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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIMYCOBACTERIALS › DRUGS FOR TREATMENT OF TUBERCULOSIS › Antibiotics
capreomycin
J04AB30
Forms & Strengths
- Injectable powder for reconstitution: 1 gram vial
Adult Dosing
- 15 mg/kg (not to exceed 1 g) intramuscularly or intravenously daily for 60 days
- Followed by 15 mg/kg 2 to 3 times weekly as part of a multi-drug regimen
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Treatment of pulmonary tuberculosis caused by Mycobacterium tuberculosis resistant to other first-line agents
- Used strictly as part of a combination regimen
Mechanism of Action
- Cyclic polypeptide antibiotic derived from Streptomyces capreolus
- Inhibits protein synthesis by binding to 70S ribosomal subunits, causing miscoding and inhibition of translocation
Contraindications
- Hypersensitivity to capreomycin or its components
- Concurrent use with other potent ototoxic or nephrotoxic agents when avoidable
Adverse Reactions
- Nephrotoxicity (elevated BUN, creatinine, tubular necrosis)
- Ototoxicity (hearing loss, tinnitus, vertigo)
- Electrolyte disturbances (hypokalemia, hypocalcemia, hypomagnesemia)
- Injection site pain and sterile abscesses
Drug Interactions
- Increased risk of ototoxicity and nephrotoxicity with aminoglycosides, polymyxins, and vancomycin
- Enhanced neuromuscular blockade with nondepolarizing muscle relaxants and anesthetics
- Additive renal toxicity with NSAIDs and other nephrotoxic drugs
Curated Content: Needs Vetting Before Put to Clinical Use