tigecycline, Tygacil

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: tigecycline

BRAND NAME: Tygacil

DRUG CLASS AND MECHANISM: Tigecycline is an injectable antibiotic used for the treatment of infections caused by susceptible bacteria. Tigecycline is similar to tetracycline antibiotics and has activity against a large number of bacteria. Tigecycline binds to bacterial ribosomes which produce the cell's proteins. The binding prevents bacterial ribosomes from producing important proteins needed for bacterial growth and multiplication. Tigecycline prevents bacteria from multiplying, but it does not kill bacteria. Tigecycline was approved by the FDA in June 2005.

PRESCRIPTION: Yes.

GENERIC AVAILABLE: No.

PREPARATIONS: Single dose vial: 50 mg

STORAGE: The powder should be stored at room temperature between 15-30 C (59-86 F). Once mixed, it may be stored at room temperature for up to 24 hours (up to six hours in the vial and the remaining time in the intravenous bag). It may also be refrigerated at 2-8 C (36-46 F) for up to 48 hours in an intravenous bag after mixing.

PRESCRIBED FOR: Tigecycline is used for the treatment of complicated skin infections caused by susceptible strains of bacteria including Escherichia coli, Enterococcus faecalis, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus anginosus group, Streptococcus pyogenes and Bacteroides fragilis.

Tigecycline is used for treating complicated intra-abdominal infections caused by susceptible strains of Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Enterococcus faecalis, Staphylococcus aureus, Streptococcus anginosus group, Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides uniformis, Bacteroides vulgatus, Clostridium perfringens, and Peptostreptococcus micros.

Tigecycline also is used for treating community-acquired bacterial pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, and Legionella pneumophila. To prevent resistance, tigecycline should only be used to treat infections caused or very likely to be caused by susceptible strains of bacteria.

DOSING: Tigecycline is administered via intravenous infusions over 30-60 minutes. The initial dose is 100 mg followed by 50 mg every 12 hours. The usual duration of treatment is 5-14 days for complicated skin infections or for complicated intra-abdominal infections, and 7-14 days for community-acquired bacterial pneumonia.

DRUG INTERACTIONS: Tigecycline may decrease the elimination of the blood thinner warfarin (Coumadin) thereby increasing warfarin levels in blood. Therefore, there is a potential for tigecycline to increase the effects of warfarin and promote bleeding. Any effect on warfarin and the potential increased risk of bleeding should be monitored by tests of bleeding.

PREGNANCY: Administration of tigecycline to pregnant women may cause harm to the fetus, and use during tooth development may cause permanent discoloration of teeth.

NURSING MOTHERS: Use of tigecycline in nursing women has not been adequately studied. It is not known whether tigecycline is excreted in human breast milk.

SIDE EFFECTS: The most common side effects of tigecycline are diarrhea, nausea and vomiting. Nausea and vomiting is mild or moderate and usually occurs during the first two days of therapy. Other side effects include pain at the injection site, swelling and irritation; increased or decreased heart rate and infections. Tigecycline is similar to tetracycline antibiotics and therefore may have similar side effects such as increased sensitivity to sunlight. Tigecycline may cause permanent discoloration of teeth if used during tooth development (last half of pregnancy, infancy, and childhood to the age of 8 years). Like other antibiotics, tygecycline can alter normal bacteria in the colon and encourage overgrowth of some bacteria such as Clostridium difficile, which causes inflammation of the colon (pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting tigecycline (diarrhea, fever, abdominal pain, and possibly shock) should contact their physician immediately.

Reference: FDA Prescribing Information

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