Are dose adjustments needed for tigecycline at high elevations?

Are dose adjustments needed for tigecycline at high elevations?

Tigecycline is a glycylcycline antibiotic approved for treating complicated skin infections, intra-abdominal infections, and community-acquired pneumonia. It is administered intravenously.

Tigecycline reaches its steady-state plasma concentration after 3-4 days of dosing at 50 mg every 12 hours.

Tigecycline has a large volume of distribution and extensive tissue penetration.

Tigecycline has an AUC/MIC ratio that determines its efficacy.

Tigecycline is eliminated unchanged primarily through the biliary/fecal route.

Tigecycline has a half-life of 27-42 hours.

How is tigecycline's pharmacokinetics altered at altitude?

Altitude-related hypoxia can increase ventilation rate and alter blood pH, resulting in respiratory alkalosis. Respiratory alkalosis may shift tigecycline's binding to plasma proteins and affect its distribution volume.

Altitude-induced hyperventilation and respiratory alkalosis can also shift plasma pH away from tigecycline's pKa, affecting its ionization state and volume of distribution.

Altitude does not affect renal excretion because tigecycline is not excreted through the kidneys.

Altitude does not affect the biliary route because no studies have examined this route at altitude.

Altitude does not affect AUC/MIC because no studies have examined this relationship at altitude.

How can patients use tigecycline safely at high elevations?

Patients traveling to high elevations who already receive tigecycline should continue their current dosing schedule.

Patients new to tigecycline at high elevations should start at the recommended 100 mg loading dose followed by 50 mg twice daily.

Patients who are in acute mountain sickness or high-altitude pulmonary edema should consult a physician before receiving tigecycline.

Patients who are at high elevations with conditions that affect pH or pH-sensitive drugs should consult a clinical pharmacist.

What happens if a patient receives tigecycline at high elevations with existing liver impairment?

Patients with severe liver impairment receive a half-dose after the loading dose.

Patients with mild or moderate liver impairment receive the full dose.

Patients with severe liver impairment at high elevations may experience further pharmacokinetic shifts from respiratory alkalosis.

Patients with severe liver impairment at high elevations may experience further distribution volume changes from respiratory alkalosis.

When does tigecycline's patent expire?

Tigecycline is produced by Pfizer Inc.

Tigecycline is covered by U.S. Patent No. 5,494,903.

Tigecycline is covered by U.S. Patent No. 5,494,903, which expires June 1, 2015.

Tigecycline is covered by U.S. Patent No. 5,494,903, which expires June 1, 2015, and is already expired.

Tigecuda is covered by U.S. Patent No. 5,494,903, which is already expired.