Gentamicin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Parenteral Susceptible infections For severe infections: 3-5 mg/kg/day in divided doses 8 hourly for 7-10 days, via IM or slow IV inj over 2-3 minutes or infused over no more than 20-30 minutes. Alternatively, initial dose of 5-7 mg/kg once daily via IV infusion, then adjust subsequent doses according to serum gentamicin concentration. Bacterial meningitis; Ventriculitis Initial: 1 mg/day via intrathecal or intraventricular inj, together with 1 mg/kg every 8 hours via IM inj. Topical Skin infections As 0.1% cream/ointment: Apply gently to cleansed affected area 3-4 times/day. Otic Otitis externa As 0.3% ear drops: Instill 2-3 drops in the affected ear 3-4 times a day and at night. Ophthalmic Ocular infections As 0.3% eye drops: Instill 1-2 drops into affected eye(s) every 4 hours. Severe: Initially, 1-2 drops every 15-20 minutes, gradually reduce frequency as the infection is controlled. As 0.3% eye ointment: Apply a small amount (approx 1/2 inch ribbon) into affected eye(s) 2-3 times/day.
Dosage Details
Ophthalmic
Ocular infections
Adult: As 0.3% eye drops: Instill 1-2 drops into affected eye(s) every 4 hours. Severe: Initially, 1-2 drops every 15-20 minutes, gradually reduce frequency as the infection is controlled. As 0.3% eye ointment: Apply a small amount (approx 1/2 inch ribbon) into affected eye(s) 2-3 times daily.
Child: Same as adult dose.

Otic/Aural
Otitis externa
Adult: As 0.3% ear drops: Instill 2-3 drops in the affected ear(s) 3-4 times a day and at night.
Child: Same as adult dose.

Parenteral
Susceptible infections
Adult: For severe infections: 3-5 mg/kg daily in divided doses 8 hourly for 7-10 days, by IM or slow IV inj over 2-3 minutes or IV infusion over no more than 20-30 minutes. Alternatively, initial dose of 5-7 mg/kg once daily via IV infusion, then adjust subsequent doses according to serum gentamicin concentration.
Child: <1 month 4-7 mg/kg daily; ≥1 month 4.5-7.5 mg/kg daily; ≥1 year 3-6 mg/kg daily. Doses are given as a single or in 2 divided doses.

Parenteral
Bacterial meningitis, Ventriculitis
Adult: Initially, 1 mg daily via intrathecal or intraventricular inj, together with 1 mg/kg every 8 hours via IM inj.

Topical/Cutaneous
Skin infections
Adult: As 0.1% cream/ointment: Apply gently to cleansed affected area 3-4 times daily.
Child: Same as adult dose.
Renal Impairment
Parenteral:
Susceptible infections: Dosage adjustment needed.
Incompatibility
Incompatible with penicillins, cephalosporins, erythromycin, furosemide, heparins, sodium bicarbonate.
Contraindications
Hypersensitivity to gentamicin and other aminoglycosides. Myasthenia gravis. Perforated tympanic membrane (otic).
Special Precautions
Patient with hypocalcaemia, hypokalaemia, hypomagnesemia; pre-existing vertigo, tinnitus, or hearing loss. Renal impairment. Children. Pregnancy and lactation.
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.
IM/IV/Parenteral: D; Ophth: C
Patient Counseling Information
Ophth gentamicin may cause transient blurring of vision, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor urinalysis, urine output, BUN, serum creatinine. Assess hearing prior to initiation, during and after treatment in patients at risk for ototoxicity.
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.
Action
Description: Gentamicin interferes with bacterial protein synthesis by binding to 30S ribosomal subunits resulting in a defective bacterial cell membrane.
Pharmacokinetics:
Absorption: Poorly absorbed from the gastrointestinal tract. Rapidly absorbed (IM). Time to peak plasma concentration: 30-60 minutes.
Distribution: Diffuses mainly into extracellular fluids; minimal penetration to CSF and ocular tissues; diffuses readily into the perilymph of the inner ear. Crosses the placenta, enters breast milk (small amounts). Plasma protein binding: <30%. Volume of distribution: 0.2-0.3 L/kg.
Excretion: Via urine (70% as unchanged drug). Plasma elimination half-life: 2-3 hours.
Chemical Structure

Chemical Structure Image
Gentamicin

Source: National Center for Biotechnology Information. PubChem Database. Gentamicin, CID=3467, https://pubchem.ncbi.nlm.nih.gov/compound/Gentamicin (accessed on Jan. 22, 2020)

Storage
Store below 25°C.
ATC Classification
J01GB03 - gentamicin ; Belongs to the class of other aminoglycosides. Used in the systemic treatment of infections.
D06AX07 - gentamicin ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases.
S03AA06 - gentamicin ; Belongs to the class of antiinfectives used in ophthalmologic and otologic preparations.
S02AA14 - gentamicin ; Belongs to the class of antiinfectives used in the treatment of ear infections.
S01AA11 - gentamicin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
References
Anon. Gentamicin (Ophthalmic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/05/2020.

Anon. Gentamicin (Systemic) . Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/05/2020.

Anon. Gentamicin (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/05/2020.

Buckingham R (ed). Gentamicin Sulfate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 06/05/2020.

Gentak Ointment (Akorn, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/05/2020.

Gentamicin 1 mg/ml solution for Infusion (B. Braun Melsungen AG). MHRA. https://products.mhra.gov.uk/. Accessed 14/05/2020.

Gentamicin 40mg/ml Injection (Hospira UK Limited). MHRA. https://products.mhra.gov.uk/. Accessed 14/05/2020.

Gentamicin Eye/Ear Drops 0.3% w/v (FDC International Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 14/05/2020.

Gentamicin Intrathecal 5mg/ml Solution for Injection (Zentiva Pharma UK Limited). MHRA. https://products.mhra.gov.uk/. Accessed 14/05/2020.

Gentamicin Sulfate Cream 0.1% (Sola Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/05/2020.

Gentamicin Sulfate Ointment (Teligent Pharma, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/05/2020.

Joint Formulary Committee. Gentamicin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/05/2020.

Disclaimer: This information is independently developed by MIMS based on Gentamicin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • Beagenta
  • Beagenta Cream
  • Garasent
  • Gentamicin Sandoz
  • Gentamycin Cusi
  • Miramycin/Miramycin Injection
  • Shin Poong Gentamicin
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in