difficulty breathing, and kidney failure. Respiratory issues can lead to apnea, respiratory arrest, or even death. In case of overdose, stop using the medication and provide supportive care.
Therapeutic Class
Colistimethate (CMS) belongs to the class of other antibacterial preparations.
Storage Conditions
Before mixing, store below 30°C. After mixing, keep Colistimethate (CMS) in the fridge between 2°C and 8°C and use Colistimethate (CMS) within 24 hours. Do not freeze.