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Capastat (Capreomycin Sulfate) - Summary

 



WARNINGS

The use of Capastat® Sulfate (Capreomycin for Injection, USP) in patients with renal insufficiency or preexisting auditory impairment must be undertaken with great caution, and the risk of additional cranial nerve VIII impairment or renal injury should be weighed against the benefits to be derived from therapy.

Refer to ANIMAL PHARMACOLOGY for additional information.

Since other parenteral antituberculosis agents (streptomycin, viomycin) also have similar and sometimes irreversible toxic effects, particularly on cranial nerve VIII and renal function, simultaneous administration of these agents with Capastat Sulfate is not recommended. Use with nonantituberculosis drugs (polymyxin A sulfate, colistin sulfate, amikacin, gentamicin, tobramycin, vancomycin, kanamycin, and neomycin) having ototoxic or nephrotoxic potential should be undertaken only with great caution.

Usage in Pregnancy: The safety of the use of Capastat Sulfate in pregnancy has not been determined.

Pediatric Usage: Safety and effectiveness in pediatric patients have not been established.

 

CAPASTAT SUMMARY

CAPASTAT® SULFATE
CAPREOMYCIN FOR INJECTION, USP

For Intramuscular and Intravenous Infusion Only

NOT FOR PEDIATRIC USE

Capastat Sulfate is a polypeptide antibiotic isolated from Streptomyces capreolus. It is a complex of 4 microbiologically active components which have been characterized in part; however, complete structural determination of all the components has not been established. Capreomycin is supplied as the disulfate salt and is soluble in water. In complete solution, it is almost colorless. Each vial contains the equivalent of 1 g capreomycin activity.

Capastat Sulfate, which is to be used concomitantly with other appropriate antituberculosis agents, is indicated in pulmonary infections caused by capreomycin–susceptible strains of M. tuberculosis when the primary agents (isoniazid, rifampin, ethambutol, aminosalicylic acid, and streptomycin) have been ineffective or cannot be used because of toxicity or the presence of resistant tubercle bacilli.

Susceptibility studies should be performed to determine the presence of a capreomycin–susceptible strain of M. tuberculosis.


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NEWS HIGHLIGHTS

Media Articles Related to Capastat (Capreomycin)

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Source: MedicineNet ICU Psychosis Specialty [2007.05.30]
Title: Extensively Drug-Resistant Tuberculosis (XDR TB)
Category: Diseases and Conditions
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Opinions: Fighting TB; Currency Transaction Tax
Source: Health News from Medical News Today [2009.11.19]
Innovation, Coordination Needed To 'Bring TB Research Into The 21st Century' Though tuberculosis "is one of the world's leading killers … few citizens, scientists and policymakers are demanding more attention to TB research, treatment and prevention.


Global Fund Approves $2.4B For Ninth Round Grants
Source: HIV / AIDS News From Medical News Today [2009.11.16]
During its recent board meeting in Addis Ababa, Ethiopia, the Global Fund to Fight AIDS, Tuberculosis and Malaria approved $2.4 billion for the three diseases, PlusNews reports. The money is for the fund's "ninth round of grants, bringing the total amount of approved funding since its inception in 2001 to $18.4 billion," according to the publication.

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Published Studies Related to Capastat (Capreomycin)

Preparation and in vivo evaluation of a dry powder for inhalation of capreomycin. [2008.04]
PURPOSE: To develop an aerosol system for efficient local lung delivery of a tuberculostatic drug... CONCLUSIONS: The results indicate that large doses of capreomycin in dry powder form can be efficiently delivered to the lungs of guinea pigs, which may result in high local drug exposure but significantly reduced systemic exposure as suggested by plasma concentrations in the present studies. These systems have considerable potential to provide more effective therapy for MDR-TB.

Inhaled large porous particles of capreomycin for treatment of tuberculosis in a guinea pig model. [2007.08]
Capreomycin is used for the treatment of multidrug-resistant tuberculosis (MDR-TB), but it is limited therapeutically by its severe side effects. The objectives of the present studies were (i) to design low-density porous capreomycin sulfate particles for efficient pulmonary delivery to improve local and systemic drug bioavailability and capacity to reduce the bacillary load in the lungs in a manner similar to that achieved with intramuscular injections; (ii) to determine pharmacokinetic parameters after pulmonary administration of these capreomycin particles; and (iii) to evaluate the efficacy of these particles in treating animals in a small-aerosol-inoculum guinea pig model of TB...

Preparation of large porous biodegradable microspheres by using a simple double-emulsion method for capreomycin sulfate pulmonary delivery. [2007.03.21]
The aim of this work was to evaluate if a simple double-emulsion method could be used for developing a new formulation of large porous microspheres (MS) potentially useful for capreomycin sulfate (CS) pulmonary delivery. Poly(DL-lactide-co-glycolide) was used for MS preparation... The use of RSM helped to establish the conditions to obtain formulations potentially useful for a possible CS pulmonary delivery, by using a simple preparation method with a consistent time, cost, and material saving.

Unilamellar vesicles as potential capreomycin sulfate carriers: preparation and physicochemical characterization. [2004.12.31]
The aim of this work was to evaluate unilamellar liposomes as new potential capreomycin sulfate (CS) delivery systems for future pulmonary targeting by aerosol administration. Dipalmitoylphosphatidylcholine, hydrogenated phosphatidylcholine, and distearoylphosphatidylcholine were used for liposome preparation...

UV spectroscopy and reverse-phase HPLC as novel methods to determine Capreomycin of liposomal fomulations. [2004.10.29]
Capreomycin (CS) is an antitubercular drug active against several Mycobacterium strains, in particular, against M... Thus we propose RP-HPLC and UV as valid alternative methods to the conventional procedures for capreomycin quantitative analysis.

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Clinical Trials Related to Capastat (Capreomycin)

A Prospective Study of Multidrug Resistance and a Pilot Study of the Safety of and Clinical and Microbiologic Response to Levofloxacin in Combination With Other Antimycobacterial Drugs for Treatment of Multidrug-Resistant Pulmonary Tuberculosis (MDRTB) in HIV-Infected Patients. [Completed]
To determine the demographic, behavioral, clinical, and geographic risk factors associated with the occurrence of multidrug-resistant pulmonary tuberculosis (MDRTB). To evaluate the clinical and microbiological responses and overall survival of MDRTB patients who are treated with levofloxacin-containing multiple-drug regimens chosen from a hierarchical list. Per 9/28/94 amendment, to assess whether persistent or recurrent positive sputum cultures of patients who show failure or relapse are due to the same strain or reinfection with a new strain.

Among TB patients, there has been an increase in progressive disease due to the emergence of antimycobacterial drug-resistant strains of Mycobacterium tuberculosis. Failure to identify patients at high risk for MDRTB increases the hazard for both treatment failure and development of resistance to additional therapeutic agents. Efforts to improve survival in patients with MDRTB will depend on improved methods of assessing the risk of acquisition of MDRTB and identifying drug susceptibility patterns in a timely fashion.

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Page last updated: 2009-11-19

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