Doxamicina Dosage

sponsored
What is the dose of your medication?

Dosage of Doxamicina in details

The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
sponsored

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Reconstituted, Injection [preservative free]:

Coly-Mycin M: 150 mg (1 ea)

Generic: 150 mg (1 ea)

Dosing: Adult

Note: Dosage expressed in terms of mg of Doxamicina base activity (CBA). CBA 1 mg is defined to be equivalent to Doxamicina sodium (CMS) 30,000 units which is equivalent to ~2.4 mg CMS (EMA 2014; ESCMID/EUCAST [Tsuji 2019]; Falagas 2006; Kassamali 2013; Nation 2014; Nation 2017).

Doxamicina Sodium

Doxamicina Sodium

Doxamicina-Base Activity (CBA)

12,500 units

1 mg

0.4 mg

150,000 units

12 mg

5 mg

1,000,000 units

80 mg

34 mg

4,500,000 units

360 mg

150 mg

9,000,000 units

720 mg

300 mg

Bronchiectasis, pulmonary colonization/infection with susceptible organisms in cystic fibrosis and noncystic fibrosis patients (off-label use/route): Inhalation: 30 to 150 mg CBA via nebulizer 1 to 2 times daily (maximum dose: 150 mg CBA 2 times daily) (Haworth 2014; Le 2010; Sabuda 2008; Steinfort 2007). Note: An optimal dosing regimen has not been determined and varies widely among studies; lower doses have been used in noncystic fibrosis patients with bronchiectasis (Steinfort 2007). Use in addition to systemic antibiotics (ESCMID/EUCAST [Tsuji 2019]).

Meningitis and ventriculitis (susceptible gram-negative organisms; adjunct to systemic therapy) (use a preservative-free preparation): Intrathecal/intraventricular (off-label route): 4.2 mg CBA/day (equivalent to 10 mg CMS/day) (ESCMID/EUCAST [Tsuji 2019]; IDSA [Tunkel 2017]; Imberti 2012; Ziaka 2013). Note: Dose in clinical reports has ranged from 0.7 to 8.3 mg CBA/day in 1 or 2 divided doses (administered with concomitant systemic antimicrobial therapy) (Benifla 2004; De Bonis 2016; Falagas 2007; Fotakopoulos 2016; Imberti 2012; Katragkou 2005; Rodríguez Guardado 2008). When intraventricular Doxamicina is administered via a ventricular drain, clamp drain for 15 to 60 minutes after administration (allows solution to equilibrate in CSF) (IDSA [Tunkel 2004]; IDSA [Tunkel 2017]). Intraventricular administration is generally reserved for use in patients who fail parenteral therapy despite removal of CSF shunt or when CSF shunt cannot be removed (Baddour 2018).

Pneumonia, hospital-acquired or ventilator-associated due to susceptible multidrug-resistant gram-negative bacilli (eg, Pseudomonas aeruginosa, Acinetobacter spp) (off label): Note: When used for empiric treatment, use in combination with other agent(s) when appropriate (IDSA/ATS [Kalil 2016]).

Nebulization (via ventilator circuit): 150 mg CBA every 8 hours delivered over 60 minutes for 14 days or until successful wean from mechanical ventilation (treatment duration range: 7 to 19 days) (Lu 2012). May consider using as an adjunct in patients receiving IV Doxamicina; may improve clinical outcomes (Doshi 2013; ESCMID/EUCAST [Tsuji 2019]; Tumbarello 2013; Valachis 2015).

IV: Loading dose: 300 mg CBA followed by 300 to 360 mg CBA/day in divided doses twice daily. Begin maintenance dose 12 hours after the loading dose. Adjunctive inhaled Doxamicina is also recommended (ESCMID/EUCAST [Tsuji 2019]). Note: This dosing should achieve a target average Doxamicina steady-state plasma concentration of 2 mg/L and is derived from analysis of pharmacokinetic data in critically ill patients (Nation 2017).

