The normal adult dose should be dissolved in 10 ml of sterile water for injections to form a clear solution and given over a minimum of 5 minutes.
The solution is for single use only and any remaining solution should be discarded.
Swirl gently during reconstitution to avoid frothing.
Colistimethate Sodium can be given as a 50 ml intravenous infusion in 0.9% sodium chloride solution a minimum of 5 days treatment is generally recommended. For the treatment of respiratory or sterile water for injections.
Exacerbations in cystic fibrosis patients, treatment should be continued for up to 12 days.
Stability and Storage Recommendations:
Store Colistimethate for Injection USP in powder form at controlled room temperature (15°C-30°C).
After reconstitution, Colistimethate for Injection USP solution should be stored refrigerated (2°C-8°C) or at room temperature (15°C-30°C) and used within 7 days.
Any infusion solution containing colistimethate sodium should be freshly prepared and used for no longer than 24 hours.
In critically ill patients - Loading dose of 9 MIU.
Maintenance Dose - 4.5 MIU every 12 hourly.
The dose and duration depend on the severity of the infection as well as the clinical response.
Normal Renal Function
3 million IU (240 mg CMS) Every 8h
For serum creatinine level 1.3-1.5 mg/dl, 16-2.5 mg/dl, or ≥ 2.6 mg/dl, the recommended dosage of intravenous colistin is 2 million IU (160 mg CMS) every 8h, 12h, or 24h, respectively
Renal Replacement Therapy
2 million IU (160 mg CMS) after each hemodialysis
2 million IU (160 mg CMS) daily during peritoneal dialysis