Flag-Colis Injection - Colistimethate Sodium (1Million IU) medicine

Colirem 1million IU Injection: Complete Medicine Guide

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🏭 Flagship Biotech International 📦 vial of 1 Injection 💊 Allopathy 📅 Updated: Sep 24, 2026
⚠️ Nephrotoxicity Risk 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Established for specific multidrug-resistant Gram-negative infections in hospital settings.
Reviewed by
SaathiMed Expert Panel | Sep 24, 2026

When to Call Your Doctor IMMEDIATELY

  • Decreased urine output or no urine output
  • Swelling in legs, ankles, or feet
  • Difficulty breathing or shortness of breath
  • Muscle weakness or paralysis
  • Seizures or confusion
  • Severe allergic reaction (rash, itching, swelling of face or throat)
  • Persistent diarrhea or abdominal pain

If experiencing severe symptoms, call emergency services immediately.

What is Flag-Colis Injection used for?

This medicine is a polymyxin antibiotic injection used to treat serious multidrug-resistant Gram-negative bacterial infections. It works by disrupting the bacterial cell membrane, leading to bacterial death. It is given under medical supervision and requires monitoring of kidney and nerve function.

  • Generic Name: Colistimethate Sodium (1Million IU)
  • Manufacturer: Flagship Biotech International
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 Flag-Colis Injection के बारे में (Hindi Summary)

उपयोग: यह दवा कोलिस्टिमेथेट सोडियम का इंजेक्शन है, जिसका उपयोग गंभीर और मल्टीड्रग-रेसिस्टेंट ग्राम-नेगेटिव बैक्टीरिया के संक्रमण के इलाज के लिए किया जाता है। यह अस्पताल में डॉक्टर की देखरेख में दी जाती है। यह निमोनिया, यूरिनरी ट्रैक्ट इंफेक्शन, ब्लड इंफेक्शन और पेट के संक्रमण में प्रभावी हो सकती है। यह दवा बैक्टीरिया की कोशिका झिल्ली को तोड़कर उन्हें मार देती है।

साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में किडनी पर असर (क्रिएटिनिन बढ़ना, पेशाब कम आना), हाथ-पैरों में झनझनाहट या सुन्नपन, चक्कर आना और इंजेक्शन की जगह पर दर्द या सूजन शामिल हैं। गंभीर दुष्प्रभावों में तीव्र किडनी इंजरी, मांसपेशियों में कमजोरी, सांस लेने में कठिनाई और दौरे पड़ सकते हैं। अगर आपको पेशाब कम आ रहा हो, सूजन हो, या सांस लेने में तकलीफ हो, तो तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: यह दवा केवल डॉक्टर की देखरेख में अस्पताल में दी जानी चाहिए। इलाज से पहले और दौरान किडनी और नर्व की जांच जरूरी है। अपने डॉक्टर को अन्य सभी दवाओं के बारे में बताएं, खासकर दर्द निवारक और अन्य एंटीबायोटिक्स। शराब का सेवन न करें। बिना डॉक्टर की सलाह के इलाज बीच में न रोकें। किसी भी एलर्जी, रैश, सूजन या सांस लेने में तकलीफ होने पर तुरंत डॉक्टर को बताएं।

💡 Did You Know? India has the highest number of USFDA-compliant plants outside the USA.

💊 Flag-Colis Injection Uses & Benefits

[{"condition":"Multidrug-resistant Gram-negative infections","description":"Used to treat serious infections caused by carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae when other options are limited.","evidence":"Well-established in hospital settings"},{"condition":"Hospital-acquired pneumonia and ventilator-associated pneumonia","description":"Prescribed for severe lung infections caused by susceptible multidrug-resistant Gram-negative bacteria.","evidence":"Established in critical care"},{"condition":"Complicated urinary tract infections","description":"Used for complicated UTIs caused by multidrug-resistant Gram-negative organisms.","evidence":"Established in hospital settings"},{"condition":"Bloodstream infections (bacteremia)","description":"Administered for bloodstream infections caused by susceptible multidrug-resistant Gram-negative bacteria.","evidence":"Established in hospital settings"},{"condition":"Intra-abdominal infections","description":"Used in combination with other antibiotics for complicated intra-abdominal infections caused by resistant Gram-negative bacteria.","evidence":"Limited to specific resistant organisms"}]

