Streptococcus spp., Staphylococcus spp.,(including MRSA and VRSA) H. influenzae, E. coli, K. pneumoniae, Entercoccus spp., M. catarrhalis, N. meningitidis, M. pneumoniae, C. pneumoniae
Binds to the 30S ribosomal subunit of rRNA and inhibits the binding of amino acyl-tRNA
Cmax (300mg IV): 2.8mcg/ml
AUC (300mg IV): 17.9mcg/ml
Half-life: May be dose dependent
GI: nausea, vomiting, abdominal pain
IV: 50mg vial
Adults: 100mg IV x 1, then 50mg IV q 12 hours
Children: Safety and efficacy have not been determined in patients < 18 years old
Disease state based dosing:
Renal failure: Dosing adjustments not necessary (including hemodialysis)
Hepatic failure: In severe hepatic impairment (Childs-Pugh class C) patients should be given the normal loading dose with the maintenance dose administered as 25mg IV q 12 hours
Warning: Tigecycline may cause fetal harm in pregnant women (Pregnancy class D)
Precautions: Tigecycline is a similar to the tetracyclines and may chelate calcium ions and discolor teeth if administered to patients during tooth development (< 8 years old).
Tigecycline does not inhibit metabolism of agents via CYP pathways 1A2, 2C8, 2C9, 2C19, 2D6, and 3A4.
Warfarin – Tigecycline decreases clearance of R-warfarin and S-warfarin. Monitoring of PT times and INR may be warranted
Category D: Risk established, but benefits may outweigh risk.
Therapeutic: Culture and sensitivities, signs and symptoms of infection
Brand names/Manufacturer: Tygacil/Wyeth Pharmaceuticals