Capastat Sulfate

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Generic Name: Capastat Sulfate Brand Name(s): Generics only. No brands available.

Uses

What is Capastat Sulfate (capreomycin) used for?

Capastat Sulfate (capreomycin) is used with other drugs to treat tuberculosis (TB) infections. Capreomycin belongs to a class of drugs known as antibiotics. It is believed to work by preventing the growth of the bacteria that causes TB.

How should I take Capastat Sulfate (capreomycin)?

This medication is given by injection into a muscle or infused into a vein over 1 hour, usually by a health care professional. It is usually given once a day for 2 to 4 months then reduced to 2 or 3 times a week depending on your condition and response to treatment, or use as directed by your doctor. Dosage is based on your medical condition, kidney function, and response to treatment.

If you are using this medication at home, learn all preparation and usage instructions from your health care professional. If you have any questions about using this medication properly, ask your health care professional. Before using this product, check it visually for particles. When mixed, this medication may be nearly colorless or very pale yellow. The color may darken over time, but this does not make this medication less effective. If the liquid has particles or has changed to any other color than pale or dark yellow, do not use it.

If you are giving this medication by injection into a muscle, remember to change the injection site with each dose to prevent irritation. Also, inject this medication into a large muscle such as the buttock or thigh to lessen pain from the injection.

Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear. Stopping the medication too early may result in a return of the infection. It may be necessary to continue treatment for TB for 1 to 2 years. If needed, your doctor may switch you to a drug for this same condition that can be taken by mouth.

For the best effect, use this antibiotic at evenly spaced times. To help you remember, use it on the same day(s) of the week or at the same time each day, depending on your doctor’s instructions. If you are using this medication several times a week, it may help to mark your calendar with a reminder.

Do not use more or less of this drug than prescribed or stop using it (or other TB medicines) even for a short time unless directed to do so by your doctor. Skipping or changing your dose without approval from your doctor may cause the amount of TB bacteria to increase, make the infection more difficult to treat (resistant), or worsen side effects. If TB becomes resistant to this medication, it might also become resistant to other TB medications.

Learn how to store and discard needles, medical supplies, and any unused medication safely. Never reuse needles or syringes.

Tell your doctor if your condition persists or worsens.

How do I store Capastat Sulfate (capreomycin)?

Capastat Sulfate (capreomycin) is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Capastat Sulfate (capreomycin) in the bathroom or the freezer. There may be different brands of Capastat Sulfate (capreomycin) that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Capastat Sulfate (capreomycin) down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Capastat Sulfate (capreomycin)?

Before using capreomycin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, hearing trouble, dehydration, liver disease, a certain muscle disease (myasthenia gravis), Parkinson’s disease.

This drug may make you dizzy. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Capreomycin may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be at a greater risk for side effects while using this drug.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Capastat Sulfate (capreomycin) during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Capastat Sulfate (capreomycin). Capastat Sulfate (capreomycin) is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Capastat Sulfate (capreomycin)?

Pain, irritation, or skin hardening at the injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: signs of kidney problems (such as change in the amount of urine), ringing in the ears, trouble hearing, dizziness.

Tell your doctor right away if any of these rare but very serious side effects occur: muscle weakness/cramps, irregular heartbeat, easy bleeding/bruising.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Capastat Sulfate (capreomycin)?

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: drugs that may harm either the kidneys or hearing (e.g., amphotericin B, colistin, cidofovir, polymyxin, aminoglycosides such as amikacin/gentamicin/kanamycin/tobramycin), certain anesthetics.

Capastat Sulfate (capreomycin) may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Capastat Sulfate (capreomycin)?

Capastat Sulfate (capreomycin) may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Capastat Sulfate (capreomycin)?

Capastat Sulfate (capreomycin) may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Capastat Sulfate (capreomycin).

What is the dose of Capastat Sulfate (capreomycin) for an adult?

Usual Adult Dose for Tuberculosis – Active

Initial dose: 20 mg/kg IM or IV once a day for 60 to 120 days

Maintenance dose: 1 gram IM or IV 2 to 3 times a week

Maximum dose: 1 gram/day

Duration of therapy: 12 to 24 months

Comments:

-Susceptibility studies should be performed prior to initiation to determine the presence of susceptible strains of Mycoplasma tuberculosis.

-This drug should be given with at least 1 other susceptible antituberculosis drug.

-Patients should be changed to appropriate oral therapy if facilities capable of administering this drug are unavailable.

