Tigecycline dosing in adults can be influenced by several factors, including renal function, hepatic function, and potential drug interactions.

Renal function plays a significant role in tigecycline clearance, as approximately 35% of the drug is excreted unchanged in the urine [1]. Therefore, dose adjustments may be necessary for patients with renal impairment. Specifically, a 50% reduction in the recommended dosage is recommended for patients with a creatinine clearance of 10-30 mL/min [1].

Hepatic function can also impact tigecycline dosing. Although tigecycline is primarily metabolized by non-hepatic mechanisms, hepatic impairment may still affect drug clearance [1]. However, no specific dose adjustments are recommended for patients with hepatic impairment [1].

Potential drug interactions may also influence tigecycline dosing. For example, concomitant administration of tigecycline and strong CYP3A4 inducers, such as rifampin, may decrease tigecycline plasma concentrations [1]. Therefore, the use of strong CYP3A4 inducers should be avoided if possible [1].

It is important to note that tigecycline has a wide therapeutic index, and dose adjustments are typically not required for most patients [1]. However, individualized dosing may be necessary based on the factors mentioned above.

In summary, renal function, hepatic function, and potential drug interactions can influence tigecycline dosing in adults. Healthcare providers should consider these factors when prescribing tigecycline to ensure safe and effective use.

Sources:

1. Tigecycline [package insert]. Wyeth Pharmaceuticals Inc., a subsidiary of Pfizer Inc.; 2017. Accessed March 15, 2023. <https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021867s020lbl.pdf>
2. DrugPatentWatch.com. Tigecycline. Accessed March 15, 2023. <https://www.drugpatentwatch.com/drugs/tigecycline>