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  • Writer's pictureShruti GOCHHWAL

Colistin tablet: dose, treatment, side effects, injection

Colistin, also called polymyxin E, belongs to the group of polymyxin antibiotics (antibacterials). It is an old antibiotic discovered in the 1940s but its clinical use was largely abandoned in the 1970s mainly due to its nephrotoxicity Parenteral and nebulisation formulations for colistin contain the sodium salt of colistin methanesulfonate (CMS), also called colistimethate, which is an inactive prodrug. The aim of this review is to give an updated summary on colistin with respect to its complex pharmacokinetics and pharmacodynamics. A literature search was conducted using PubMed where colistin or colistin methanesulfonate were combined with key words such as chemistry, bioanalysis, pharmacokinetics

Some reports showed that polymyxins act through an alternative mode of action, a secondary mechanism, which involves inhibition of type II nicotinamide adenine dinucleotide (NADH)-quinone oxidoreductases (NDH-2) activity in inner membrane of Gram-negative bacteria.

Uses of colistin

colistin dose

colistin antibiotic

Antibacterial Activity Susceptibility breakpoints for colistin published by EUCAST are 2 mg/L for P. aeruginosa, Acinetobacter spp. and Enterobacteriaceae. For now, the susceptibility breakpoint published by CLSI is 2 mg/L for both P. aeruginosa and Acinetobacter spp. (resistance if MIC C8 and 4 mg/L, respectively) but this breakpoint should be revised.

Resistance to colistin has been described in many GNB species such as A. baumannii, K. pneumoniae and P. aeruginosa. Colistin resistance in GNB is most commonly related to LPS modifications via diverse routes, of which several involve two-component regulatory systems (TCSs). PhoPQ and PmrAB are two TCSs whose functions and regulations overlap.

Dosage Forms of colistin

Colistin can be administered in the form of an injection. For colistin injection 150 mg/vial dose is given.

Side effects of colistin

colistin side effects

colistin tab

Two main types of toxicity, nephrotoxicity and neurotoxicity, are reported with the use of colistin. However, recent studies have reported that the incidence of nephrotoxicity is less common and severe than that reported in studies and case reports published until 1983.

Dosing Suggestions Considering the pharmacokinetics of both CMS and colistin, the CMS dose has to be adapted to each patient’s renal function. In case of normal renal function, all of the previous cited studies recommend a maintenance dose of 9 MIU of CMS per day in two or three injections, which corresponds to the calculated maintenance dose suggested by the algorithm of Garonzik et al. It is of note that the most recent publications all agree that CMS should be administered twice daily.


If you are taking other drugs along with this, then your doctor must know about this. Taking other drugs with it could alter how your medicines react. You should know about all products be it advised by doctor or taken by you over the counter or any herbal/ayurvedic medicines. Do not stop taking the medicines as per your choice. Always consult the medical professional before making any alteration in the medicine list.

It is of note that the cyclic structure of colistin helps to protect colistin from proteolytic endopeptidases and the hydrophobic acyl chain helps to protect against exopeptidases, thus explaining that the colistin half-life (t) is longer than that of many peptide

Precautions to be taken with colistin

colistin side effects

colistin antibiotic Tablet

If you have any allergy specially to colistin then you must inform your chemist or doctor about it. you should discuss in detail before consuming this. This could contain certain components which could cause allergy. You should discuss in detail about your medical or family history, or problems related to the renal system.

Consuming this could make you dizzy or light headed. Alertness could be reduced, so you should avoid doing things that require utmost attention. Do not take drinks or alcohol with it. weed or marijuana also should not be taken. In case you are taking any of these then talk to your doctor to it. stomach could also feel upset about it. if that is the case then take medical help immediately.

As such there are no serious side effects to it. It is very widely prescribed by doctors and many patients consume it.

Few of the side effects could be numbness around arms, legs etc. Mood and mental alteration can be done leading to confusion, dizzy feeling, slurry speech, weak muscles, breathing issues, changed urine color.

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