Capreomycin (Cm)

Therapeutic action

– Antibacterial (cyclic polypeptide) with bactericidal activity

Presentation

– Capreomycin sulfate, eq. 1 g base, vial of powder for injection, for deep IM injection

Dosage

– Child under 30 kg: 15 to 30 mg/kg once daily
– Child over 30 kg and adult: 15 to 20 mg/kg once daily
– Maximum dose: 1000 mg daily
– Patient over 60 years: 10 mg/kg once daily (max. 750 mg daily)
– Patient with severe renal impairment: 12 to 15 mg/kg/dose, 2 or 3 times per week

The daily doses take into account the displacement volume (see the note on displacement volume - powders for injection).

Weight
(kg)

Daily dose
(mg)

Daily dose - Deep IM injection1
(1 g dans 2 ml d’eau ppi;
volume final 2,7 ml; 390
mg/ml)

5

75-150

0.3 ml

6

90-180

0.3 ml

7

105-210

0.4 ml

8

120-240

0.4 ml

9

135-270

0.5 ml

10

150-300

0.5 ml

11

165-330

0.5 ml

12

180-360

0.6 ml

13

195-390

0.6 ml

14

210-420

0.6 ml

15

225-450

0.8 ml

16

240-480

0.8 ml

17

255-510

0.8 ml

18

270-540

0.8 ml

19

285-570

0.8 ml

20

300-600

1 ml

21

315-630

1 ml

22

330-660

1 ml

23

345-690

1 ml

24

360-720

1 ml

25

375-750

1.3 ml

26

390-780

1.3 ml

27

405-810

1.3 ml

28

420-840

1.3 ml

29

435-870

1.3 ml


30-33

500

1.3 ml

34-40

600

1.6 ml

41-45

750

1.8 ml

46-50

800

2 ml

51-70

1000

Entire volume

> 70

1000

Entire volume

Contra-indications, adverse effects, precautions

– Do not administer to patients with history of allergy to capreomycin.
– Administer with caution to patients over 60 years or with pre-existing renal, vestibular or auditory impairment.
– May cause:
• electrolyte disturbances, nephrotoxicity, ototoxicity (vestibular and auditory toxicity); rarely, hypersensitivity reaction.
• local pain after injection.
– For the management of adverse effects, see Appendix 10.
– Avoid or monitor combination with other ototoxic and/or nephrotoxic drugs (furosemide, amphotericin B, tenofovir, etc.).
Pregnancy: safety is not established however capreomycin is the only option if an injectable agent is required, as aminoglycosides are contra-indicated during pregnancy.
Breast-feeding: no contra-indication

Monitoring

– Symptomatic monitoring, serum creatinine and electrolytes, audiometric test before and during treatment

Patient instructions

– Maintain a good fluid intake to limit renal problems.

Remarks

Storage: below 25°C
Reconstituted solution must be kept refrigerated (2°C to 8°C) and may be used for up to 24 hours; it may develop a straw colour during the storage but this does not indicate a loss of potency.


Footnotes
Ref Notes
1

For doses less than 1 ml, use a 1 ml syringe graduated in 0.01 ml.