tigecycline

J01AA12

Forms & Strengths

Adult Dosing

Complicated skin and skin structure infections: 100 mg initial dose, then 50 mg IV every 12 hours for 7-14 days
Complicated intra-abdominal infections: 100 mg initial dose, then 50 mg IV every 12 hours for 5-14 days
Community-acquired bacterial pneumonia: 100 mg initial dose, then 50 mg IV every 12 hours for 7-14 days
No renal dose adjustment required
Hepatic impairment: Reduce maintenance dose to 25 mg IV every 12 hours in severe hepatic impairment (Child-Pugh C)

Pediatric Dosing

Safety and efficacy in pediatric patients below 18 years of age have not been established; use is not recommended

Indications

Mechanism of Action

Glycylcycline antibiotic that binds to the 30S ribosomal subunit, inhibiting bacterial protein translation
Bacteriostatic activity against a broad spectrum of Gram-positive, Gram-negative, and anaerobic pathogens
Designed to overcome common tetracycline resistance mechanisms such as efflux pumps and ribosomal protection

Contraindications

Adverse Reactions

Nausea and vomiting (very common, often requiring antiemetic therapy)
Diarrhea and Clostridioides difficile-associated diarrhea
Elevated liver transaminases, bilirubin, and alkaline phosphatase
Pancreatitis (rare, occasionally fatal)
Increased all-cause mortality risk observed in clinical trials compared to other comparators
Tooth discoloration and enamel hypoplasia if used during tooth development

Drug Interactions

Warfarin: May increase the International Normalized Ratio (INR); monitor coagulation parameters closely
Oral contraceptives: May reduce the efficacy of estrogen-containing contraceptives; recommend alternative or additional contraception
Inhibitors or inducers of CYP450 enzymes have minimal effect on tigecycline clearance due to its primary elimination via biliary excretion

Curated Content: Needs Vetting Before Put to Clinical Use