Indications

Antibiotic

Contraindication

Unless facilities for close observation and BP monitoring, avoid use in patients w/ uncontrolled HTN, pheochromocytoma, thyrotoxicosis, carcinoid syndrome, bipolar depression, schizoaffective disorder, acute confusional states. Patients w/ gm-ve bacterial infections. Concomitant use w/ MAOI or w/in 2 wk of discontinuing MAOI; SSRIs, TCAs, selective serotonin- and norepinephrine-reuptake inhibitors (SNRIs), or other serotonergic drugs (e.g. bupropion, vilazodone, mirtazapine, amoxapine, buspirone, maprotiline, meperidine, trazodone, nefazodone), dopamine, dobutamine, epinephrine, norepinephrine, pseudoephedrine.

Special Precautions

Patients w/ pre-existing myelosuppression, history of seizure, DM, phenylketonuria, mixed (gm+ve and gm-ve) infections. Severe renal impairment. Pregnancy and lactation. Monitoring Parameters Monitor CBC wkly. Monitor visual function in patients on extended therapy (≥3 mth) or in patients w/ new visual symptoms.

Side Effects

Reversible myelosuppression (e.g. leucopenia, thrombocytopenia, anaemia, pancytopenia); headache, fever, convulsions and seizures, rashes, dizziness, nausea and vomiting, metallic taste, insomnia, constipation, diarrhoea, abdominal pain, skin disorder, cough, pharyngitis, upper resp tract infection, visual impairment (e.g. changes in visual acuity or color vision, visual field defect or blurred vision), peripheral and optic neuropathy which progress to loss of vision, lactic acidosis, oral and vaginal candidiasis, superficial teeth and tongue discoloration and abnormal LFT.

Drug Interactions

May reduce serum levels w/ rifampicin and phenytoin. May cause hypoglycaemia w/ insulin or oral antidiabetics. May increase risk of seizures w/ tramadol.

Route of Administration

Oral

Dosage

As directed by the physician