Amupime IM/IV Injection

Amupime Hydrochloride is a preparation of Amupime. It is a fourth generation broad-spectrum cephalosporin antibiotic. Amupime acts by inhibition of bacterial cell wall synthesis. It is highly resistant to hydrolysis by most beta-lactamases and exhibits rapid penetration into gram-negative bacterial cells.

Amupime has been shown to be active against most strains of the following microorganisms:

 

Gram-Positive Microorganisms:

Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Viridans group streptococci, Staphylococcus epidermidis, Staphylococcus saprophyticus, Staphylococcus hominis, Streptococcus agalactiae.

 

Gram-Negative Microorganisms:

Enterobacter, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Acinetobacter calcoaceticus, Citrobacter diversus, Citrobacter freundii, Enterobacter spp., Haemophilus influenzae (including beta-lactamase producing strains), Haemophilus parainfluenzae, Hafnia alvei, Klebsiella oxytoca, Moraxella catarrhalis (including beta-lactamase producing strains), Morganella morganii, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, Serratia marcescens, Neisseria meningitidis.

 

Anaerobes:

Clostridium perfringens, Mobiluncus spp.

Uses

Amupime Hydrochloride is used for the treatment of the following infections:

• Pneumonia (moderate to severe)

• Uncomplicated and Complicated Urinary Tract Infections (including pyelonephritis)

• Uncomplicated Skin and Skin Structure Infections

• Complicated Intra-abdominal Infections

• Empiric Therapy for Febrile Neutropenic Patients.

Amupime is also used to associated treatment for these conditions: Bacterial Infections, Complicated Intra-Abdominal Infections, Complicated Urinary Tract Infection, Febrile Neutropenia, Meningitis, Bacterial, Pyelonephritis, Severe Pneumonia, Uncomplicated Urinary Tract Infections, Moderate Pneumonia, Uncomplicated skin and subcutaneous tissue bacterial infections

Trade Name Amupime
Generic Cefepime
Other Names Cefepima, Cefepime, Cefepimum
Weight 500mg/vial
Type IM/IV Injection
Formula C19H24N6O5S2
Weight Average: 480.561
Monoisotopic: 480.124959288
Protein binding

The serum protein binding of cefepime is approximately 20% and is independent of its concentration in serum.

Therapeutic Class Fourth generation Cephalosporins
Manufacturer Amulet Pharmaceuticals Ltd
Available Country Bangladesh
Last Updated: June 23, 2021 at 11:17 am

Dosage

Amupime dosage

Recommended dosage schedule for adults with normal renal function

Type of Infection Dose Frequency Duration (Days)

Moderate to severe Pneumonia 1-2 g IV q12h 10

Empiric Therapy for Febrile Neutropenic Patients 2 g IV q8h 7

Mild to moderate Uncomplicated or Complicated Urinary 0.5-1 g IV/IM q12h 7-10

Tract Infections (including pyelonephritis)

Severe Uncomplicated or Complicated Urinary 2 g IV q12h 10

Tract Infections (including pyelonephritis)

Moderate to severe Uncomplicated Skin and Skin Structure 2 g IV q12h 10

Infections

Complicated Intra-abdominal Infections 2 g IV q12h 7-10

Pediatric Patients (2 months up to 16 years)

The maximum dose for pediatric patients should not exceed the recommended adult dose.

Type of Infection Pediatric patients up to 40 kg in weight

Dose Frequency Duration

(Days)

Uncomplicated and Complicated Urinary Tract Infections 50 mg/kg q12h 7-10

(including pyelonephritis)

Uncomplicated Skin and Skin Structure Infections 50 mg/kg q12h 10

Pneumonia 50 mg/kg q12h 10

Febrile Neutropenic Patients 50 mg/kg q8h 7

Impaired Hepatic Function - No adjustment is necessary for patients with impaired hepatic function.

