Details of Drug

Drug General Information (ID: D1310)
Drug Name	Polymyxin B
Drug Type	Small molecule
Drug Synonymous	polymyxin b; 1404-26-8; POLUMYXIN B; BDBM50410807; DB00781 Click to Show/Hide
Therapeutic Class	Antibiotics
Structure
Structure	3D Structure		2D Structure
Formula	C56H98N16O13
InChI	InChI=1S/C56H98N16O13/c1-7-32(4)13-11-12-16-44(75)63-36(17-23-57)51(80)72-46(34(6)74)56(85)68-39(20-26-60)48(77)67-41-22-28-62-55(84)45(33(5)73)71-52(81)40(21-27-61)65-47(76)37(18-24-58)66-53(82)42(29-31(2)3)69-54(83)43(30-35-14-9-8-10-15-35)70-49(78)38(19-25-59)64-50(41)79/h8-10,14-15,31-34,36-43,45-46,73-74H,7,11-13,16-30,57-61H2,1-6H3,(H,62,84)(H,63,75)(H,64,79)(H,65,76)(H,66,82)(H,67,77)(H,68,85)(H,69,83)(H,70,78)(H,71,81)(H,72,80)/t32?,33-,34-,36+,37+,38-,39+,40+,41+,42+,43-,45+,46+/m1/s1
InChIKey	WQVJHHACXVLGBL-BPJDFBQWSA-N
Canonical SMILES	CCC(C)CCCCC(=O)N[C@@H](CCN)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CCN)C(=O)N[C@H]1CCNC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@@H](NC(=O)[C@H](NC(=O)[C@H](NC1=O)CCN)CC2=CC=CC=C2)CC(C)C)CCN)CCN)[C@@H](C)O
External Link
External Link	Pubchem ID	49800004

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM001 Affected gastrointestinal absorption AM003 Affected organization distribution AM005 Affected excretion pathways AM006 Pharmacodynamic additive effects AM007 Pharmacodynamic antagonistic effects BM002 Altered intestinal flora BM014 Interference of cell/tissue uptake BM027 Decreased renal excretion due to nephrotoxicity BM045 Additive neuromuscular blocking effects BM072 Increased risk of nephrotoxicity BM100 Antagonize the effect of vaccine/toxoid BM107 Attenuated pharmacological effects (Unspecific)
Relation Graph

