Usual dose

Pediatric dose

Safety and effectiveness for use in pediatric patients under 16 years of age not established; however, the manufacturer recommends a dose of 7.5 mg/kg every 12 hours for pediatric patients (12 to less than 18 years of age). Dose recommendations for patients less than 12 years of age are not available. Doses of 7.5 mg/kg every 8 or 12 hours have been used under emergency-use conditions in a limited number of pediatric patients.

Dose adjustments

No dose adjustments required in the elderly, pediatric patients, patients with renal insufficiency, or patients undergoing hemodialysis or peritoneal dialysis. See Maternal/Child. ■ Dose reduction may be required in patients with hepatic cirrhosis (Child-Pugh Class A or B). Exact recommendations are not currently available, but one source recommends decreasing dose to 5 mg/kg in patients who cannot tolerate the usual dose. ■ Patients experiencing arthralgias and myalgias may respond to a reduction in dose frequency to every 12 hours; see Precautions. ■ See Drug/Lab Interactions.

Dilution

Reconstitute the 500-mg single-dose vial by slowly adding 5 mL of D5W or SWFI. Swirl gently to limit foam formation. Do not shake. Allow solution to sit until foam has disappeared. Final concentration of reconstituted solution is 100 mg/mL. Must be further diluted; withdraw calculated dose and add to 250 mL of D5W. Desired concentration is approximately 2 mg/mL. If moderate to severe venous irritation occurs following peripheral administration, consideration should be given to increasing infusion volume to 500 to 750 mL of D5W; see Precautions. An infusion volume of 100 mL may be used for central line infusions.

Compatibility (underline indicates conflicting compatibility information)

Consider any drug NOT listed as compatible to be INCOMPATIBLE until consulting a pharmacist; specific conditions may apply.

Manufacturer lists saline solutions and heparin as incompatible and recommends administering quinupristin/dalfopristin separately. Always flush line with D5W before and after administration of any other drug through the same IV line.

Manufacturer lists Y-site compatibility

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