Impaired Renal Function - In patients with impaired renal function (creatinine clearance <60 ml/min), the dose of Amupime should be adjusted. The recommended initial dose of Amupime should be the same as in patients with normal renal function except in patients undergoing hemodialysis. The recommended doses of Amupime in patients with renal insufficiency are presented in the following table:

 

Creatinine Clearance Recommended Maintenance Schedule

(ml/min)

>60 500 mg q12h 1g q12h 2g q12h 2g q8h

Normal recommended

dosing schedule

30-60 500 mg q24h 1g q24h 2g q24h 2g q12h

11-29 500 mg q24h 500 mg q24h 1g q24h 2g q24h

<11 250 mg q24h 250 mg q24h 500 mg q24h 1g q24h

CAPD 500 mg q48h 1g q48h 2g q48h 2g q48h

Hemodialysis 1g on day 1, then 500 mg q24h thereafter 1g q24h

Preparation of Solutions of Amupime Hydrochloride

Single-dose vial Administration Amount of diluent to be added

500 mg IM 1.3 ml

500 mg IV 5 ml

1 gm IM 2.4 ml

1 gm IV 10 ml

These solutions may be stored up to 24 hours at room temperature or 7 days in a refrigerator.

Amupime Hydrochloride is compatible at concentrations between 1 and 40 mg/ml with the following IV infusion fluids: (1) 0.9% Sodium chloride, (2) 5% and 10% Dextrose.

IV infusion: Add 5 mL, 10 mL, or 10 mL of a compatible IV soln to a vial labeled as containing 500 mg, 1 g, or 2 g, respectively, to provide soln containing approx 100 mg/mL, 100 mg/mL, or 160 mg/mL of the drug, respectively. The appropriate dose of the drug should then be added to a compatible IV soln.

IM inj: Add 1.3 mL or 2.4 mL of an appropriate diluent (e.g. sterile water for inj, NaCl 0.9%) to a vial labeled as containing 500 mg or 1 g respectively, to provide a soln containing approx 280 mg/mL.

Side Effects

Generally Amupime is well tolerated. However, few side-effects including rash, pruritus, urticaria, fever, headache, nausea, vomiting, diarrhea, dizziness, oral moniliasis may occur.

Precaution

In patients with impaired renal function (creatinine clearance <60 ml/min), the dose of Amupime should be adjusted. Amupime should be prescribed with caution in individuals with a history of gastrointestinal diseases, particularly colitis.

Interaction

Increased potential for nephrotoxicity and ototoxicity of aminoglycosides. Increased risk of nephrotoxicity with potent diuretics (e.g. furosemide).

Food Interaction

No interactions found.

Volume of Distribution

  • 18.0 ±2.0 L
  • 0.3 ±0.1 L/kg [Pediatric]

Half Life

2.0 (± 0.3) hours in normal patients. The average half-life in patients requiring hemodialysis was 13.5 (± 2.7) hours and in patients requiring continuous peritoneal dialysis was 19.0 (± 2.0) hours.

Clearance

  • 120 mL/min [Healthy adult male receiving a single 30-minute IV infusions of cefepime]
  • 3.3 +/-1.0 mL/min/kg [Petriatic patients (2 months – 11 years of age) receiving a single IV dose]

Pregnancy & Breastfeeding use

Pregnancy: There are no adequate and well-controlled studies of Amupime use in pregnant women. Amupime should be used during pregnancy only if clearly needed.

Lactation: Amupime is excreted in human breast milk in very low concentrations. Caution should be exercised when Amupime is administered to a nursing woman.

Contraindication

Hypersensitivity to cefepime or other cephalosporins.

Acute Overdose

Patients who receive an overdose should be carefully observed and given supportive treatment. Symptoms of overdose include encephalopathy (disturbance of consciousness including confusion, hallucinations, stupor, and coma), myoclonus, seizures, and neuromuscular excitability.

Interaction with other Medicine

Renal function should be monitored carefully if high doses of aminoglycosides are to be administered with Amupime because of the increased potential of nephrotoxicity and ototoxicity of aminoglycoside antibiotics. Nephrotoxicity has been reported following concomitant administration of other cephalosporins with potent diuretics such as furosemide.

Storage Condition

Amupime Hydrochloride should be stored in a cool & dry place and protected from light.

Amupime contains Cefepime see full prescribing information from innovator Monograph