Indications/Uses
Listed in Dosage.
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Dosage/Direction for Use
Adult: PO Pre-op intestinal antisepsis 1 g hrly for 4 hr then 4 hrly for 2-3 days before surgery. Hepatic encephalopathy As an adjunct: 4-12 g/day in divided doses for 5-7 days. Chronic hepatic insufficiency: 4 g/day over an indefinite period. Topical/Cutaneous Skin infections As cream/oint: Clean the affected area and apply bid.
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Administration
May be taken with or without food.
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Contraindications
Hypersensitivity to neomycin and other aminoglycosides. Intestinal obstruction. Infants <1 yr.
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Special Precautions
Patient w/ neuromuscular disorders (e.g. myasthenia gravis), pre-existing vertigo, tinnitus or hearing loss. Prolonged use may result in overgrowth of non-susceptible organisms. Renal and hepatic impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor auditory, vestibular and renal function.
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Adverse Reactions
Ototoxicity; nausea, vomiting, diarrhoea, increased salivation, stomatitis, increased hepatic enzymes and bilirubin levels, blood dyscrasias, haemolytic anaemia, confusion, paraesthesia, disorientation, nystagmus, hypersensitivity reactions (e.g. dermatitis, pruritus, drug fever); malabsorption syndrome w/ steatorrhoea and diarrhoea, electrolyte disturbances (e.g. hypomagnesaemia, hypocalcaemia, hypokalaemia).
Potentially Fatal: Nephrotoxicity; resp depression and arrest following neuromuscular blockade; anaphylaxis. |
Drug Interactions
Additive nephrotoxic and neurotoxic effect w/ other aminoglycosides (e.g. paromomycin), bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin. Enhanced toxicity w/ potent diuretics (e.g. ethacrynic acid, furosemide). May impair the absorption of other drugs (e.g. phenoxymethylpenicillin, digoxin, methotrexate and some vit). May reduce the efficacy of OCs. May enhance the effect of acarbose. May enhance the effect of non-depolarising muscle relaxants. May antagonise the parasympathomimetic effect of neostigmine and pyridostigmine. May increase the risk of hypocalcaemia in patients receiving bisphosphonates. May alter INR when given w/ anticoagulants. May inactivate oral typhoid vaccine.
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CIMS Class
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ATC Classification
A01AB08 - neomycin ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth.
S03AA01 - neomycin ; Belongs to the class of antiinfectives used in ophthalmologic and otologic preparations. R02AB01 - neomycin ; Belongs to the class of antibiotics used in throat preparations. J01GB05 - neomycin ; Belongs to the class of other aminoglycosides. Used in the systemic treatment of infections. A07AA01 - neomycin ; Belongs to the class of antibiotics. Used in the treatment of intestinal infections. D06AX04 - neomycin ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases. B05CA09 - neomycin ; Belongs to the class of antiinfectives used as irrigating solutions. S02AA07 - neomycin ; Belongs to the class of antiinfectives used in the treatment of ear infections. S01AA03 - neomycin ; Belongs to the class of antibiotics. Used in the treatment of eye infections. |