Colistimethate Sodium

Also known as colistin

Trade name

Colistin Link

Presentation and preparation

For IV or IM administration:

Vial size (powder volume)	Fluid to add	Volume to add	Resulting concentration
150 mg (negligible)	Water for injections	2 mL	75 mg/mL

Expressed as colistin base.

Colistin base 1 mg is equivalent to 30 000 units.

Reconstitute to 75 mg/mL for IV or IM administration. Swirl gently to avoid frothing. Do not shake.

IV administration

Give undiluted over 3 to 5 minutes or further dilute to a convenient volume and infuse over 30 minutes.

Alternative administration method:

Give half the daily dose over 3 to 5 minutes. Dilute the remaining half dose to a convenient volume and give by continuous infusion over 22 to 23 hours, commencing 1 to 2 hours after the initial dose.

Other routes of administration

IV is the preferred route.

IM: Suitable. Give undiluted by deep IM injection.

SC: Not recommended.

Compatible IV fluids

Glucose 5%

Glucose 5% and sodium chloride 0.9%

Glucose 5% and sodium chloride 0.45%

Hartmann’s

Sodium chloride 0.9%

Y-site only and colistimethate sodium 0.7 mg/mL or weaker:

Potassium chloride 20 mmol/L

Additional information

Monitor for signs of transient neurotoxicity such as tingling or numbness of extremities. If patient experiences symptoms, dosage adjustment may be necessary.

Reconstituted solution should be clear and colourless or slightly yellow.

Neonates: Electrolyte disturbance can occur, monitor. Neurotoxicity may present differently in term or preterm neonates as apnoea or seizures; monitor closely.