Contraindications
Hypersensitivity to gentamicin and other aminoglycosides. Myasthenia gravis. Perforated tympanic membrane (otic).
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Special Precautions
Patient with hypocalcaemia, hypokalaemia, hypomagnesaemia; pre-existing vertigo, tinnitus, or hearing loss; family history of ototoxicity. Patient with known m.1555A>G mitochondrial mutation. Renal impairment. Children. Pregnancy and lactation. Patient Counselling Ophthalmic gentamicin may cause transient blurring of vision, if affected, do not drive or operate machinery. Monitoring Parameters Monitor urinalysis, urine output, BUN, serum creatinine, hepatic function (prior to, during, and after treatment); peak and trough gentamicin serum concentrations (regularly for systemic treatment). Assess hearing function prior to initiation, during and after treatment.
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Adverse Reactions
Significant: Hypersensitivity, nephrotoxicity, neuromuscular blockade, respiratory paralysis, neurotoxicity, ototoxicity; superinfection (prolonged use).
Blood and lymphatic system disorders: Anaemia, blood dyscrasias, purpura.
Eye disorders: Ocular burning and/or irritation (ophth).
Gastrointestinal disorders: Vomiting, nausea, stomatitis.
Infections and infestations: Antibiotic-associated colitis.
Metabolism and nutrition disorders: Rarely, hypomagnesia.
Nervous system disorders: Convulsion.
Renal and urinary disorders: Acute renal failure.
Skin and subcutaneous tissue disorders: Erythema, pruritus (topical), rash.
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ROUTE(S) : Ophth: C
ROUTE(S) : IM / IV / Parenteral: D
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Drug Interactions
Additive effect with other neurotoxic and/or nephrotoxic drugs including cephalosporins, methicillin, amphotericin B, ciclosporin, cisplatin, potent diuretics (e.g. ethacrynic acid, furosemide) and neuromuscular blocking agents (e.g. succinylcholine, tubocurarine). May increase hypothrombinanaemic effect of oral anticoagulants. May antagonise the effect of neostigmine and pyridostigmine. Increased risk of hypocalcaemia with bisphosphonates. Increased risk of neuromuscular blockade with botulinum toxin. Increased plasma concentration with indometacin in neonates.
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ATC Classification
S01AA11 - gentamicin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
S02AA14 - gentamicin ; Belongs to the class of antiinfectives used in the treatment of ear infections. S03AA06 - gentamicin ; Belongs to the class of antiinfectives used in ophthalmologic and otologic preparations. D06AX07 - gentamicin ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases. J01GB03 - gentamicin ; Belongs to the class of other aminoglycosides. Used in the systemic treatment of infections. |