Roche (not available from CDC)
*Prices represent cost per unit specified, are representative of "Average Wholesale Price" (AWP).
^Dosage is indicated in mg unless otherwise noted.
USUAL ADULT DOSING
1-1.5 mg/kg/day (up to 90mg/day) IM or deep subcutaneous injection.
- Note: contraindicated in patients with renal or cardiac impairments.
- Telemetry/ECG cardiac monitoring recommended with administration.
ADULT RENAL DOSING
DOSING FOR GLOMERULAR FILTRATION OF 50-80
DOSING FOR GLOMERULAR FILTRATION OF 10-50
DOSING FOR GLOMERULAR FILTRATION OF <10 ML/MIN
DOSING IN HEMODIALYSIS
DOSING IN PERITONEAL DIALYSIS
DOSING IN HEMOFILTRATION
USUAL PEDIATRIC DOSING
Dose not established
ADVERSE DRUG REACTIONS
- Precordial pain
- Pain at injection site
- Muscle weakness
- GI: diarrhea; vomiting
- Heart failure
Inhibits polypeptide chain elongation and mammalian cells.
Rapid absorption after intramuscular administration.
Metabolism and Excretion
Slow renal excretion.
Cmax, Cmin, and AUC
Unchanged emetine may be excreted in the urine for 40-60 days after administration.
Well distributed into liver. Also distributed into spleen, lung and kidney.
DOSING FOR DECREASED HEPATIC FUNCTION
X-Contraindicated, animal and human studies shows potential of teratogenicity.
BREAST FEEDING COMPATIBILITY
Contraindicated in breast feeding.
- Dehydroemetine (synthetic derivative of emetine) 65mg/ml IV (1ml vial no longer available from CDC). Emetine was originally derived from ipecac root.
- Rarely used for invasive amebiasis due to severe local and systemic side effects most famously heart failure and arrhythmia (close EKG monitoring recommended) and availability of less toxic agents (e.g., metronidazole).
- May be an option in the treatment of amebic dysentery and/or extraintestinal amebiasis that fails to respond to metronidazole.
- Jain NK et al: Hepatopulmonary amoebiasis. Efficacy of various treatment regimens containing dehydroemetine and/or metronidazole. J Assoc Physicians India 38:269, 1990 [PMID:2202709]
Comment: The best therapeutic results were obtained with a combination of dehydroemetine and metronidazole. However, metronidazole was found to be comparable dehydroemetine.
- Yang WC, Dubick M: Mechanism of emetine cardiotoxicity. Pharmacol Ther 10:15, 1980 [PMID:6996003]
Comment: Addresses major toxicity with this drug.
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