Kolelang (Colistimethate Sodium)

Kolelang is a polymyxin antibiotic used for serious Gram‑negative bacterial infections affecting the central nervous system.

• Gram‑negative bacterial meningitis: provides bactericidal activity to eradicate the infection within the cerebrospinal fluid.
• Post‑neurosurgical CNS infection: helps control resistant Gram‑negative pathogens after surgical procedures.
• Ventriculitis caused by susceptible organisms: delivers high local concentrations to clear infection in the ventricular system.

• Colistimethate sodium binds to the lipopolysaccharide component of the outer membrane of Gram‑negative bacteria. This interaction displaces calcium and magnesium ions, destabilizing the membrane and increasing its permeability. The resulting loss of barrier function leads to leakage of cellular contents and rapid bacterial cell death, providing a bactericidal effect against susceptible organisms.

Colistimethate sodium may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Headache: mild to moderate pain in the head region.
• Nausea: feeling of sickness often accompanied by an urge to vomit.
• Fever: elevated body temperature during treatment.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Injection‑site pain: local discomfort at the administration site.
• Tingling or paresthesia: transient sensory disturbances.

Serious or Rare Side Effects

• Seizures: convulsive episodes requiring immediate medical attention.
• Anaphylaxis: severe allergic reaction with airway compromise.
• Nephrotoxicity: acute kidney injury manifested by rising creatinine.
• Severe neurotoxicity: profound peripheral neuropathy or encephalopathy.
• Respiratory paralysis: loss of breathing effort, potentially life‑threatening.
• Hypersensitivity reactions: rash, urticaria, or angioedema.

When using Kolelang, several precautions should be observed to minimize risks.

• Renal function monitoring: assess serum creatinine before and during therapy.
• Neurological assessment: watch for signs of neurotoxicity.
• Dosage adjustment in renal impairment: reduce dose as recommended.
• Avoid concurrent nephrotoxic agents: limit exposure to other kidney‑toxic drugs.
• Pregnancy and lactation: use only if benefit outweighs risk.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Colistimethate sodium can interact with other medicines, affecting safety or efficacy.

Major Interactions (Avoid)

• Aminoglycosides: additive nephrotoxicity and neurotoxicity.
• Loop diuretics: increased risk of kidney injury.
• Neuromuscular blocking agents: potentiation of respiratory paralysis.

Moderate Interactions (Monitor Closely)

• Vancomycin: possible additive nephrotoxicity.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may worsen renal function.