Who can administer
  
                  May be administered by registered competent doctor or nurse/midwife
      
  
        Important information
  
                  
- Red light antimicrobial: Restricted for indications in the antimicrobial prescribing guidelines, or following approval by microbiology/infectious diseases
 
      
  
        Available preparations
  
                  Tigecycline Accord 50mg vial
Tygacil 50mg vial
      
  
        Reconstitution
  
                  Sodium Chloride 0.9% or Glucose 5%
- Add 5.3ml to each 50mg vial
 
- Swirl gently to dissolve.
 
- This produces a 10mg per ml solution (overage in vial)
 
- Dilute further prior to administration.
 
- Reconstituted solutions are yellow to orange in colour - if not the solution should be discarded
 
- Also discard if any particulate matter or discoloration (e.g. green or black) noted
 
      
  
        Infusion fluids
  
                  Sodium chloride 0.9% or Glucose 5%
      
  
        Methods of intravenous administration
  
                  Intermittent intravenous infusion
- Add required dose to 100ml infusion fluid and administer over 30 to 60 minutes
 
      
  
        Dose in adults
  
                  Loading (initial) dose
- Give 100mg as a stat dose followed by maintenance dose below
 
Maintenance dose
- Give 50mg every twelve hours
 
- Treatment is normally continued for 5 to 14 days
 
- Higher loading and maintenance doses may be recommended by microbiology or ID
 
Hepatic impairment
- In patients with severe hepatic impairment (Child Pugh C) the dose should be reduced to 25mg every twelve hours following the initial 100mg loading dose. Child-Pugh classification applies to patients with cirrhosis. If the patient has hepatic impairment but does not have cirrhosis, dosage adjustment should be discussed with Micro/ID
 
- Patients should be treated with caution and monitored for treatment response
 
Renal impairment
- No dosage adjustment is necessary in patients with renal impairment.
 
      
  
        Monitoring
  
                  
- Monitoring of coagulation tests such as PT, aPTT and fibribogen advised when using tigecycline
 
- Special care is recommended in seriously ill patients and in patients also using anticoagulants
 
      
  
        Further information
  
                  
- Patients hypersensitive to tetracycline class antibiotics may be hypersensitive to tigecycline
 
      
  
        Storage
  
                  Store below 250C
      
  
        References
  
                  Tygacil SPC September 2022
Tigecycline Accord SPC July 2023
      
  
        Therapeutic classification
  
                  Glycylcycline antibiotic