Off-label uses: [{"condition":"Nebulized therapy for respiratory infections","description":"Sometimes used off-label via nebulization for patients with difficult-to-treat respiratory infections, though this is not the approved route for this injection product.","evidence":"Limited"},{"condition":"Intraventricular or intrathecal administration for central nervous system infections","description":"Rarely used off-label for meningitis or ventriculitis caused by multidrug-resistant Gram-negative bacteria when systemic therapy is inadequate.","evidence":"Limited"}]

Primary treatment for: Multidrug-resistant Gram-negative bacterial infections

Also treats: Hospital-acquired pneumonia, Ventilator-associated pneumonia, Complicated urinary tract infections, Bloodstream infections, Intra-abdominal infections

📋 Drug Information

Generic Name(s)Colistimethate Sodium (1Million IU)
Brand NameFlag-Colis Injection
ManufacturerFlagship Biotech International
Packaging / Formvial of 1 Injection (Allopathy)
Therapeutic Class
Action Class
Route of AdministrationParenteral (intravenous or intramuscular injection)
StorageStore below 25°C, protected from light. Reconstituted solutions should be used immediately or stored as directed by the manufacturer. Do not freeze.
Shelf LifeRefer to the product label for the expiry date. Typically 24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Monitor kidney function closely before and during treatment with this medicine.
2
Adjust the dose based on creatinine clearance to reduce the risk of nephrotoxicity.
3
Watch for signs of neurotoxicity such as tingling, numbness, or muscle weakness.
4
Avoid concurrent use with other nephrotoxic or neurotoxic drugs when possible.
5
Ensure adequate hydration unless contraindicated.
6
Educate patients to report any decrease in urine output or breathing difficulty immediately.
7
Use the correct reconstitution and administration technique to ensure efficacy and safety.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Fever with severe infection
This medicine is used for serious multidrug-resistant Gram-negative infections.
Likely Use
Common cold
This medicine is not effective against viral infections.
Not Primary
Mild urinary tract infection
This medicine is reserved for complicated or resistant infections.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionThis medicine is administered by injection and is directly absorbed into the bloodstream. Absorption from the gastrointestinal tract does not apply to this route.
DistributionColistin distributes into various body tissues, but its distribution may be limited in some compartments. It does not cross the blood-brain barrier well unless the meninges are inflamed. Protein binding is moderate.
Protein BindingApproximately 50% bound to plasma proteins.
MetabolismColistimethate sodium is converted to colistin by hydrolysis in the body. Colistin itself is not extensively metabolized.
Half-LifeThe elimination half-life of colistin is approximately 2 to 3 hours in patients with normal kidney function, but it is prolonged in patients with renal impairment.
ExcretionColistin and its metabolites are primarily excreted by the kidneys. Renal excretion is a major route of elimination, and dose adjustment is required in patients with kidney disease.
BioavailabilityBioavailability is 100% when administered intravenously. Intramuscular administration may have slightly lower bioavailability.
Onset of ActionThe onset of action is rapid, typically within 1 to 2 hours after intravenous administration, but clinical improvement may take longer depending on the infection.
Peak Plasma TimePeak plasma concentrations are reached at the end of an intravenous infusion.
Duration of ActionThe duration of action depends on the dosing interval and renal function. With normal kidney function, effective levels are maintained for approximately 8 to 12 hours after a dose.

How It Works

Colistimethate sodium is an inactive prodrug that is hydrolyzed in the body to colistin, a polymyxin antibiotic. Colistin binds to the lipopolysaccharide component of the outer membrane of Gram-negative bacteria, displacing calcium and magnesium ions and disrupting the membrane integrity. This leads to leakage of intracellular contents and rapid bacterial cell death. It is bactericidal against many Gram-negative organisms, including multidrug-resistant strains.

Mechanism Steps

1
Prodrug conversion: Colistimethate sodium is converted in the body to colistin, the active antibiotic form.
2
Binding to LPS: Colistin binds to the lipopolysaccharide layer of the outer membrane of Gram-negative bacteria.
3
Membrane disruption: This binding displaces calcium and magnesium ions, destabilizing the membrane.
4
Cell lysis: The disrupted membrane allows leakage of cell contents, causing bacterial death.

