Acetohydroxamic acid

Acetohydroxamic acid: Drug information
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(For additional information see “Acetohydroxamic acid: Patient drug information”)

Brand Names: U.S. Lithostat®
Brand Names: Canada Lithostat®
Pharmacologic Category Urinary Tract Product
Dosing: Adult Susceptible infections: Oral: 250 mg 3-4 times/day for a total daily dose of 10-15 mg/kg/day
Dosing: Pediatric Susceptible infections: Oral: Initial: 10 mg/kg/day
Dosing: Geriatric Refer to adult dosing.
Dosing: Renal Impairment Not recommended for use in significant renal impairment (Srcr >2.5 mg/dL).
Dosage Forms: U.S. Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, oral:

Lithostat®: 250 mg

Generic Equivalent Available: U.S. No
Administration Should be administered on an empty stomach, 1 hour before or 2 hours after meals.
Use Adjunctive therapy in chronic urea-splitting urinary infection
Medication Safety Issues
Sound-alike/look-alike issues:
Lithostat® may be confused with Lithobid®

Adverse Reactions Significant Frequency not defined.
Cardiovascular: Deep vein thrombosis (rare), embolism, palpitation, phlebitis

Central nervous system: Anorexia, anxiety, depression, headache, malaise, nervousness, tremor

Dermatologic: Flushing (with ethanol consumption), rash (nonpruritic, macular)

Gastrointestinal: Nausea, vomiting

Hematologic: Hemolytic anemia (15% with laboratory evidence; ~3% severe requiring discontinuation; may be accompanied by GI symptoms or systemic complaints of malaise and/or fatigue); hyperbilirubinemia

Respiratory: Pulmonary embolism (rare)

Contraindications Hypersensitivity to acetohydroxamic acid or any component of the formulation; pregnancy
Warnings/Precautions
Concerns related to adverse effects:

• Bone marrow suppression: May suppress bone marrow function; use with caution in patients with prior bone marrow depression. Close monitoring of hematologic function is recommended.

• Hemolytic anemia: Has been associated with hemolytic anemia (Coombs’ negative), which may be associated with gastrointestinal distress and systemic symptoms; use with caution in patients with anemia. Monitor hematologic parameters during extended therapy.

• Hepatotoxicity: May cause hepatic injury; close monitoring of hepatic function is recommended.

Disease-related concerns:

• Psychiatric disorders: Use with caution in patients with pre-existing psychiatric disorders; may be associated with nervousness, anxiety, and/or depression.

Drug Interactions
(For additional information: Launch Lexi-Interact™ Drug Interactions Program )
There are no known significant interactions.
Ethanol/Nutrition/Herb Interactions
Ethanol: Avoid ethanol (may increase incidence of rash and/or flushing).

Food: May decrease absorption of acetohydroxamic acid.

Pregnancy Risk Factor X (show table)
Lactation Excretion in breast milk unknown/not recommended
Dietary Considerations Should be taken on an empty stomach, 1 hour before or 2 hours after meals.
Pricing: U.S. (www.drugstore.com)
Tablets (Lithostat)

250 mg (100): $169.98

Monitoring Parameters In patients receiving therapy >2 weeks, monitor CBC with reticulocytes at 3-month intervals during the duration of treatment.
International Brand Names Uronefrex (BE, ES, FR, LU)
Mechanism of Action Acetohydroxamic acid inhibits bacterial urease enzymes, decreasing the formation of ammonia in the urine by urea-splitting organisms. A reduction in urinary ammonia may increase the antibacterial activity of some antibiotic agents.