Quinupristin and dalfopristin injection (patient information)

# About your treatment
Your doctor has ordered quinupristin and dalfopristin, a streptogramin antibiotic, to help treat your infection. The medication will be added to an intravenous fluid that will drip through a needle or catheter placed in your vein for 60 minutes two or three times a day.
Quinupristin and dalfopristin eliminates bacteria that cause serious infections, including infections of the blood and skin. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.

# Precautions
Before administering quinupristin and dalfopristin:
- tell your doctor and pharmacist if you are allergic to quinupristin and dalfopristin, pristinamycin, virginiamycin, or any other medications.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: allergy medications such as astemizole (Hismanal) and terfenadine (Seldane); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan); cancer chemotherapy medications such as docetaxel (Taxotere), paclitaxel (Taxol), vinblastine (Velban), vincristine (Oncovin, Vincasar), and vinorelbine (Navelbine); carbamazepine (Tegretol); cholesterol-lowering medications (statins) such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), and simvastatin (Zocor); cisapride (Propulsid); diazepam (Valium); HIV medications such as delavirdine (Rescriptor), nevirapine (Viramune), indinavir (Crixivan), and ritonavir (Norvir); medications for irregular heartbeats such as amiodarone (Cordarone), digoxin (Lanoxin), disopyramide (Norpace), dofetilide (Tikosyn), and quinidine (Quinidex); medications that suppress the immune system such as cyclosporine (Neoral, Sandimmune) and tacrolimus (Prograf); methylprednisolone (Medrol); and midazolam (Versed). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking quinupristin and dalfopristin, call your doctor.

# Administering your medication
Before you administer quinupristin and dalfopristin, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.
It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason because your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

# Side effects

## Mild side effects
Quinupristin and dalfopristin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- rash
- upset stomach
- vomiting
- itching
- pain

## Severe side effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- diarrhea
- muscle or joint pain
- yellowing of the skin or eyes
Quinupristin and dalfopristin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storing your medication
Your health care provider probably will give you a several-day supply of quinupristin and dalfopristin at a time. You probably will be told to store it in the refrigerator. Do not freeze. 
Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature.
Store your medication only as directed. Make sure you understand what you need to store your medication properly.
Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Signs of infection
If you are receiving quinupristin and dalfopristin in your vein, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:
- tenderness
- warmth
- irritation
- drainage
- redness
- swelling
- pain

# Brand names
- Synercid