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Capreomycin

Class
Antimycobacterials
Subclass
Aminoglycosides
Substance name
Capreomycin sulfate
Brand names
Capastat®
Common formulations
Powder for parenteral solution
Indications for use
Labeled indications
Adults
•
Treatment of pulmonary tuberculosis (as a part of combination therapy)
•
Treatment of tuberculosis (multi-drug resistant, as a part of combination therapy)
Safety risks
Contraindications
Hypersensitivity to capreomycin
Warnings and precautions
Abnormal LFTs
•
Use caution pre-existing hepatic disease.
Dehydration
•
Use caution impaired renal function.
Hearing loss
•
Use caution pre-existing hearing impairment.
Specific populations
Renal impairment
eGFR 20-50 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required. Monitor for hypokalemia.
eGFR 10-20 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required. Monitor for hypokalemia.
eGFR < 10 mL/min/1.73 m²
•
Reduce dose. Maximal dose of 1g. Do not exceed frequency of q48h. Monitor for hypokalemia.
Renal replacement therapy
Continuous renal replacement
•
Use acceptable. No dose adjustment required. Monitor for hypokalemia.
Intermittent hemodialysis
•
Reduce dose. Dose as in eGFR < 10 mL/min/1.73 m². Maximal dose of 1g. Maximal frequency of q48h. Monitor for hypokalemia.
Peritoneal dialysis
•
Reduce dose. Dose as in eGFR < 10 mL/min/1.73 m². Maximal dose of 1g. Maximal frequency of q48h. Monitor for hypokalemia.
Hepatic impairment
Any severity
•
Use acceptable. No dose adjustment required.
Pregnancy and breastfeeding
Pregnancy
All trimesters
•
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals.
Breastfeeding
Use with caution during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Very common > 10%
•
↑ BUN, hearing loss
Common 1-10%
•
↓ WBC count, ↓ platelet count, ↓ serum magnesium, ↓ serum potassium, hypocalcemia, ↑ WBC count, ↑ blood eosinophil count, maculopapular rash, fever, injection site reactions, tinnitus, vertigo, urticaria
Uncommon < 1%
•
Peripheral neuropathy
Unknown frequency
•
Cardiac arrhythmias, ↑ liver enzymes, ↑ serum TBIL, ototoxicity, renal tubular necrosis, diarrhea, low urine output, nausea, vomiting, respiratory distress
Interactions
Drug(s)
Check Interactions
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