💡 How to Take Flag-Colis Injection

Strength: Colistimethate sodium 1 million IU injection

1This medicine is given by a healthcare professional as an injection into a vein or muscle.
2The injection is prepared and administered under sterile conditions.
3The dose and frequency are determined by your doctor based on your condition and kidney function.
4Do not attempt to self-administer this medicine.
5Report any side effects to your healthcare provider immediately.

Dosage Information

Adult DosageThe dose of this medicine must be individualized by a qualified clinician based on the type and severity of infection, patient weight, kidney function, and other factors. It is usually administered intravenously in a hospital setting. Doses are often expressed in international units (IU) or milligrams of colistin base activity. A common approach is to give a loading dose followed by maintenance doses at intervals adjusted for renal function. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients are at increased risk of kidney and nerve toxicity. Dose should be adjusted based on renal function. Close monitoring is required.
Renal ImpairmentDose adjustment is required in patients with renal impairment. The dose and dosing interval should be modified based on creatinine clearance. Consult a qualified clinician for specific dosing.
Hepatic ImpairmentNo specific dose adjustment is established for hepatic impairment. Use with caution and monitor liver function.
Maximum Daily DoseThe maximum daily dose must be determined by a qualified clinician based on the patient's condition and renal function. Do not exceed the prescribed dose.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

No specific food interactions
No restrictions
This medicine is given by injection and does not interact with food.

⏰ What to Do If You Miss a Dose

📌 You miss a scheduled dose in the hospital
→ Inform your nurse or doctor immediately.
💡 They will adjust the schedule as needed. Do not attempt to self-administer.
📌 You are self-administering at home under supervision and miss a dose
→ Contact your healthcare provider for guidance.
💡 Do not double the dose. Follow the new schedule provided.

⚠️ Side Effects of Flag-Colis Injection

✅ Common Side Effects

Kidney problems (increased creatinine, decreased urine output) (Common (up to 20-30%))
Report any decrease in urine output or swelling to your doctor. Regular blood tests are needed to monitor kidney function.
Nerve-related symptoms (tingling, numbness, dizziness) (Common (up to 10-20%))
Inform your doctor if you experience persistent tingling, numbness, or dizziness. Dose adjustment may be needed.
Injection site reactions (pain, redness, swelling) (Common (up to 10%))
Apply a cold compress if needed. Report severe pain or swelling to your healthcare provider.

🚨 Serious Side Effects

Acute kidney injury (Uncommon (1-10%))
Seek immediate medical attention if you notice decreased urine output, swelling in legs, or fatigue. Kidney function tests are essential.
Neurotoxicity (muscle weakness, difficulty breathing, seizures) (Rare (<1%))
Seek emergency care if you experience muscle weakness, difficulty breathing, or seizures.
Severe allergic reactions (anaphylaxis) (Rare (<0.1%))
Seek immediate medical attention if you develop rash, itching, swelling of face or throat, or difficulty breathing.
Clostridioides difficile-associated diarrhea (Rare (<1%))
Report persistent diarrhea, abdominal pain, or fever to your doctor.

⚠️ Rare Side Effects

Respiratory paralysis
Seek emergency care if you experience difficulty breathing or muscle paralysis.
Nephrogenic diabetes insipidus
Report excessive thirst and urination to your doctor.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Aminoglycosides Major
Amphotericin B Major
Vancomycin Major
NSAIDs Major
Neuromuscular blockers Major
Loop diuretics Moderate
Cephalosporins Moderate
Anticholinergics Minor

🚨 Major Interactions

  • Other nephrotoxic drugs (e.g., aminoglycosides, amphotericin B, vancomycin, NSAIDs)
  • Neuromuscular blocking agents (e.g., vecuronium, pancuronium)
  • Other neurotoxic drugs

⚡ Moderate Interactions

  • Loop diuretics (e.g., furosemide)
  • Cephalosporins

🍷 Alcohol Interaction

Alcohol may worsen kidney and nerve-related side effects. It is advisable to avoid alcohol during treatment with this medicine.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known hypersensitivity to colistimethate sodium or polymyxin antibiotics","Severe renal impairment without appropriate dose adjustment","Myasthenia gravis (may worsen muscle weakness)"]

