Synercid (Quinupristin and Dalfopristin) Drug Information: Description, User Reviews, Drug Side Effects, Interactions

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May 21, 2012

Synercid

Streptococcal Infections »

Group A streptococcal infections facts

Group A streptococci (GAS) are defined gram-positive coccal-shaped bacteria that produce beta-hemolysis (lysis of red blood cells producing clear or transparent areas in special growth media) and appear usually as a chain of two or more bacteria and have molecules on their surface known as Lancefield group A antigens.
Group A Streptococcus (GAS) organisms are usually spread by direct human-to-human transfer. Occasionally, they can be spread by droplets or by a person touching items recently handled by an infected individual (also termed fomites).
GAS can cause a wide range of diseases, but most notably, strep throat; other diseases (or complications) include scarlet fever, rheumatic fever, kidney damage, skin and wound infections and occasionally, necrotizing fasciitis and toxic shock syndrome...

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Synercid® I.V.
(quinupristin and dalfopristin) for Injection

DRUG DESCRIPTION

Synercid® (quinupristin and dalfopristin powder for injection) I.V., a streptogramin antibacterial agent for intravenous administration, is a sterile lyophilized formulation of two semisynthetic pristinamycin derivatives, quinupristin (derived from pristinamycin I) and dalfopristin (derived from pristinamycin IIA) in the ratio of 30:70 (w/w).

Quinupristin is a white to very slightly yellow, hygroscopic powder. It is a combination of three peptide macrolactones. The main component of quinupristin ( > 88.0%) has the following chemical name: N-[(6R,9S,10R,13S,15aS,18R,22S,24aS )-22-[p-(dimethylamino)benzyl]-6-ethyldocosahydro-10,23-dimethyl-5,8,12,15,17,21,24-heptaoxo-13-phenyl-18-[[(3S )-3-quinuclidinylthio] methyl]-12H-pyrido[2,1-f ]pyrrolo-[2,1-l ][1,4,7,10,13,16]oxapentaazacyclononadecin-9-yl]-3-hydroxypicolinamide.

The main component of quinupristin has an empirical formula of C₅₃H₆₇N₉O₁₀S, a molecular weight of 1022.24 and the following structural formula:

Quinupristin Structural Formula Illustration

Dalfopristin is a slightly yellow to yellow, hygroscopic, powder. The chemical name for dalfopristin is: (3R,4R,5E,10E,12E,14S,26R,26aS )-26-[[2-(diethylamino)ethyl]sulfonyl]-8,9,14,15,24,25,26,26a-octahydro-14-hydroxy-3-isopropyl-4,12-dimethyl-3H-21,18-nitrilo-1H,22H-pyrrolo[2,1-c ][1,8,4,19]-dioxadiazacyclotetracosine-1,7,16,22(4H,17H )-tetrone.

Dalfopristin has an empirical formula of C₃₄H₅₀N₄O₉S, a molecular weight of 690.85 and the following structural formula:

Dalfopristin Structural Formula Illustration

What are the possible side effects of dalfopristin and quinupristin (Synercid)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

diarrhea that is watery or bloody;
jaundice (yellowing of the skin or eyes);
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
confusion, seizure (convulsions);
feeling light-headed,...

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What are the precautions when taking quinupristin and dalfopristin (Synercid)?

Before using quinupristin/dalfopristin, tell your doctor or pharmacist if you are allergic to it; or to other streptogramin antibiotics (e.g., pristinamycin, virginiamycin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, high levels of bilirubin in the blood (hyperbilirubinemia).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Consult your doctor before...

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Last reviewed on RxList: 3/19/2012
This monograph has been modified to include the generic and brand name in many instances.