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Hopstin Injection (Colistimethate Sodium)

  • Each vial contains: Colistimethate Sodium IP 1,2,3,4.5 MIU.
  • Treatment by inhalation of Pseudomonas aeruginosa lung infection in patients with cystic fibrosis.
  • Colistimethate is a cyclic polypeptide antibacterial agent belonging to the polymyxin group. Polymyxins work by damaging the cell membrane and the resulting physiological effects are lethal to the bacterium. Polymyxins are selective for aerobic Gram-negative bacteria that have a hydrophobic outer membrane.
  • A minimum of 5-day treatment is generally recommended. Adults (including the elderly) (Over 60 kg): 1-2 million units three times a day. The maximum dose is 6 million units in 24 hrs. Children (up to 60kg): 50,000 units/kg/day, to a maximum of 75,000 units/kg/day.The total daily dose should be divided into three doses given at approximately 8-hour intervals.
  • Hypersensitivity to colistimethate sodium or to polymyxin B.
  • Consideration should be given to co-administering intravenous colistimethate sodium with another antibacterial agent whenever this is possible, taking into account the remaining susceptibilities of the pathogen(s) under treatment.In case of an allergic reaction, treatment with colistimethate sodium must be discontinued and appropriate measures implemented. Nephrotoxicity can occur and is probably a dose-dependent effect of colistimethate sodium. Used with caution in renal impairment. Transient neurological disturbances may occur.
  • Pregnancy Category C. It is not known whether colistimethate sodium is excreted in human breast milk. However, colistin sulphate is excreted in human breast milk. Therefore, caution should be exercised when colistimethate sodium is administered to nursing women. Close clinical monitoring of paediatric patients is recommended.
  • Certain other antibiotics (aminoglycosides and polymyxin) have also been reported to interfere with the nerve transmission at the neuromuscular junction. Based on this reported activity, they should not be given concomitantly with Hopstin except with the greatest caution. Curariform muscle relaxants (e.g., tubocurarine) and other drugs, including ether, succinylcholine, gallamine, decamethonium and sodium citrate, potentiate the neuromuscular blocking effect and should be used with extreme caution in patients being treated with Hopstin. Sodium cephalothin may enhance the nephrotoxicity of Hopstin. The concomitant use of sodium cephalothin and Hopstin should be avoided.
  • Effects may include nephrotoxicity, decreased urine output, apnoea, transient sensory disturbances (such as facial paraesthesia and vertigo) and, rarely, vasomotor instability, slurred speech, visual disturbances, confusion or psychosis. Hypersensitivity reactions including skin rash have been reported. If these occur, treatment should be withdrawn.
  • Anti-Bacterials