Drug Interaction:
Drug interactions -summary-
Cytochrome P450 3A inhibition-
avoid concomittant medications metabolised by cytochrome
P450 3A that may prolong qTc interval
Nifedipine /Midazolam -
Coadministration of quinupristin/dalfopristin and nifedipine ( repeated oral dose ) and
midazolam ( IV bolus dose ) led to elevated plasma concentration of these drugs
Indication:
Skin and skin structure infections
Life threatening infections
Adverse Reaction:
Adverse reactions-
Cardiovascular - palpitation, phelbitis
CNS - anxiety, confusion, dizziness, hypertonia, insomnia, leg cramps, paresthesia,
vasodilation
Dermatologic- macropapular rash, sweating, urticaria
GI - constiption, dyspepsia, oral monoliasis, pancreatitis, peudomembrous enterocolitis
stomatitis
GU - haematuria, vaginitis
Metabolic - Gout, peripheral edema
Musculoskeletal - arthalgia, myalgia, myasthenia
Respiratory - dyspnea, pleural effusion
Miscellaneous- abdominal pain, worsening of underlying illness, allergic reaction,
chest pain, fever, infection
Contra-Indications:
Hypersensitivity to the drug or components
Special precaution/warnngs-
Pseudomembraneous colitis- has been reported with nearly all antibacterial agents, including
quinipristin.dafopristin. Consider this in patients who present with diarrhea susequent to
administeration of antibacterial agents.
Arthalgia/myalgias- some severe cases of arthalgia/myalgias have been reported in patients
with quinupristin/dalfopristin
Hyperbilirubinemia - elevation of total bilirubin more than 5 times the upper limit of normal
were noted in approximately 25% of the patients
Superinfection-Prolonged or repeated therapy of antibiotics may result in superinfection. Appropiate
measures should be taken if superinfection occurs.
Pregnancy- use during pregnancy only if clearly needed.
Lactation- exercise caution when administering to breast feeding woman
Children- safety and efficacy in patients younger than 16 years have not been established
Dosages/ Overdosage Etc:
Indication-
Skin and skin structure infections
Life threatening infections
Dosage-
7.5mg/kg IV every 12 hours
Children younger than 16 years of age- 7.5mg/kg IV every 8 to 12 years has been used in limited
number of children under emergency
Pharmacology/ Pharmacokinetics:
Pharmacology-
Quinupristin/daflfropristin , a streptogramin antibacterial agent for IV administration is a sterile
lyophilised formulation of 2 semi-syntehetic pristinamycin derivative, quinipristin (derived from
pristinamycin I and dalfopristin ( derived from pristinamin II A)
Quinipristin /dalfopristin is bacteriostatic against E faecium and bactericidal against strains
of methicilin-susceptible and methicillin -resistent syaphylococci
Pregnancy and lactation:
Pregnancy-
Use during pregnancy only if clearly needed.
Lactation-
Exercise caution when administering to breast feeding woman
Children-
Safety and efficacy in patients younger than 16 years have not been established