⚠️ Warnings & Precautions

["Nephrotoxicity: Monitor kidney function closely; dose adjustment may be needed.","Neurotoxicity: May cause tingling, numbness, weakness, or seizures; monitor neurological status.","Respiratory paralysis: Rarely, neuromuscular blockade may lead to respiratory depression; use caution in patients with neuromuscular disorders.","Superinfection: Prolonged use may lead to overgrowth of non-susceptible organisms.","Clostridioides difficile-associated diarrhea: Report persistent diarrhea.","Use in pregnancy and lactation: Only if clearly needed; consult your doctor.","Pediatric use: Safety and efficacy not established in children; consult a pediatrician.","Elderly use: Increased risk of kidney and nerve toxicity; monitor closely."]

🤱 Lactation Safety

It is not known whether colistimethate sodium is excreted in human breast milk. Because many drugs are excreted in human milk, caution should be exercised when this medicine is administered to a nursing woman. Consult your doctor.

💊 Overdose Management

Overdose may cause severe kidney damage, neurotoxicity, and respiratory paralysis. Treatment is supportive and symptomatic. Hemodialysis may be considered to remove the drug in cases of severe toxicity. Seek immediate medical attention.

⏰ Missed Dose

If you miss a dose of this medicine, contact your healthcare provider for guidance. Do not double the dose to catch up. The dosing schedule is usually managed by healthcare professionals in a hospital setting.

Additional Safety Advice

General Safety

This medicine must be given only under the supervision of a qualified healthcare professional, usually in a hospital or clinic setting. Kidney function and nerve function should be monitored before and during treatment. Patients should inform their doctor about all other medicines, especially other antibiotics, pain relievers, or drugs that affect the kidneys. Do not self-administer this injection at home unless specifically trained and instructed by a healthcare provider. Report any signs of allergic reaction, such as rash, itching, swelling, or difficulty breathing, immediately. Avoid alcohol during treatment as it may worsen side effects. Maintain good hydration unless your doctor has restricted fluids. Do not stop treatment early without consulting your doctor, even if you feel better, to prevent resistance and relapse.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are at higher risk of kidney and nerve toxicity. Dose adjustment based on renal function is essential. Close monitoring is required during treatment.

🤰 Pregnancy Planning (TTC)

If you are planning pregnancy, consult your doctor before starting this medicine. It should be used during pregnancy only if clearly needed. Discuss the risks and benefits with your healthcare provider.

🏥 Post-Surgery Considerations

This medicine may be used to treat or prevent surgical site infections caused by multidrug-resistant Gram-negative bacteria. It is administered under medical supervision. Inform your surgeon if you are on this medicine before any surgery.

🦷 Dental Procedures

Inform your dentist if you are receiving this medicine. No specific precautions are established, but maintain good oral hygiene and report any signs of infection.

💚 Lifestyle Tips for Better Results

🏃
Stay well hydrated unless your doctor has restricted fluids.
🥗
Follow a balanced diet to support your immune system.
😴
Avoid alcohol during treatment.
💧
Get adequate rest to help your body recover.
🧘
Report any new symptoms to your healthcare provider promptly.
🌞
Wash your hands frequently to prevent new infections.

🏋️ Exercise Considerations

Avoid strenuous exercise during treatment, especially if you experience muscle weakness or fatigue. Light activity may be allowed as tolerated, but consult your doctor before starting any exercise routine.

🥗 Diet Recommendations

Drink plenty of water to help flush your kidneys.
Eat a balanced diet rich in fruits and vegetables.
Include protein-rich foods to support healing.
Avoid processed and high-salt foods to reduce kidney stress.

💼 Impact on Daily Work & Life

This medicine is usually given in a hospital setting, so it may require hospitalization or frequent clinic visits. You should not drive or operate heavy machinery if you experience dizziness, muscle weakness, or fatigue. Discuss with your doctor when you can return to work.

🛑 When to Stop This Medicine

Do not stop this medicine without consulting your doctor. Stopping early may lead to treatment failure, relapse, or bacterial resistance. Your doctor will decide when to stop based on your clinical response and test results.