Full list of drugs interacting with Polymyxin B
Affected gastrointestinal absorption
	Altered intestinal flora					Drug Num: 2
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1094		Mycophenolate mofetil	C23H31NO7	5281078	Moderate		Inter Info	[50], [51]
D1095		Mycophenolic acid	C17H20O6	446541	Moderate		Inter Info	[50], [51]
Affected organization distribution
	Interference of cell/tissue uptake					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1817		Indium In-111 oxyquinoline	C27H18InN3O3	16685037	Moderate		Inter Info	[60]
Affected excretion pathways
	Decreased renal excretion due to nephrotoxicity					Drug Num: 6
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0576		Entecavir	C12H15N5O3	135398508	Moderate		Inter Info	[34]
D1193		Oxaliplatin	C8H14N2O4Pt	9887053	Moderate		Inter Info	[52]
D1241		Pemetrexed	C20H21N5O6	135410875	Moderate		Inter Info	[54]
D0668		Flucytosine	C4H4FN3O	3366	Moderate		Inter Info	[59]
D1389		Remdesivir	C27H35N6O8P	121304016	Moderate		Inter Info	[31], [26], [64], [65], [66]
D1543		Telbivudine	C10H14N2O5	159269	Moderate		Inter Info	[67]
Pharmacodynamic additive effects
	Additive neuromuscular blocking effects					Drug Num: 14
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0196		Botulinum toxin type A	NA	NA	Major		Inter Info	[4], [5], [6]
D0197		Botulinum Toxin Type B	NA	NA	Major		Inter Info	[4], [5], [6]
D0343		Cisatracurium	C53H72N2O12+2	62887	Major		Inter Info	[8], [9], [10]
D0122		Atracurium	C53H72N2O12+2	47319	Major		Inter Info	[8], [9], [10]
D0522		Doxacurium	C56H78N2O16+2	60169	Major		Inter Info	[8], [9], [10]
D1047		Metocurine	C40H48N2O6+2	21233	Major		Inter Info	[8], [9], [10]
D1080		Mivacurium	C58H80N2O14+2	5281042	Major		Inter Info	[8], [9], [10]
D1219		Pancuronium	C35H60N2O4+2	441289	Major		Inter Info	[8], [9], [10]
D1295		Pipecuronium	C35H62N4O4+2	50192	Major		Inter Info	[8], [9], [10]
D1384		Rapacuronium	C37H61N2O4+	5311399	Major		Inter Info	[8], [9], [10]
D1659		Tubocurarine	C37H41N2O6+	6000	Major		Inter Info	[8], [9], [10]
D1684		Vecuronium	C34H57N2O4+	39765	Major		Inter Info	[8], [9], [10]
D1420		Rocuronium	C32H53N2O4+	441290	Major		Inter Info	[8], [9], [10]
D1510		Succinylcholine	C14H30N2O4+2	5314	Major		Inter Info	[8], [9], [10]
	Increased risk of nephrotoxicity					Drug Num: 39
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0056		Amikacin	C22H43N5O13	37768	Major		Inter Info	[1], [2], [3]
D0057		Amikacin (liposome)	C22H43N5O13	37768	Major		Inter Info	[1], [2], [3]
D0335		Cidofovir	C8H14N3O6P	60613	Major		Inter Info	[7]
D0472		Diatrizoate	C11H9I3N2O4	2140	Major		Inter Info	[11], [12], [13], [14], [15], [16], [17]
D0765		Human immunoglobulin G (intravenous)	NA	NA	Major		Inter Info	[18], [19], [20]
D0432		Deferasirox	C21H15N3O4	214348	Major		Inter Info	[21], [22]
D0629		Everolimus	C53H83NO14	6442177	Major		Inter Info	[23], [24], [25]
D0718		Gentamicin	C21H43N5O7	3467	Major		Inter Info	[1], [2], [3]
D0761		Human botulinum neurotoxin A/B immune globulin	NA	NA	Major		Inter Info	[18], [19], [20]
D0763		Human cytomegalovirus immune globulin	NA	NA	Major		Inter Info	[18], [19], [20]
