Excreted Unchanged %
See notes
Half-Life (Normalesrd) Hours
0.7-1.0/0.7-1.0
Plasma Protein Binding %
See notes
Volume Of Distribution L/Kg
See notes
Dose For Normal Renal Function
7.5 mg/kg q8h
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [B]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [B]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
100% [B]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: No dose adjustment, [D]
Supplement For Dialysis [Recommendation Level]: Pd
PD: No dose adjustment, [B]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [C]
References
Chevalier P, Rey J, Pasquier O, Leclerc V, Baguet JC, Meyrier A, et al. Pharmaco-kinetics of quinupristin/ dalfopristin in patients with severe chronic renal insufficiency. Clin Pharmacokinet. 2000; 39: 77-84. [PMID: 10926351] / Johnson CA, Taylor CA 3rd, Zimmerman SW, Bridson WE, Chevalier P, Pasquier O, et al. Pharmacokinetics of quinupristin-dalfopristin in continuous ambulatory peritoneal dialysis patients. Antimicrob Agents Chemother. 1999; 43: 152-6. [PMID: 9869581] / Kim MK, Banevicius MA, Zhong M, Shi X, Hu M, Nightingale CH, et al. Clearance of quinupristin-dalfopristin (Synercid) and their main metabolites during continuous veno-venous hemofiltration (CVVH) with or without dialysis. Int J Artif Organs. 2002; 25: 33-9. [PMID: 11853069] / Schwenger V, Mü ndlein E, Dagrosa EE, Fahr AM, Zeier M, Mikus G, et al. Treatment of life-threatening multiresistant staphylococcal and enterococcal infections in patients with end-stage renal failure with quinupristin/dalfopristin: preliminary report. Infection. 2002; 30: 257-61. [PMID: 12382082]
Toxicity Notes
Urinary excretion of unchanged drug: quinupristin 5%, dalfopristin 0%. Half-life similar in both drugs. Protein binding: quinupristin 30%, dalfopristin 60%. Vd: quinupristin 0.24-1.5 L/kg, dalfopristin 0.45-1.45 L/kg. Dalfopristin and metabolites of quinupristin may accumulate in renal failure; significance unknown.