tigecycline (Tygacil)

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.

What brand names are available for tigecycline?

Tygacil

Is tigecycline available as a generic drug?

No.

Do I need a prescription for tigecycline?

Yes.

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.

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.

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.

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

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

What preparations of tigecycline are available?

Single dose vial: 50 mg

How should I keep tigecycline stored?

The powder should be stored at room temperature between 15 C - 30 C (59 F - 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 C - 8 C (36 F - 46 F) for up to 48 hours in an intravenous bag after mixing.