Table 1 Pharmacokinetics of colistin (CMS)
Metabolism: CMS is a prodrug that is hydrolyzed after i.v. administration to produce derivatives, including the active drug colistin |
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It is not absorbed from the gastrointestinal tract |
Distribution of CMS to lung parenchyma, pleural cavity, pericardial fluids, and CSF is poor |
Time to peak: 10 min following i.v. administration |
Half-life elimination: 2-3 h (CMS i.v. administration, with normal renal function). In patients with anuria = 2-3 days. |
For colistin (base): 250 min |
CMS is tightly bound to membrane lipids of cells in many body tissues, including liver, lungs, kidneys, brain, heart, and muscles |
CMS is excreted primarily in the urine (as unchanged drug). No biliary excretion has been reported in humans |
Data on the pharmacokinetics of i.v. CMS in critically ill patients are limited |