Kimyrsa
Kimyrsa Uses, Dosage, Side Effects, Food Interaction and all others data.
Kimyrsa is a glycopeptide antibiotic used for the treatment of skin infections. It was developed by The Medicines Company (acquired by Novartis). Kimyrsa was initially approved by the FDA in 2014 and formulated to combat susceptible gram-positive bacteria that cause skin and skin structure infections. It boasts the option of single-dose administration and has been proven as non-inferior to a full course of vancomycin therapy.
On March 12, 2021 the FDA approved Kimyrsa, a complete course of therapy in a single, 1 hour 1200 mg infusion. Orbactiv, the other FDA approved oritavancin product, is administered over a 3 hour infusion and contains a lower dose of 400 mg. Marketed by Melinta Therapeutics, Kimyrsa offers effective and time-efficient treatment for skin and skin structure infections.
Kimyrsa interferes with bacterial cell wall synthesis and integrity, treating susceptible skin and subcutaneous tissue infections with gram-positive bacteria. This drug is known to artifically increase INR and aPTT, interfering with coagulation testing. Cases of infusion reactions have also been reported.
| Trade Name | Kimyrsa |
| Availability | Prescription only |
| Generic | Oritavancin |
| Oritavancin Other Names | Oritavancin |
| Related Drugs | ciprofloxacin, azithromycin, ceftriaxone, Augmentin, amoxicillin / clavulanate, cefdinir |
| Type | Injection, powder, lyophilized, for solution |
| Formula | C86H97Cl3N10O26 |
| Weight | Average: 1793.101 Monoisotopic: 1790.564106447 |
| Protein binding | Oritavancin is about 85% bound to plasma proteins. |
| Groups | Approved, Investigational |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | United States, |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Kimyrsa is an antibacterial agent used to treat acute bacterial skin and skin structure infections caused by susceptible Gram-positive bacteria.
Kimyrsa is indicated for the treatment of adult patients with acute bacterial skin and skin structure (including subcutaneous) infection. It is used for confirmed/suspected infections with designated and susceptible gram-positive organisms. There are two preparations of oritavancin; the 400 mg dose that is administered over 3 hours, and the 1200 mg dose administered over 1 hour. Both are indicated for susceptible gram-positive skin and skin structure infections in adults.
As antimicrobial susceptibility patterns are geographically distinct, local antibiograms should be consulted to ensure adequate coverage of relevant pathogens prior to use.
Kimyrsa is also used to associated treatment for these conditions: Skin and skin-structure infections
How Kimyrsa works
The cell wall is vital for the survival and replication of bacteria, making it a primary target for antibiotic therapy. Kimyrsa works against susceptible gram-positive organisms via three separate mechanisms. Firstly, it binds to the stem peptide of peptidoglycan precursors, inhibiting transglycosylation (polymerization). This process normally occurs during cell wall synthesis. Secondly, oritavancin inhibits crosslinking during bacterial cell wall biosynthesis via binding to cell wall pentaglycyl peptide bridging segments. Finally, this drug also acts by disrupting the bacterial cell membrane, interfering with its integrity, which eventually leads to cell death by various mechanisms.
Toxicity
The LD50 of oritavancin in rats is >500m mg/kg. Prescribing information indicates no experience with overdose during the clinical program for oritavancin, however, an overdose is likely to result in an increased risk of adverse effects, such as headache, nausea vomiting, and diarrhea. This drug is not dialyzable, and in the case of an overdose, supportive measures should be undertaken.
Food Interaction
No interactions found.Kimyrsa Drug Interaction
Major: heparinUnknown: charcoal, amoxicillin / clavulanate, sulfamethoxazole / trimethoprim, nebivolol / valsartan, ciprofloxacin, sulfamethoxazole / trimethoprim, ubiquinone, copper gluconate, glucose, diltiazem, glycerin, infliximab, sodium iodide, arginine, levocarnitine, cysteine, lithium, aluminum hydroxide / magnesium hydroxide / simethicone, acetaminophen
Kimyrsa Disease Interaction
Major: colitisModerate: bleeding, hepatic impairment, renal impairment
Volume of Distribution
The volume of distribution of oritavancin is estimated at 87.6 L, suggesting extensive tissue distribution.
Elimination Route
Pharmacokinetic analysis of oritavancin revealed a Cmax of 138 and μg/mL and an AUC0-∞ of 2800 μg•h/mL. The AUC0-t in a study of healthy volunteers after an 800 mg dose 1,1111 μg•h/mL. was also be Another pharmacokinetic study reported a Cmax of 4.7-7.6 micrograms/mL, generally achieved within 24 hours of administration.
Half Life
The average terminal half-life of oritavancin is about 245 hours. A pharmacokinetic study revealed a terminal half-life ranging from 135.8-273.8 hours.
Clearance
The clearance of oritavancin is approximately 0.445 L/h. One study revealed a renal clearance of 0.457 mL/min.
Elimination Route
Kimyrsa is excreted as unchanged drug in both the urine and feces. Less than 5% has been recovered in the urine, and 1% has been recovered in the feces.
Innovators Monograph
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