Megabac 2 MIU IM/IV Injection

Maintenance dose: 9 MIU/day in 2-3 divided doses. In patients who are critically ill, a loading dose of 9 MIU should be administered.

Renal impairment patients: Dose adjustments in renal impairment patients are necessary. Dose reductions are recommended for patients with creatinine clearance < 50 ml/min. Twice daily dosing is recommended.

• Creatinine clearance <50-30 ml/min: daily dose 5.5-7.5 MIU
• Creatinine clearance <30-10 ml/min: daily dose 4.5-5.5 MIU
• Creatinine clearance <10 ml/min: daily dose 3.5 MIU

Haemodialysis (HD) patients:

• No-HD days: 2.25 MIU/day (2.2-2.3 MIU/day).
• HD days: 3 MIU/day (Should be given after the HD session) Twice daily dosing is recommended.

Pediatric population: The dose should be based on lean body weight.

• Children ?40 kg: 75,000-150,000 IU/kg/day divided into 3 doses.
• Children >40 kg: >150,000 IU/kg/day has been reported in children with cystic fibrosis.

Hepatic impairment patients: There are no data in patients with hepatic impairment. Caution is advised when administering colistimethate sodium in these patients.