Medication Pearl of the Day: Omadacycline (Nuzyra)
Indication: Omadacycline (Nuzyra) is a tetracycline class antibacterial indicated for the treatment of adult patients with infections caused by susceptible microorganisms—community-acquired bacterial pneumonia (CAPB) and acute bacterial skin and skin structure infections (ABSSSI).
- Dosing: The IV loading dose is 200 mg over 60 minutes or 100 mg over 30 minutes twice. The loading dose for tablets is 450 mg orally once daily. The maintenance dosing is 100 mg IV over 30 minutes or 300 mg orally once daily.
- Dosage forms: For injection, 100 mg of omadacycline (equivalent to 131 mg omadacycline tosylate) as a lyophilized powder in a single-dose vial for reconstitution and further dilution before intravenous infusion. For tablets: 150 mg omadacycline.
- Adverse events: The most common adverse reactions (incidence ≥ 2%) are nausea, vomiting, infusion site reactions, alanine aminotransferase increased, aspartate aminotransferase increased, gamma-glutamyl transferase increased, hypertension, headache, diarrhea, insomnia, and constipation.
- Mechanism of action: Omadacycline is an aminomethylcycline antibacterial within the tetracycline class of antibacterial drugs. Omadacycline binds to the 30S ribosomal subunit and blocks protein synthesis. Omadacycline is active in vitro against Gram positive bacteria expressing tetracycline resistance active efflux pumps (tetK and tet L) and ribosomal protection proteins (tet M). In general, omadacycline is considered bacteriostatic; however, omadacycline has demonstrated bactericidal activity against some isolates of S pneumoniae and H influenzae.
Source: NUZYRA (omadacycline) (fda.gov)