Use: Concomitantly with other appropriate antituberculosis agents to treat pulmonary infections caused by susceptible strains of M tuberculosis when the primary agents (isoniazid, rifampin, ethambutol, aminosalicylic acid, streptomycin) have been ineffective or cannot be used because of toxicity or the presence of resistant tubercle bacilli

American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations:

15 mg/kg IM or IV once a day OR 25 mg/kg IM or IV 3 times a week

Maximum dose: 1 gram/day

Use: Second-line treatment of drug-susceptible tuberculosis caused by susceptible organisms

Usual Geriatric Dose for Tuberculosis – Active

ATS, US CDC, and IDSA Recommendations:

15 mg/kg IM or IV once a day OR 15 to 25 mg IM or IV 3 times a week

Comment: Patients with renal dysfunction and/or those who are older may require 15 mg/kg given 3 times a week.

Use: Second-line treatment of drug-susceptible tuberculosis caused by susceptible organisms

Renal Dose Adjustments

Steady-state concentrations of 10 mcg/mL may be attained by the following doses:

CrCl 110 mL/min: 13.9 mg/kg IM or IV every 24 hours

CrCl 100 mL/min: 12.7 mg/kg IM or IV every 24 hours

CrCl 80 mL/min: 10.4 mg/kg IM or IV every 24 hours

CrCl 60 mL/min: 8.16 mg/kg IM or IV every 24 hours

CrCl 50 mL/min: 7.01 mg/kg IM or IV every 24 hours OR 14 mg/kg IM or IV every 48 hours

CrCl 40 mL/min: 5.87 mg/kg IM or IV every 24 hours OR 11.7 mg/kg IM or IV every 48 hours

CrCl 30 mL/min: 4.72 mg/kg IM or IV every 24 hours OR 9.45 mg/kg IM or IV every 48 hours OR 14.2 mg/kg IM or IV every 72 hours

CrCl 20 mL/min: 3.58 mg/kg IM or IV every 24 hours OR 7.16 mg/kg IM or IV every 48 hours OR 10.7 mg/kg IM or IV every 72 hours

CrCl 10 mL/min: 2.43 mg/kg IM or IV every 24 hours OR 4.87 mg/kg IM or IV every 48 hours OR 7.3 mg/kg IM or IV every 72 hours

Anuric patients (CrCl 0 mL/min): 1.29 mg/kg IM or IV every 24 hours OR 2.58 mg/kg IM or IV every 48 hours OR 3.87 mg/kg IM or IV every 72 hours

ATS, US CDC, and IDSA Recommendations:

15 mg/kg IM or IV once a day OR 15 to 25 mg IM or IV 3 times a week

Other Comments

Administration advice:

-IM: Administer deep into a large muscle mass

-IV: Administer over 60 minutes

Storage requirements:

-Reconstituted solutions may be stored for up to 24 hours under refrigeration.

Reconstitution/preparation techniques:

-Dissolve in Sterile Water for Injection or 0.9% sodium chloride; allow 2 to 3 minutes for complete dissolution.

-Shake well during reconstitution.

General:

-Superficial IM administration may result in increased pain and sterile abscesses.

-Toxicity and/or a loss of potency is not associated with a change in the color of the solution (darkening of a pale straw color).

Monitoring:

The following tests should be performed prior to initiation and at regular intervals thereafter:

-Hepatic: Liver function tests

-Metabolic: Serum calcium, magnesium, potassium

-Nervous System: Vestibular function

-Other: Audiometric measurements

-Renal: Renal function tests

Patient advice:

-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

-Patients should be told to report any unusual or severe side effects, including signs/symptoms of ototoxicity and nephrotoxicity.

What is the dose of Capastat Sulfate (capreomycin) for a child?

Usual Pediatric Dose for Tuberculosis – Active

American Academy of Pediatrics (AAP) Recommendations:

Infants, Children, and Adolescents: 15 to 30 mg/kg IM once a day

Maximum dose: 1 gram/day

Duration of therapy: 2 months (with isoniazid, rifampin, and pyrazinamide)

Uses:

-Adjunctive treatment of drug-resistant tuberculosis

-Adjunctive treatment of drug-susceptible meningitis caused by Mycobacteria bovis in geographic areas where resistance to streptomycin is common

ATS, US CDC, and IDSA Recommendations:

Less than 15 years AND less than 40 kg:

15 to 20 mg/kg IM or IV once a day OR 25 to 30 mg/kg IM or IV 2 times a week

15 years and older AND/OR greater than 40 kg:

15 mg/kg IM or IV once a day OR 25 mg/kg IM or IV 3 times a week

Maximum dose: 1 gram/day

Comment: Patients with renal dysfunction may require 15 mg/kg given 3 times a week.

Use: Second-line treatment of drug-susceptible tuberculosis caused by susceptible organisms

Precautions

Safety and effectiveness in pediatric patients have not been established.

How is Capastat Sulfate (capreomycin) available?

Capastat Sulfate (capreomycin) is available in the following dosage forms and strengths:

  • Intramuscular powder for injection.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Capastat Sulfate (capreomycin), take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: June 4, 2018 | Last Modified: June 4, 2018

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