Telithromycin
KETEK
Pronunciation: tel-ith-roe-MYE-sin (KEE-tek)
What it isKetolide inhibiting the 50S subunit; withdrawn.
Why this oneIt retained activity against macrolide-resistant pneumococcus.
What limits itFatal hepatotoxicity and visual disturbance, and it is contraindicated in myasthenia gravis. Withdrawn.
FDA-approved for
- community-acquired pneumonia (2004)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Community-acquired pneumonia (mild-moderate) | Adults | 800 mg QD | 800 mg QD × 7–10 days | 800 mg QD |
Renal CrCl <30 (incl. dialysis): 600 mg QD; CrCl <30 with coexisting hepatic impairment: 400 mg QD; give after dialysis on dialysis days
Hepatic No adjustment for hepatic impairment alone
Instructions
- Take orally once every 24 hours, with or without food
- In hemodialysis patients, give after the dialysis session on dialysis days
Available strengths
- tab 400 mg
Contraindications
- Myasthenia gravis
- Prior hepatitis and/or jaundice with Ketek or any macrolide
- Concomitant cisapride or pimozide
- Concomitant colchicine in renal or hepatic impairment
Cautions
- Exacerbation of myasthenia gravis (may be fatal, rapid onset)
- Hepatotoxicity — hepatitis and hepatic failure reported
- QT prolongation risk
- Visual disturbances and loss of consciousness reported
Adverse reactions
- Diarrhea, nausea, headache, dizziness, vomiting, loose stools, dysgeusia
Pregnancy Pregnancy Category C — not teratogenic in animals; use only if benefit justifies risk
Lactation Undefined
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 400 mg | tab | 30 qd | not offered |
⚠ BOXED WARNING
- Contraindicated in myasthenia gravis
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilitySevere hepatotoxicity, myasthenic respiratory failure and QT risk