📅 Long-Term Use Effects

Long-term use of this medicine may increase the risk of kidney damage and nerve damage. Regular monitoring of kidney function and neurological status is required. Prolonged use may also lead to bacterial resistance or superinfection. The duration of treatment should be determined by your doctor based on your response and clinical condition.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Other antibiotics

Depending on the susceptibility of the bacteria, other antibiotics such as polymyxin B, tigecycline, or newer beta-lactam/beta-lactamase inhibitor combinations may be used.

Evidence: Well-established
Combination therapy

Combining this medicine with other antibiotics may improve efficacy and reduce resistance.

Evidence: Emerging evidence

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

There are no specific vaccine interactions reported with this medicine. However, patients with severe infections may have a weakened immune response. Discuss with your doctor about appropriate vaccinations.

📦 Storage Guide

✅ DO

Store below 25°C, protected from light

❌ DON'T

Do not freeze

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Use reconstituted solution immediately or as directed

❌ DON'T

Do not use if solution is discolored or contains particles

✈️ Traveling with This Medicine

This medicine is usually administered in a hospital setting, so travel is not typically applicable. If you are discharged with a prescription for this medicine, carry it in its original packaging with the prescription copy. Keep it in a cool, dry place away from direct sunlight. Inform security at airports about any injectable medicines and carry a doctor&#039;s letter. Check customs regulations for carrying prescription medicines across borders.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 65-year-old man with hospital-acquired pneumonia caused by multidrug-resistant Acinetobacter
He was started on this medicine intravenously in the hospital. His kidney function was monitored daily. After 10 days of treatment, his infection improved, but his creatinine levels rose slightly. The dose was adjusted, and he recovered fully with supportive care.
💡 Lesson: Close monitoring of kidney function is essential during treatment with this medicine, and dose adjustment can help prevent serious kidney damage.
👤 A 45-year-old woman with a complicated urinary tract infection caused by carbapenem-resistant Klebsiella
She received this medicine as part of combination therapy. She experienced tingling in her hands and feet, which resolved after the dose was reduced. She completed the course and the infection cleared.
💡 Lesson: Neurotoxicity can occur and may require dose adjustment. Patients should report any unusual sensations promptly.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine starts working within 1 to 2 hours after injection, but clinical improvement may take a few days. Your doctor will monitor your progress.

Q: Can I take this medicine at home?

A: This medicine is usually given in a hospital or clinic under medical supervision. Do not self-administer unless specifically trained and instructed by your healthcare provider.

Q: What are the most important side effects to watch for?

A: Watch for decreased urine output, swelling, tingling or numbness, muscle weakness, and difficulty breathing. Report these to your doctor immediately.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can this medicine affect my kidney function?
  • How long will I need to take this medicine?
  • Can I take this medicine if I am pregnant?
  • What should I do if I miss a dose?
  • Can I drink alcohol while on this medicine?
  • Will this medicine interact with my other medications?

🔄 Substitutes for Flag-Colis Injection

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can be used for any type of infection.
    Fact: This medicine is only effective against certain Gram-negative bacteria and is reserved for serious multidrug-resistant infections.
  • Myth: This medicine is safe for everyone.
    Fact: It can cause kidney and nerve damage, and requires careful monitoring, especially in patients with kidney disease.
  • Myth: You can stop the injection once you feel better.
    Fact: You must complete the full course as prescribed to prevent resistance and relapse.

🔄 Alternative Options

Generic Alternatives

  • Colistimethate sodium injection (generic)

Brand Alternatives

  • Colirem 1million IU injection
  • Colistin 1million IU injection
  • Coly-Mycin M Parenteral

📊 Comparison with Similar Medicines

[{"medicine":"Colistimethate sodium","class":"Polymyxin antibiotic","route":"Parenteral","main_use":"Multidrug-resistant Gram-negative infections","key_side_effect":"Nephrotoxicity, neurotoxicity"},{"medicine":"Polymyxin B","class":"Polymyxin antibiotic","route":"Parenteral","main_use":"Multidrug-resistant Gram-negative infections","key_side_effect":"Nephrotoxicity, neurotoxicity"},{"medicine":"Tigecycline","class":"Glycylcycline antibiotic","route":"Parenteral","main_use":"Complicated infections","key_side_effect":"Nausea, vomiting, increased mortality risk"}]

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