Vaxcel Polymyxin E Special Precautions

Use with extreme caution in patients with porphyria. Nephrotoxicity or neurotoxicity may occur if the recommended parenteral dose is exceeded. Use with caution in renal impairment. It is advisable to assess baseline renal function and to monitor during treatment. Serum colistimethate sodium concentrations should be monitored. Few cases of pseudo-Bartter syndrome have been reported in children and adults with the intravenous use of colistimethate sodium. Monitoring of serum electrolytes should be started in suspected cases and appropriate management should be implemented, however, normalisation of electrolyte imbalance might not be achieved without discontinuation of colistimethate sodium. Brochospasm may occur on inhalation of antibiotics. This may be prevented or treated with appropriate use of beta2-agonists. If troublesome, treatment should be withdrawn.
Effects on Ability to Drive and Use Machines: During parenteral treatment with colistimethate sodium, neurotoxicity may occur with the possibility of dizziness, confusion or visual disturbances. Patients should be warned not to drive or operate machinery if these effects occur.
Use in Pregnancy & Lactation: See USE IN PREGNANCY & LACTATION section for further information.