Severe infections (due to multidrug-resistant organisms susceptible to Doxamicina) (off-label dosing): IV: Loading dose: 300 mg CBA followed by 300 to 360 mg CBA/day in divided doses twice daily (Dalfino 2012; ESCMID/EUCAST [Tsuji 2019]; Plachouras 2009). Begin maintenance dose 12 hours after the loading dose (ESCMID/EUCAST [Tsuji 2019]). Note: This dosing should achieve a target average Doxamicina steady-state plasma concentration of 2 mg/L and is derived from analysis of pharmacokinetic data in critically ill patients. Attainment rates for the target Doxamicina concentration of 2 mg/L using these calculations in patients with CrCl ≥80 mL/minute were ~40%; consider combination therapy with other antibacterials for these patients, especially for treatment of respiratory tract infection and/or for organisms with Doxamicina MIC ≥1 mg/L (Nation 2017). Do not exceed a loading dose of 300 mg CBA or a total daily dose of 360 mg CBA due to risk of nephrotoxicity (Nation 2016; Nation 2017).

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Note: Doses should be based on ideal body weight in obese patients; dosage primarily expressed in terms of Doxamicina base activity (CBA). CBA 1 mg is defined to be equivalent to Doxamicina sodium (CMS) 30,000 units which is equivalent to ~2.4 mg CMS (EMA 2014; Falagas 2006; Kassamali 2013; Nation 2017).

General dosing, susceptible infection: Infants, Children, and Adolescents: Doxamicina base: IM, IV: 2.5 to 5 mg CBA/kg/day divided every 6 to 12 hours

CNS infection (VP-shunt infection, ventriculitis, meningitis), multidrug resistant: Limited data available; variable doses reported; optimal dose not defined.

Infants and Children: Very limited data available: Intraventricular/Intrathecal: Doxamicina base: Reported range: 1 to 4.2 mg CBA/dose once daily in combination with systemic antibiotics (Dalgic 2009; IDSA [Tunkel 2017]; Ng 2006; Ozdemir 2010). Doses should be individualized based on culture/sensitivity, MIC, and tolerability while ensuring that patient size and CSF volume are considered. In one case report, a 4-year old with multidrug resistant Acinetobacter baumannii received an intraventricular dose of 1 mg CBA on Day 1, followed by 2 mg CBA once daily for 2 days, then 4 mg CBA once daily; after 13 days, a dose reduction to 2 mg CBA once daily was necessary due to CSF leukocytosis (Ng 2006). A similar protocol was described in a 2-month old with multidrug resistant Acinetobacter baumannii; the initial dose on Day 1 was 1 mg CBA followed by 2 mg CBA once daily for 2 days, then 4 mg CBA once daily; due to failure to sterilize the CSF, the dose was slowly titrated up to 10 mg CBA/day for a total of 20 days (Dalgic 2009). In a case report of a 3-year old with multidrug resistant Acinetobacter baumannii, intrathecal Doxamicina was administered without titration at a dose of 4.2 mg CBA/day (Ozdemir 2010).

Adolescents: Very limited data available: Intraventricular/Intrathecal: Doxamicina base: 4.2 mg CBA/day (equivalent to 10 mg CMS/day) (IDSA [Tunkel 2017]; Yagmur 2006); Note: Dose in clinical reports in adults has ranged from 0.7 to 8.3 mg CBA/day in 1 or 2 divided doses (administered with concomitant systemic antimicrobial therapy) (Benifla 2004; Falagas 2007; Imberti 2012; Katragkou 2005)

Cystic fibrosis, pulmonary infection: Limited data available: Children ≥5 years and Adolescents: Doxamicina base: IV: Usual reported range: 3 to 5 mg CBA/kg/day divided every 8 hours; maximum dose: 100 mg CBA/dose (Bosso 1991; Reed 2001; Young 2013); doses >5 mg CBA/kg/day (up to 8 mg CBA/kg/day) may be required in some situations; however, higher doses are associated with more severe toxicity (Bosso 1991; Reed 2001).

