Indications for: CAPASTAT
Adjunct in susceptible tuberculosis when first-line agents (INH, rifampin, ethambutol, aminosalicylic acid, streptomycin) are inappropriate.
Give by IV infusion over 1 hour or deep IM inj. 1g (max 20mg/kg) daily for 60–120 days, then 1g (max 20mg/kg) 2–3 times per week; max 20mg/kg per day. Treat for 12–24 months. Renal dysfunction: reduce dose (see full labeling).
May be associated with worse clinical outcomes (eg, decreased effectiveness, increased mortality) compared with other parenteral therapy for pulmonary MDR-TB. Use with extreme caution in patients with renal insufficiency or preexisting auditory impairment.
See Boxed warning. Should reserve for those with resistance to injectable aminoglycosides and limited treatment options. Renal or auditory impairment. Risk for additional cranial nerve VIII impairment or renal injury. Assess audiometric measurements and vestibular function prior to initiation and at regular intervals during therapy. Monitor renal function at baseline and weekly during therapy; reduce dose or discontinue if BUN>30mg/dL or if renal function decreases. Monitor hepatic function and serum potassium, magnesium, and calcium levels. Elderly. Pregnancy: may be teratogenic. Nursing mothers.
Concomitant streptomycin, other parenteral antituberculars: not recommended. Increased toxicity with other neuro/ototoxic drugs (eg, aminoglycosides); use cautiously.
Neurotoxicity (esp. ototoxicity), renal toxicity, leukocytosis, leukopenia, abnormal liver function tests, inj site reactions (eg, pain, induration, bleeding), rash.