Classifications: antibiotic; glycylcycline; Therapeutic: antibiotic
Pregnancy Category: D
50 mg injection
Tigecycline inhibits protein production in bacteria by binding to the 30S ribosomal subunit and blocking entry of transfer
RNA molecules into the ribosome of the bacteria. This prevents formation of peptide chains in bacteria, thus interfering
with their growth.
Tigecycline is active against a broad spectrum of bacterial pathogens and is bacteriostatic.
Treatment of complicated skin and skin structure infections and complicated intraabdominal infections.
Hypersensitivity to tigecycline; pregnancy (category D) and during tooth development of the fetus; viral infections.
Severe hepatic impairment (Child-Pugh class C); hypersensitivity to tetracycline, intestinal perforations, intraabdominal
infections; GI disorders; lactation; children <18 y.
Route & Dosage
|Complicated Skin and Intraabdominal Infections
Adult: IV 100 mg initially, followed by 50 mg q12h over 3060 min x 514 d
Child-Pugh class C: Initial dose 100 mg, followed by 25 mg q12h
- Note that dosage adjustment is required with severe hepatic impairment.
PREPARE: Intermittent: Reconstitute each vial (50 mg) with 5.3 mL of NS or D5W to yield 10 mg/mL. Swirl gently to dissolve; reconstituted solution
should be yellow to orange in color. After reconstitution, immediately withdraw exactly 5 mL from each vial and add to 100
mL of NS or D5W for infusion. The maximum concentration in the IV bag should be 1 mg/mL (two 50 mg doses).
ADMINISTER: Intermittent: Give over 3060 min; when using Y-site, flush IV line with NS or D5W before/after infusion.
INCOMPATIBILITIES Y-site: Amphotericin B, chlorpromazine, methylprednisolone, voriconazole.
- Store in the IV bag at room temperature for up to 6 h, or refrigerated at 2°8° C (36°46°
F) for up to 24 h.
Adverse Effects (≥1%)CNS:
Asthenia, dizziness, headache, insomnia
Hypertension, hypotension, peripheral edema, phlebitis. GI:
Abdominal pain, constipation
, diarrhea, dyspepsia, nausea, vomiting. Hematologic/Lymphatic:
Abnormal healing, anemia, infection, leukocytosis, thrombocythemia. Metabolic/Nutritional:
Alkaline phosphatase increased, ALT increased, amylase increased, AST increased, bilirubinemia, BUN increased, hyperglycemia,
hypokalemia, hypoproteinemia, lactic dehydrogenase increased. Musculoskeletal:
Back pain. Respiratory:
Dyspnea, increased cough, pulmonary physical findings. Skin:
Pruritus, rash, sweating. Body as a Whole:
Abscess, fever, local reaction to injection, pain.
Increased concentrations of warfarin
required close monitoring of INR. Efficacy of oral contraceptives
may be decreased when used in combination with tigecycline.
7189% protein bound. Metabolism:
Fecal (major) and renal. Half-Life:
27 h (single dose); 42 h (multiple doses).
Assessment & Drug Effects
- Monitor for hypersensitivity reaction in those with reported tetracycline allergy.
- Monitor for and report S&S of superinfection (see Appendix F) or pseudomembranous enterocolitis (see Appendix F).
- Lab tests: C&S prior to initiation of therapy; periodic serum electrolytes, LFTs and kidney function tests; PT and INT with
concurrent anticoagulant therapy.
- Monitor diabetics for loss of glycemic control.
Patient & Family Education
- Avoid direct exposure to sunlight during and for several days after therapy is terminated to reduce risk of photosensitivity
- Report to physician loose stools or diarrhea either during or shortly after termination of therapy.
- Use a barrier contraceptive in addition to oral contraceptives if trying to avoid pregnancy.