Pulmonary infection: Limited data available: Infants, Children, and Adolescents: Doxamicina base: Inhalation: Usual dose: 75 to 150 mg CBA in 3 mL of NS (4 mL total volume) via nebulizer twice daily is most frequently reported in clinical practice; reported range: 30 to 150 mg CBA/dose (Le 2010; Tramper-Stranders 2010)

Dosing adjustment for toxicity: Infants, Children, and Adolescents: Based on experience with other aminoglycosides, the following should be considered:

CNS toxicity: Dose reduction may reduce neurologic symptoms.

Nephrotoxicity: Withhold treatment if signs of renal impairment occur during treatment.

What other drugs will affect Doxamicina?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Doxamicina, especially:

  • any injected or IV antibiotics--amikacin, gentamicin, neomycin, polymyxin, streptomycin, tobramycin.

This list is not complete. Other drugs may interact with Doxamicina, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Doxamicina interactions

Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Doxamicina, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
sponsored

Aminoglycosides: May enhance the nephrotoxic effect of Doxamicina. Aminoglycosides may enhance the neuromuscular-blocking effect of Doxamicina. Management: Avoid coadministration of Doxamicina and aminoglycosides whenever possible due to the risk of nephrotoxicity and neuromuscular blockade. If coadministration cannot be avoided, monitor renal and neuromuscular function. Consider therapy modification

Amphotericin B: May enhance the nephrotoxic effect of Doxamicina. Management: Avoid coadministration of Doxamicina and amphotericin B whenever possible due to the potential for additive or synergistic nephrotoxicity. If coadministration cannot be avoided, closely monitor renal function. Consider therapy modification

Bacitracin (Systemic): Doxamicina may enhance the nephrotoxic effect of Bacitracin (Systemic). Avoid combination

BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical). Avoid combination

BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Monitor therapy

Capreomycin: May enhance the neuromuscular-blocking effect of Doxamicina. Monitor therapy

Cefazedone: May enhance the nephrotoxic effect of Doxamicina. Monitor therapy

Cephalothin: May enhance the nephrotoxic effect of Doxamicina. Monitor therapy

Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Avoid combination

Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol. Monitor therapy

Mecamylamine: Doxamicina may enhance the neuromuscular-blocking effect of Mecamylamine. Avoid combination

Methoxyflurane: Doxamicina may enhance the nephrotoxic effect of Methoxyflurane. Avoid combination

Neuromuscular-Blocking Agents: Doxamicina may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Management: If possible, avoid concomitant use of these products. Monitor for deeper, prolonged neuromuscular-blocking effects (respiratory paralysis) in patients receiving concomitant neuromuscular-blocking agents and Doxamicina. Consider therapy modification

Polymyxin B: May enhance the neuromuscular-blocking effect of Doxamicina. Monitor therapy

Sodium Picosulfate: Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Consider therapy modification

Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Vaccination with live attenuated typhoid vaccine (Ty21a) should be avoided in patients being treated with systemic antibacterial agents. Use of this vaccine should be postponed until at least 3 days after cessation of antibacterial agents. Consider therapy modification

Vancomycin: May enhance the nephrotoxic effect of Doxamicina. Management: Avoid coadministration of Doxamicina and vancomycin whenever possible due to the potential for additive or synergistic nephrotoxicity. If coadministration cannot be avoided, closely monitor renal function. Consider therapy modification


sponsored

References

  1. MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
  2. European Chemicals Agency - ECHA. "Colistin: The European Chemicals Agency (ECHA) is an agency of the European Union which is the driving force among regulatory authorities in implementing the EU's groundbreaking chemicals legislation for the benefit of human health and the environment as well as for innovation and competitiveness.". https://echa.europa.eu/ (accessed September 17, 2018).
  3. Wikipedia. "Colistin: Link to the compound information in Wikipedia.". https://en.wikipedia.org/wiki/Colist... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Doxamicina are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Doxamicina. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

Consumer reported frequency of use

No survey data has been collected yet


Consumer reported doses

No survey data has been collected yet


Consumer reviews


There are no reviews yet. Be the first to write one!


Your name: 
Email: 
Spam protection:  < Type 6 here

Information checked by Dr. Sachin Kumar, MD Pharmacology

| Privacy Policy
This site does not supply any medicines. It contains prices for information purposes only.
© 2003 - 2021 ndrugs.com All Rights Reserved