Formulary
Tigecycline: Indications, Dosing, Side Effects and Interactions
Tigecycline is a glycylcycline antibacterial structurally related to the tetracyclines.
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Tigecycline: Indications, Dosing, Side Effects and Interactions
Tigecycline is a glycylcycline antibacterial structurally related to the tetracyclines.
Drug action
Tigecycline is a glycylcycline antibacterial structurally related to the tetracyclines. Tigecycline is active against Gram-positive and Gram-negative bacteria, including tetracycline-resistant organisms, and some anaerobes. It is also active against meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, but Pseudomonas aeruginosa and many strains of Proteus spp. are resistant to tigecycline.
Indications and dose
**Complicated skin and soft tissue infections (when other antibiotics are not suitable),Complicated intra-abdominal infections (when other antibiotics are not suitable)**
- **Adult** (By Intravenous Infusion): Initially 100 mg for 1 dose, followed by 50 mg every 12 hours for 5-14 days.
**Complicated skin and soft tissue infections (when other antibiotics are not suitable), Complicated intra-abdominal infections (when other antibiotics are not suitable) for tigecycline**
- **Child 8-11 years (under expert supervision)** (By intravenous infusion): 1.2 mg/kg every 12 hours (max. per dose 50 mg) for 5-14 days.
- **Child 12-17 years (under expert supervision)** (By intravenous infusion): 50 mg every 12 hours for 5-14 days.
Cautions
Cholestasis
Contraindications
Diabetic foot infections
Side effects
Common or very common Abscess; appetite decreased; diarrhoea; dizziness; gastrointestinal discomfort; headache; healing impaired; hyperbilirubinaemia; hypoglycaemia; hypoproteinaemia; increased risk of infection; nausea; sepsis; skin reactions; vomiting Uncommon Hepatic disorders; pancreatitis; thrombocytopenia; thrombophlebitis Frequency not known Acidosis; azotaemia; hyperphosphataemia; hypofibrinogenaemia; idiopathic intracranial hypertension; photosensitivity reaction; pseudomembranous enterocolitis; severe cutaneous adverse reactions (SCARs); tooth discolouration Side-effects, further information Side-effects similar to those of the tetracyclines can potentially occur.
Interactions
**Other interactions (13):**
- Concomitant administration of tigecycline and warfarin (25 mg single-dose) to healthy subjects resulted in a decrease in clearance of R-warfarin and S-warfarin by 40 % and 23 %, and an increase in...
- However, since tigecycline may prolong both prothrombin time (PT) and activated partial thromboplastin time (aPTT), the relevant coagulation tests should be closely monitored when tigecycline is...
- Warfarin did not affect the pharmacokinetic profile of tigecycline.
- Tigecycline is not extensively metabolised.
- In vitro , tigecycline is neither a competitive inhibitor nor an irreversible inhibitor of CYP450 enzymes (see section 5.2).
- Tigecycline in recommended dosage did not affect the rate or extent of absorption, or clearance of digoxin (0.5 mg followed by 0.25 mg daily) when administered in healthy adults.
Pregnancy
Tetracyclines should not be given to pregnant women; effects on skeletal development have been documented in the first trimester in animal studies. Administration during the second or third trimester may cause discoloration of the child's teeth, and maternal hepatotoxicity has been reported with large parenteral doses.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution in severe impairment. Dose adjustments Manufacturer advises dose reduction to 25 mg every 12 hours following the loading dose in severe impairment.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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