colistimethate sodium at a glance
Medicine class
Polymyxin antibiotic
Main inhaled use
Chronic Pseudomonas lung infection in cystic fibrosis
Available routes
Dry-powder inhaler, nebuliser or intravenous administration, depending on the product and indication
First inhaled use
Usually supervised because coughing, wheezing or bronchospasm can occur
What is colistimethate sodium used for?
Uses represented by the selected products include:
Inhaled management of chronic Pseudomonas aeruginosa lung infection in adults and children with cystic fibrosis; the dry-powder capsule product is licensed from six years of age.
Intravenous treatment of serious infections caused by selected aerobic Gram-negative bacteria when treatment options are limited.
Specialist, non-licensed inhaled use for adults with non-cystic-fibrosis bronchiectasis and chronic Pseudomonas aeruginosa infection.
How does colistimethate sodium work?
Colistimethate sodium is a prodrug that forms colistin. Colistin disrupts the outer membrane of susceptible Gram-negative bacteria, causing bacterial death. Inhalation delivers it directly into the airways with relatively low systemic absorption.
colistimethate sodium preparations and strengths
Capsule
Route: Oral
Strengths: 1662500 units
How to take colistimethate sodium
Use only the formulation and device supplied or specified by the specialist team.
Dry-powder capsules are inhaled only through the Turbospin device; never swallow them. Rinse your mouth with water afterwards and spit it out.
Prepare nebuliser vials with the instructed sterile diluent using the taught technique. Mix gently and use the solution promptly.
Sit upright and breathe normally through the nebuliser in a well-ventilated room. Clean and disinfect the equipment as instructed.
Follow the respiratory team's specified order for bronchodilators, airway clearance and other inhaled treatments.
Healthcare professionals prepare and administer intravenous treatment.
colistimethate sodium side effects
Common or expected effects
- Cough, chest tightness, wheezing or bronchospasm with inhaled treatment
- Throat irritation, sore mouth or hoarse voice
- Unpleasant or altered taste
- Breathlessness, nausea or headache, particularly with dry-powder inhalation
- Injection-site irritation with systemic treatment
Get urgent medical advice
- Severe bronchospasm or breathing difficulty
- Allergic reaction with swelling or breathing problems
- Kidney injury, possibly with substantially reduced urine output
- Neurotoxicity, including marked tingling, confusion, visual disturbance, slurred speech or muscle weakness
- Neuromuscular blockade causing severe weakness or impaired breathing
- Severe or persistent diarrhoea during or after systemic treatment
colistimethate sodium in pregnancy
Pregnancy information is limited, and colistimethate sodium crosses the placenta. Specialist assessment of maternal benefit and fetal risk is required; the dry-powder product is not recommended during pregnancy. Do not stop prescribed treatment without discussing it with the specialist team.
colistimethate sodium while breastfeeding
Advice differs by product: Promixin advises against breastfeeding during therapy, Colomycin permits use only when clearly needed, and Colobreathe requires weighing the benefits of breastfeeding and treatment. Seek product-specific advice from the prescriber.
colistimethate sodium interactions
Tell the prescriber about all treatments, including inhaled and hospital-administered medicines.
Aminoglycosides, such as gentamicin, amikacin or tobramycin
Combined treatment can increase kidney and nervous-system toxicity and requires careful monitoring.
Other nephrotoxic or neurotoxic medicines
Kidney or neurological toxicity may increase, particularly with systemic treatment.
Common questions about colistimethate sodium
Answers are fully visible for fast scanning and source review.
Is colistimethate sodium the same as colistin?
Not exactly. Colistimethate sodium is a prodrug converted into the active antibiotic colistin.
Can the dry-powder capsules be swallowed?
No. They must be placed in the Turbospin device and inhaled.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.