D0768		Human Rho(D) immune globulin	NA	NA	Major		Inter Info	[18], [19], [20]
D0805		Inotersen	C230H318N69O121P19S19	121492004	Major		Inter Info	[26], [27]
D0831		Iodipamide	C20H14I6N2O6	3739	Major		Inter Info	[11], [12], [13], [14], [15], [16], [17]
D0832		Iodixanol	C35H44I6N6O15	3724	Major		Inter Info	[11], [12], [13], [14], [15], [16], [17]
D0833		Iohexol	C19H26I3N3O9	3730	Major		Inter Info	[11], [12], [13], [14], [15], [16], [17]
D0834		Iopamidol	C17H22I3N3O8	65492	Major		Inter Info	[11], [12], [13], [14], [15], [16], [17]
D0836		Iopromide	C18H24I3N3O8	3736	Major		Inter Info	[11], [12], [13], [14], [15], [16], [17]
D0837		Iothalamic acid	C11H9I3N2O4	3737	Major		Inter Info	[13], [14], [15]
D0838		Ioversol	C18H24I3N3O9	3741	Major		Inter Info	[11], [12], [13], [14], [15], [16], [17]
D0839		Ioxilan	C18H24I3N3O8	3743	Major		Inter Info	[11], [12], [13], [14], [15], [16], [17]
D0876		Kanamycin	C18H36N4O11	6032	Major		Inter Info	[1], [2], [3]
D1120		Neomycin	C23H46N6O13	8378	Major		Inter Info	[1], [2], [3]
D1126		Netilmicin	C21H41N5O7	441306	Major		Inter Info	[1], [2], [3]
D1304		Plazomicin	C25H48N6O10	42613186	Major		Inter Info	[1], [2], [3]
D1476		Sirolimus	C51H79NO13	5284616	Major		Inter Info	[23], [24], [25]
D1507		Streptomycin	C21H39N7O12	19649	Major		Inter Info	[1], [2], [3]
D1526		Tacrolimus	C44H69NO12	445643	Major		Inter Info	[23], [24], [25]
D1549		Temsirolimus	C56H87NO16	6918289	Major		Inter Info	[23], [24], [25]
D1597		Tobramycin	C18H37N5O9	36294	Major		Inter Info	[1], [2], [3]
D0252		Capreomycin	C50H88N28O15	3000502	Moderate		Inter Info	[31], [14], [32]
D0357		Clofarabine	C10H11ClFN5O3	119182	Moderate		Inter Info	[33]
D0783		Ibandronate	C9H23NO7P2	60852	Moderate		Inter Info	[35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45], [46]
D1009		Mesalazine	C7H7NO3	4075	Moderate		Inter Info	[47], [48], [49]
D1217		Pamidronic acid	C3H11NO7P2	4674	Moderate		Inter Info	[53], [38], [45]
D0145		Balsalazide	C17H15N3O6	54585	Moderate		Inter Info	[55], [47], [48], [49]
D0623		Etidronic acid	C2H8O7P2	3305	Moderate		Inter Info	[53], [38], [45]
D1173		Olsalazine	C14H10N2O6	22419	Moderate		Inter Info	[55], [47], [48], [49]
D1517		Sulfasalazine	C18H14N4O5S	5339	Moderate		Inter Info	[55], [47], [48], [49]
D1680		Vancomycin	C66H75Cl2N9O24	14969	Moderate		Inter Info	[31], [14], [32]
Pharmacodynamic antagonistic effects
	Antagonize the effect of vaccine/toxoid					Drug Num: 2
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1914		Typhoid vaccine (live)	NA	NA	Major		Inter Info	[26], [28], [29]
D1693		Vibrio cholerae CVD 103-HgR strain live antigen (live)	NA	NA	Major		Inter Info	[30]
	Attenuated pharmacological effects (Unspecific)					Drug Num: 4
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0606		Estradiol	C18H24O2	5757	Moderate		Inter Info	[56], [57], [58]
D0619		Ethinylestradiol	C20H24O2	5991	Moderate		Inter Info	[56], [57], [58]
D1011		Mestranol	C21H26O2	6291	Moderate		Inter Info	[56], [57], [58]
D1287		Picosulfuric acid	C18H15NO8S2	5243	Moderate		Inter Info	[61], [62], [63]

