Integrated & Community Services - Nebulised Colomycin - Antibiotic Therapy

What is Colomycin and for what it is used?

Colomycin is Colistimethate Sodium, an antibiotic that fights infections caused by Pseudomonas Aeruginosa.
Colomycin is breathed into the lungs (inhaled) so that more of the antibiotic can work against the bacteria causing the infection.

Before you take Colomycin

Tell your doctor if:

• You are pregnant or could get pregnant
• You are breast-feeding
• You are allergic (hypersensitive) to Colistimethate Sodium
• You suffer from myasthenia gravis (a rare disease where your muscles are extremely weak and get tired very quickly)

Take special care with Colomycin and tell your doctor if:

• You have or have had kidney problems
• You suffer from porphyria (a rare metabolic disease that some people are born with)
• If you have asthma

Using other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines you bought without a prescription. These medicie may intefere with the effect of Colomycin.

• If you are taking antibiotics such as Cephalothin Sodium, Gentamicin, Amikacin, Netilmicin and Tobramycin, please tell your doctor. Taking Colomycin at the same time as these other antibiotics could increase your risk of kidney problems
• Colomycin could prolong the effects of muscle relaxing medicines, which may be used as part of a general anaesthetic if you have an operation. If you need to have a general anaesthetic, tell the anaesthetist that you are taking Colomycin

Pregnancy and breast-feeding

You must not take Colomycin if you are pregnant or trying to get pregnant. Colomycin may harm your unborn baby.

Do not breast-feed while you are taking this medicine as Colomycin can pass into breast milk.

Driving and using machines

Colomycin may make you feel dizzy, confused or have problems with your sight, such as blurred vision. If this happens to you, do not drive or use any tools or machines.

How to take Colomycin

Always take Colomycin exactly as demonstrated to you.

You should check with your specialist or pharmacist if you are not sure.

The usual dose for adults is 1 or 2 Million International Units (MIU) twice daily.

There are 2 options, but your specialist will decide the best dose for you and share the monitoring of your condition with your GP.

How to prepare Colomycin

Equipment and medicine needed:

On prescription from your GP:

• Salbutamol 2.5mg/2.5ml nebules (to mix with the Colomycin powder)
• Water for injection 1.5ml (to mix with the Colomycin powder)
• Colomycin Antibiotic dry powder drug vial (tiny glass bottle with dry powder with antibiotic inside)

Provided by your hospital specialist:

• Nebuliser Compression machine with mask or mouthpiece
• Filter pads
• 5ml syringe and blunt drawing up needle
• Replacement filters and consumables for the nebulised kit

Instructions

• Before Colomycin can be taken it must be dissolved
• Carefully tear off the metal ring from around the top of the glass Colomycin bottle and take out the rubber bung slowly and gently
• Draw up 2.5 ml of Salbutamol with a needle and syringe and
• 1.5 ml of water for injection (4ml total volume) per vial
• If intolerant to Salbutamol, 4ml or normal saline or 4ml of water for injection per vial is to be used to dilute
• Add slowly and gently to the powder to avoid frothing of the mixture
• Replace the bung
• Roll the glass vial of powder and liquid slowly in between both hands to mix thoroughly. Do not shake
• Wait for a few minutes until the solution has mixed and looks clear
• Once prepared the medication must be taken straight away
• Take the top off the nebuliser unit and pour in the solution and then put the top back on
• Connect the ventilation pipe (elephant tubing) and place out of an open window
• Switch on the nebuliser
• Breath through your mouth at your usual rate and rhythm (not too deep or too fast, just relaxed breathing)
• Keep the mouthpiece in your mouth during the treatment
• Once completed remove the mouthpiece and switch off the compressor machine
• Rinse your mouth with fresh water
• Wash the nebuliser unit thoroughly and allow to dry in the room air

You should have your treatment in a well-ventilated room, and it is recommended that nobody else is in the room during administration of nebulised Colomycin where possible.

Keep the room well-ventilated with the window open for one hour after completion.

If you take more Colomycin than you should

If you realise that you have taken more Colomycin than your doctor has recommended (or if someone else has taken some of your Colomycin), contact your doctor straight away.

Cleaning and maintaining your nebuliser kit

• Your nebuliser kit and consumables should be cleaned as per manufacturers instructions
• Filter pads should be replaced after each dose or daily as a minimum
• Consumables such as mask, tubing, filter valve and air filter should be replaced annually
• Please contact the Respiratory Nurses on 0161 206 3161 to arrange replacement of this equipment
• Date replacement equipment is needed is:

If you forget to take Colomycin

Take the dose as soon as you remember, unless it is near the time for your next dose. You do not need to make up for the dose you have missed.

If you stop taking Colomycin

Do not stop your treatment early unless you have a side effect, or your doctor says that you can. Your doctor will tell you how long your treatment will last.

Possible Side Effects

Like all medicines Colomycin can cause side effects, although not everybody gets them.

Colomycin can sometimes cause allergic reactions like skin rash. If this happens you should stop taking Colomycin and
tell your doctor immediately.

It is possible to experience a delayed reaction to the drug within 12 hours, if you become extremely wheezy or breathless you must attend the emergency department for medical review.

Colomycin can also affect your kidneys, especially if the dose is high or you are taking other medicines that may affect your kidneys.

Colomycin may sometimes cause you to have a sore mouth or sore throat. Always rinse your mouth after nebulisation. 

This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

Other side effects can include:

• Tingling or numbness around the lips and face
• Dizziness and spinning sensation (vertigo)
• Slurred speech
• Visual disturbance
• Confusion
• Mental disturbance
• Flushing (reddening of the face)

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your specialist, GP or pharmacist.

How to store Colomycin

Keep Colomycin out of the reach and sight of children.

Do not use Colomycin after the expiry date which is stated on the vial or box. The expiry date refers to the last day of that month.

Colomycin does not require any special storage conditions.

Colomycin contains no preservatives.

Once prepared, Colomycin should be used immediately.

Medicines should not be disposed of via wastewater or household waste.

Ask your pharmacist how to dispose of medicines you no longer require. These measures will help to protect the environment.

For further Advice

Nebuliser Service: 0161 206 4423
Email respiratorynurses@nca.nhs.uk