Tigecycline

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

Non-formulary

Dosing

Adult

Initial dose of 100 mg IV load, followed by 50 mg IV q12h

Hepatic

Mild-to-moderate hepatic impairment (Child-Pugh class A or B):
no dosage adjustment necessary

Severe hepatic impairment (Child-Pugh class C):
Initial dose of 100 mg IV load, followed by 25 mg IV q12h

General Information

Unacceptable Uses

Non-formulary

Common Usage

Reserved for highly resistant infections or when significant allergies restrict other options and when there is documented susceptibility.

Associated with more treatment failures than alternatives and excess mortality - Black Box Warning.

Adverse Effects

Avoid or use with caution in patients with tetracycline reactions due to possibility of cross-reaction.

GI side effects very prominent with significant nausea and vomiting.

Tetracycline related adverse events: photosensitivity, acute pancreatitis.

Rash, abnormal liver enzymes.

Major Interactions

May increase warfarin concentrations.
Oral contraceptives less effective.

Additional Information

Documented safety concerns in bacteremia especially.

Pharmacology

Antimicrobial class: Tetracycline derivative

Pregnancy category: D

Average serum half life: Single dose: 27 hours; following multiple doses or at steady state: 42 hours

Biliary penetration: Therapeutic

Lung penetration: Therapeutic