References
1	Product Information. Arikayce (amikacin liposome). Insmed Incorporated, Bridgewater, NJ.
2	Product Information. Garamycin (gentamicin). Schering-Plough Corporation, Kenilworth, NJ.
3	Lindesmith LA, Baines RD Jr, Bigelow DB, Petty TL "Reversible respiratory paralysis associated with polymyxin therapy." Ann Intern Med 68 (1968): 318-27.[PMID: 4306125]
4	Product Information. Myobloc (botulinum toxin type B) Elan Pharmaceuticals, S. San Francisco, CA.
5	Product Information. Dysport (abobotulinumtoxinA). Tercica Inc, Brisbane, CA.
6	Product Information. Jeuveau (prabotulinumtoxinA). Evolus, Inc., Santa Barbara, CA.
7	Product Information. Vistide (cidofovir). Gilead Sciences, Foster City, CA.
8	Fogdall RP, Miller RD "Prolongation of a pancuronium-induced neuromuscular blockade by polymyxin B." Anesthesiology 40 (1974): 84-7. [PMID: 4359101]
9	Levine RA, Beiber MP, Forte FA, et al "Polymyxin B-induced respiratory paralysis reversed by intravenous calcium chloride." J Mt Sinai Hosp N Y 36 (1969): 380-7. [PMID: 4310774]
10	Product Information. Raplon (rapacuronium) Organon, West Orange, NJ.
11	Wong GT, Lee EY, Irwin MG. Contrast induced nephropathy in vascular surgery.?Br J Anaesth. 2016;117 Suppl 2:ii63-ii73. [PMID: 27566809]
12	Bennett WM, Porter GA "Nephrotoxicity of common drugs used by urologists." Urol Clin North Am 17 (1990): 145-56. [PMID: 2407013]
13	Bentley ML, Corwin HL, Dasta J "Drug-induced acute kidney injury in the critically ill adult: recognition and prevention strategies." Crit Care Med 38(6 Suppl) (2010): S169-74. [PMID: 20502171]
14	Dubrovskaya Y, Prasad N, Lee Y, Esaian D, Figueroa DA, Tam VH "Risk factors for nephrotoxicity onset associated with polymyxin B therapy." J Antimicrob Chemother 70 (2015): 1903-7. [PMID: 25652747]
15	Kellum JA, Leblanc M, Venkataraman R "Acute renal failure." BMJ Clin Evid 9 (2008): 2001. [PMID: 19445797]
16	Marcos LA, Camins BC, Ritchie DJ, Casabar E, Warren DK "Acute renal insufficiency during telavancin therapy in clinical practice." J Antimicrob Chemother 67 (2012): 723-6. [PMID: 22174040]
17	van den Berk G, Tonino S, de Fijter C, Smit W, Schultz MJ "Bench-to-bedside review: Preventative measures for contrast-induced nephropathy in critically ill patients." Crit Care 9 (2005): 361-70. [PMID: 16137385]
18	Guo X, Nzerue C "How to prevent, recognize, and treat drug-induced nephrotoxicity.".
19	Centers for Disease Control and Prevention (CDC). Renal insufficiency and failure associated with immune globulin intravenous therapy--United States, 1985-1998.?MMWR Morb Mortal Wkly Rep. 1999;48(24):518-521. [PMID: 10401909]
20	Product Information. BabyBIG (botulism immune globulin). FFF Enterprises, Temecula, CA.
21	Product Information. Exjade (deferasirox). Novartis Pharmaceuticals, East Hanover, NJ.
22	Rafat C, Fakhouri F, Ribeil JA, Delarue R, Le Quintrec M "Fanconi Syndrome Due to Deferasirox." Am J Kidney Dis (2009):. [PMID: 19493602]
23	Product Information. Prograf (tacrolimus). Fujisawa, Deerfield, IL.
24	Product Information. Rapamune (sirolimus) Wyeth-Ayerst Laboratories, Philadelphia, PA.
25	Sheiner PA, Mor E, Chodoff L, Glabman S, Emre S, Schwartz ME, Miller CM "Acute renal, failure associated with the use of ibuprofen in two liver transplant recipients on FK506." Transplantation 57 (1994): 1132-3. [PMID: 7513099]
26	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
27	Product Information. Tegsedi (inotersen). Akcea Therapeutics, Cambridge, MA.
28	UK government "Typhoid.".
29	American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association (1994).
30	Product Information. Vaxchora (cholera vaccine, live). PaxVax, Miami, FL.
31	Cerner Multum, Inc. "Australian Product Information.".
32	Product Information. Vancocin (vancomycin). Lilly, Eli and Company, Indianapolis, IN.
33	Product Information. Clolar (clofarabine). sanofi-aventis, Bridgewater, NJ.
34	Product Information. Baraclude (entecavir). Bristol-Myers Squibb, Princeton, NJ.
35	Banerjee D, Asif A, Striker L, Preston RA, Bourgoignie JJ, Roth D "Short-term, high-dose pamidronate-induced acute tubular necrosis: The postulated mechanisms of bisphosphonate nephrotoxicity." Am J Kidney Dis 41 (2003): E18. [PMID: 12778436]
