Tigecycline Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

• Red light antimicrobial: Restricted for indications in the antimicrobial prescribing guidelines, or following approval by microbiology/infectious diseases

Available preparations

Tigecycline Accord 50mg vial

Tygacil 50mg vial

Reconstitution

Sodium Chloride 0.9% or Glucose 5%

• Add 5.3ml to each 50mg vial
• Swirl gently to dissolve.
• This produces a 10mg per ml solution (overage in vial)
• Dilute further prior to administration.

• Reconstituted solutions are yellow to orange in colour - if not the solution should be discarded
• Also discard if any particulate matter or discoloration (e.g. green or black) noted

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Intermittent intravenous infusion

• Add required dose to 100ml infusion fluid and administer over 30 to 60 minutes

Dose in adults

Loading (initial) dose

• Give 100mg as a stat dose followed by maintenance dose below

Maintenance dose

• Give 50mg every twelve hours
• Treatment is normally continued for 5 to 14 days
• Higher loading and maintenance doses may be recommended by microbiology or ID

Hepatic impairment

• In patients with severe hepatic impairment (Child Pugh C) the dose should be reduced to 25mg every twelve hours following the initial 100mg loading dose. Child-Pugh classification applies to patients with cirrhosis. If the patient has hepatic impairment but does not have cirrhosis, dosage adjustment should be discussed with Micro/ID
• Patients should be treated with caution and monitored for treatment response

Renal impairment

• No dosage adjustment is necessary in patients with renal impairment.

Monitoring

• Monitoring of coagulation tests such as PT, aPTT and fibribogen advised when using tigecycline
• Special care is recommended in seriously ill patients and in patients also using anticoagulants

Further information

• Patients hypersensitive to tetracycline class antibiotics may be hypersensitive to tigecycline

Storage

Store below 25⁰C

References

Tygacil SPC September 2022

Tigecycline Accord SPC July 2023

Therapeutic classification

Glycylcycline antibiotic