Ticoplan400 mg/vial

Ticoplan 400 mg/vial is indicated in adults and in children of the following infections- Complicated skin and soft tissue infections Bone and joint infections Hospital-acquired pneumonia Community-acquired pneumonia Complicated urinary tract infections Infective endocarditis ... Read moreTicoplan 400 mg/vial is indicated in adults and in children of the following infections- Complicated skin and soft tissue infections Bone and joint infections Hospital-acquired pneumonia Community-acquired pneumonia Complicated urinary tract infections Infective endocarditis Ticoplan 400 mg/vial is also indicated as an alternative oral treatment for Clostridium difficile infection-associated diarrhoea and colitis. Where appropriate, Ticoplan 400 mg/vial should be administered in combination with other antibacterial agents.

Glycopeptide

Ticoplan 400 mg/vial is a glycopeptide antibiotic that has shown in vitro bactericidal activity against both anaerobic and aerobic gram-positive organisms. Ticoplan 400 mg/vial inhibits the growth of susceptible organisms by interfering with cell-wall biosynthesis at a site different from that affected by beta-lactams. It is active against staphylococci (including those resistant to methicillin and other beta-lactam antibiotics), streptococci, enterococci, Listeria monocytogenes, micrococci, group JK corynebacteria and gram-positive anaerobes including Clostridium difficile and peptococci.

Ticoplan 400 mg/vial can be given intravenously (as a bolus injection or infusion) or intramuscularly. The intravenous injection may be administered either as a bolus over 3 to 5 minutes or as a 30-minute infusion. Only the infusion method should be used in neonates. It should be given once daily after one or more loading doses. The dosage of Ticoplan 400 mg/vial should be adapted on the severity of the infection and patient’s response to treatment.In adults (Normal kidney function): On the first day, a dose of 6 mg/kg (generally 400 mg) intravenously is recommended. On the following days, the dose may be 6 mg/kg/day (generally 400 mg) intravenously or 3 mg/kg/day (generally 200 mg) intravenously or intramuscularly as a single daily dose. The highest dose and the intravenous route are recommended for serious infections. In potentially fatal infections, treatment should be started with 6 mg/kg (usually 400 mg) twice daily for 1 to 4 days (loading dose) and continued with 6 mg/kg/day intravenously on the following days (maintenance dose). In adults and elderly (Kidney failure): In patients with kidney failure, the dosage should be adjusted from the 4th day of treatment as follows: In moderate kidney failure (creatinine clearance between 40 and 60 ml/min), the daily dose of Ticoplan 400 mg/vial should be halved or given on alternate days. In severe kidney failure (creatinine clearance less than 40 ml/min) and in hemodialysis patients, the daily dose of Ticoplan 400 mg/vial should be reduced to a third, or given every 3 days. If creatinine clearance is equal to or less than 20 ml/min, treatment with Ticoplan 400 mg/vial may be given only if monitoring of drug levels in the blood can be guaranteed. In children (Normal kidney function): In Children (2 months to 12 years): Treatment should be started at a dose of 10 mg/kg every 12 hours for a total of 3 doses and then continued at a dose of 6-10 mg/kg/day, the highest dose being used for the most serious infections or for children with neutropenia. In neonates (up to 2 months): Treatment should be started at a dose of 16 mg/kg on the first day, followed by maintenance doses of 8 mg/kg/day by slow intravenous infusion (lasting approximately 30 minutes). In children (Kidney failure): As like adults, dosage adjustment is recommended. Measuring Ticoplan 400 mg/vial levels in the blood may be useful to make treatment as effective as possible.Clostridium difficile infection associated diarrhea: The recommended dose is 100-200 mg administered twice a day for 7 to 14 days. Giving Ticoplan 400 mg/vial along with another suitable bactericidal antibiotic is recommended for infections requiring maximum bactericidal activity or in situations where the presence of Gram-negative bacteria cannot be ruled out (empirical treatment of fever in patients with neutropenia). In most patients, this medicine can be seen to have an effect 48 to 72 hours after the start of treatment. However, the total duration of treatment is determined based on the type and severity of the infection and the patient’s response to treatment. In endocarditis and osteomyelitis, a period of at least 3 weeks is recommended.

3 ml water for injection should be added slowly down the side wall of the vial of Ticoplan 400 mg/vial 200 mg or 400 mg. The vial should be rolled gently between the palms until the powder is completely dissolved. During the rolling, we have to be cautious about the solution that it does not become foamy. The solution must not be shaken. If foam formed then it should be allowed to stand for 15 minutes for the foam to be subsided. The entire contents from the vial should be withdrawn slowly into a syringe.

Due to potential for increased adverse effects, Ticoplan 400 mg/vial should be administered with caution in patients receiving concurrent nephrotoxic or ototoxic drugs, such as Aminoglycosides, Amphotericin B, Cyclosporion and Frusemide.

Ticoplan 400 mg/vial is contraindicated in patients with known Hypersensitivity to the drug.

Local reaction: Erythema, injection site abscess when given intramuscularly.Allergic reaction: Rash, pruritus, fever, shivering, anaphylactic reactions.Gastrointestinal reactions: Nausea, vomiting, diarrhea.CNS reactions: Physical weakness, dizziness, headache.Hearing reactions: Ringing in the ears, balance disorders.

There are no adequate and well-controlled studies in pregnant women about administration of Ticoplan 400 mg/vial; this drug should be used during pregnancy only if clearly needed. Information about the excretion of Ticoplan 400 mg/vial in milk is not known.

Ticoplan 400 mg/vial should be administered with caution in patients known to be hypersensitive to Vancomycin since cross-hypersensitivity may occur.

Store at a temperature not exceeding 30°C in a dry place. Protect from light. The reconstituted solution should be used immediately, or stored under refrigeration (2 to 8° C) for 24 hours maximum.

Patients with renal impairment: For patients with impaired renal function, reduction of dosage is not required until the fourth day of Ticoplan 400 mg/vial treatment. From the fourth day of treatment-In mild renal insufficiency: Ticoplan 400 mg/vial dose should be halved either by administering the initial unit dose every two days, or by administering half of this dose once a day when creatinine clearance is 40-60 ml/min.In severe renal insufficiency: Ticoplan 400 mg/vial dose should be 1/3 of the normal either by administering the initial unit dose every third day or by administering 1/3 of this dose once a day when creatinine clearance is less than 40 ml/min and in haemodialysed patients. Ticoplan 400 mg/vial is not removed by dialysis.

3 ml water for injection should be added slowly down the side wall of the vial of Ticoplan 400 mg/vial 200 mg or 400 mg. The vial should be rolled gently between the palms until the powder is completely dissolved. During the rolling, we have to be cautious about the solution that it does not become foamy. The solution must not be shaken. If foam formed then it should be allowed to stand for 15 minutes for the foam to be subsided. The entire contents from the vial should be withdrawn slowly into a syringe.

Glycopeptide

Ticoplan 400 mg/vial is a glycopeptide-antibiotic produced by Actinoplanes teichomyceticus. It is presented as a sterile, pyrogen-free ivory white powder for reconstitution with water for injection. It is freely soluble in water and on reconstitution gives a clear solution. Ticoplan 400 mg/vial inhibits the growth of susceptible organisms by interfering with cell-wall biosynthesis at a site different from that affected by beta-lactams. Peptidoglycan synthesis is blocked by specific binding to D-alanyl-D-alanine residues.

Pregnancy Category B3. Ticoplan 400 mg/vial should not be used during confirmed or presumed pregnancy or during lactation unless the potential benefits outweigh possible risks.