36	Chang JT, Green L, Beitz J "Renal failure with the use of zoledronic acid." N Engl J Med 349 (2003): 1676-9 discussion 1676-9. [PMID: 14573746]
37	Janssen Van Doorn K, Neyns B, Van Der Niepen P, Verbeelen D "Pamidronate-related nephrotoxicity (tubulointerstitial nephritis) in a patient with osteolytic bone metastases." Nephron 89 (2001): 467-8. [PMID: 11721169]
38	Kanis JA, Preston CJ, Yates AJ, Percival RC, Mundy KI, Russell RG "Effects of intravenous diphosphonates on renal function." Lancet 1 (1983): 1328. [PMID: 6134112]
39	Lockridge L, Papac RJ, Perazella MA "Pamidronate-associated nephrotoxicity in a patient with Langerhans's histiocytosis." Am J Kidney Dis 40 (2002): E2. [PMID: 12087588]
40	Markowitz GS, Fine PL, Stack JI, et al. "Toxic acute tubular necrosis following treatment with zoledronate (Zometa)." Kidney Int 64 (2003): 281-289. [PMID: 12787420]
41	Osullivan TL, Akbari A, Cadnapaphornchai P "Acute renal failure associated with the administration of parenteral etidronate." Ren Fail 16 (1994): 767-73. [PMID: 7899588]
42	Product Information. Aredia (pamidronate). Novartis Pharmaceuticals, East Hanover, NJ.
43	Product Information. Boniva (ibandronate). Roche Laboratories, Nutley, NJ.
44	Product Information. Ostac (clodronate). Hoffmann-La Roche Limited, Mississauga, IA.
45	Product Information. Zometa (zoledronic acid). Novartis Pharmaceuticals, East Hanover, NJ.
46	Zazgornik J, Grafinger P, Biesenbach G, Hubmann R, Fridrik M "Acute renal failure and alendronate." Nephrol Dial Transplant 12 (1997): 2797-8. [PMID: 9430905]
47	Product Information. Canasa (mesalamine (5-aminosalicylic acid)). Axcan Scandipharm Inc, Birmingham, AL.
48	Product Information. Lialda (mesalamine (5-aminosalicylic acid)). Shire US Inc, Florence, KY.
49	Schreiber S. Hamling J, Zehnter E, et al "Renal tubular dysfunction in patients with inflammatory bowel disease treated with aminosalicylate." Gut 40 (1997): 761-6. [PMID: 9245930]
50	Product Information. CellCept (mycophenolate mofetil). Roche Laboratories, Nutley, NJ.
51	Product Information. Myfortic (mycophenolic acid). Novartis Pharmaceuticals, East Hanover, NJ.
52	Product Information. Eloxatin (oxaliplatin). Sanofi Winthrop Pharmaceuticals, New York, NY.
53	Chang JT, Green L, Beitz J "Renal failure with the use of zoledronic acid." N Engl J Med 349 (2003): 1676-9 discussion 1676-9. [PMID: 14573746]
54	Product Information. Alimta (pemetrexed). Lilly, Eli and Company, Indianapolis, IN.
55	Novis BH, Korzets Z, Chen P, Bernheim J "Nephrotic syndrome after treatment with 5-aminosalicylic acid." Br Med J (Clin Res Ed) 296 (1988): 1442. [PMID: 3132281]
56	Back DJ, Breckenridge AM, Crawford FE, MacIver M, Orne ML, Rowe PH "Interindividual variation and drug interactions with hormonal steroid contraceptives." Drugs 21 (1981): 46-61. [PMID: 7009137]
57	Barnett ML "Inhibition of oral contraceptive effectiveness by concurrent antibiotic administration." J Periodontol 56 (1985): 18-20. [PMID: 3882930]
58	King VJ "OC failure rates and oral antibiotics." J Fam Pract 45 (1997): 104-5. [PMID: 9267366]
59	Product Information. Ancobon (flucytosine). Roche Laboratories, Nutley, NJ.
60	Product Information. Indium Oxyquinoline In-111 (indium oxyquinoline In-111). GE Healthcare, Princeton, NJ.
61	Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate). Ferring Pharmaceuticals Inc, Tarrytown, NY.
62	MHRA. Medicines and Healthcare Regulatory Agency (general site Reference).
63	Product Information. Clenpiq (citric acid/Mg oxide/Na picosulfate). Ferring Pharmaceuticals Inc, Tarrytown, NY.
64	European Medicines Agency "Summary on compassionate use. Remdesivir Gilead.".
65	Gilead Sciences, Inc "About Remdesivir.".
66	US Food and Drug Administration "Fact sheet for health care providers emergency use authorization (EUA) of remdesivir (GS-5734TM)".
67	Product Information. Tyzeka (telbivudine). IDEC Pharmaceuticals Corporation, San Diego, CA.

Details of Drug

Details of Drug

Cite MecDDI

About MecDDI

Correspondence