Lefalin 600

Indications

Lefamulin is an antibiotic used to treat community-acquired bacterial pneumonia (lung infection caught outside hospital) in adults. It works against the common bacteria that cause pneumonia, including Streptococcus pneumoniae, Haemophilus influenzae, and atypical bacteria such as Mycoplasma, Chlamydophila and Legionella.

How It Works

Lefamulin belongs to a group called pleuromutilins. It attaches to the part of the bacterial cell that makes proteins (the ribosome) and stops the bacteria making the proteins they need to grow. Because it acts at a unique site, cross-resistance with other antibiotic groups is uncommon.

Dosage and Administration

Tablets (adults): usually 600 mg every 12 hours for 5 days, as prescribed. Take on an empty stomach, at least 1 hour before or 2 hours after a meal, with a full glass of water, and swallow whole. It is also available as an infusion given into a vein in hospital by a doctor or nurse. Finish the full course even if you feel better.

Interactions

Lefamulin is processed by the liver enzyme CYP3A4. Strong CYP3A4 inhibitors (such as Ketoconazole, Clarithromycin or Ritonavir) and strong inducers (such as Rifampicin, Carbamazepine or Phenytoin) should not be taken with the tablets. It can raise blood levels of medicines like Midazolam. Avoid other medicines that prolong the QT interval (such as some antiarrhythmics, Erythromycin, Haloperidol, certain antidepressants). Tell your doctor about all medicines.

Contraindications

Do not use if you are allergic to Lefamulin or other pleuromutilins, or with CYP3A4 substrates that prolong the QT interval (such as Pimozide). It should not be used during pregnancy.

Side Effects

Diarrhoea, nausea and vomiting are the most common with tablets. Others include stomach pain, headache, sleeplessness, low potassium and raised liver enzymes. Infusion can cause pain or swelling at the injection site. It can prolong the QT interval on the heart tracing. As with other antibiotics, a severe bowel infection (Clostridioides difficile) can occur.

Get urgent medical help if you have a fast or irregular heartbeat, fainting, severe or bloody diarrhoea, or signs of a severe allergic reaction such as swelling of the face or difficulty breathing.

Pregnancy and Lactation

Lefamulin may harm an unborn baby. Women who could become pregnant should have pregnancy excluded and use effective contraception during treatment and for 2 days after the last dose. Do not breastfeed during treatment and for 2 days after the last dose; milk may be expressed and discarded during this time.

Precautions and Warnings

Tell your doctor about any heart rhythm problem, low potassium or magnesium, or liver disease. An ECG may be needed in people at risk of QT prolongation. Use antibiotics only for bacterial infections. See a doctor if symptoms do not improve within a few days.

Overdose

There is limited experience. An overdose may increase stomach upset and heart rhythm effects. Seek medical help; treatment is supportive with heart monitoring.

Therapeutic Class

Antibacterial, pleuromutilin antibiotic.

Storage

Store tablets below 30°C in a dry place, away from light and out of the reach of children. Injection: as directed on the pack, usually refrigerated at 2 to 8°C.