Adult: 15 mg/kg in 2-4 divided doses by IM inj or IV infusion of a 0.25-0.5% soln over 30-60 min. Max: 1.5 g daily. Treatment duration: 7-10 days. Child: 15-30 mg/kg daily in 3 divided doses.
Renal Impairment
Dosage adjustment needed.
Reconstitution
IV infusion: Add 500 mg to 100-200 mL of compatible IV fluid (e.g. NaCl 0.9%, dextrose 5%). Inhalation: Dilute 1 mL (250 mg) in 3 mL of NaCl 0.9%. Intraperitoneal: Dilute 500 mg in 20 mL of sterile water for inj.
Incompatibility
β-lactam antibiotics (penicillins or cephalosporins), heparin.
Contraindications
Hypersensitivity to kanamycin and other aminoglycosides.
Special Precautions
Patient w/ neuromuscular disorders (e.g. myasthenia gravis, parkinsonism, or infant botulism), pre-existing vertigo, tinnitus or hearing loss, hypocalcemia. Prolonged use may result in overgrowth of non-susceptible organisms. Renal impairment. Childn, premature infants, neonates. Pregnancy and lactation.
Adverse Reactions
Ototoxicity, skin rash, drug fever, headache, paraesthesia, nausea, vomiting, diarrhoea, malabsorption syndrome characterised by an increase in faecal fat, decrease in serum carotene, and fall in xylose absorption; irritation or pain on inj site (IM). Potentially Fatal: Nephrotoxicity, neuromuscular blockade w/ resp paralysis.
IM/Inhalation/Respiratory/Irrigation/IV/Parenteral/PO: D
Patient Counseling Information
Maintain adequate fluid intake prior to and during therapy to minimise chemical irritation of renal tubules.
Monitoring Parameters
Monitor renal and auditory function.
Drug Interactions
Additive nephrotoxic and neurotoxic effects w/ polymyxin B, bacitracin, colistin, amphotericin B, cisplatin, vancomycin, and other aminoglycosides (e.g. paromomycin). Enhanced toxicity w/ potent diuretics (e.g. ethacrynic acid, furosemide, meralluride Na, Na mercaptomerin, or mannitol). Increased risk of nephrotoxicity w/ cephalosporins. May potentiate the effects of succinylcholine and non-depolarising muscle relaxants (e.g. rocuronium). NSAIDs may increase concentrations of kanamycin.
Action
Description: Kanamycin interferes w/ protein synthesis in bacterial cell by binding to ribosomal subunit. Pharmacokinetics: Absorption: Poorly absorbed from the GI tract (<1%) but may be significantly increased if the GI mucosa is inflamed or ulcerated. Rapidly absorbed (IM). Time to peak plasma concentration: Approx 1 hr (IM). Distribution: Distributed into most body tissues and fluids. Crosses the placenta (IM) and enters breast milk. Volume of distribution: Approx 0.3 L/kg. Excretion: Via urine as unchanged drug. Plasma half-life: Approx 3 hr.
Chemical Structure
Kanamycin Source: National Center for Biotechnology Information. PubChem Database. Kanamycin, CID=6032, https://pubchem.ncbi.nlm.nih.gov/compound/Kanamycin (accessed on Jan. 21, 2020)
Anon. Kanamycin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 21/10/2014.Buckingham R (ed). Kanamycin Acid Sulfate . Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 21/10/2014.Kanamycin Sulfate Injection, Solution (APP Pharmaceuticals, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 21/10/2014.McEvoy GK, Snow EK, Miller J et al (eds). Kanamycin Sulfate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 21/10/2014.Wickersham RM. Kanamycin Sulfate Injection. Facts and Comparisons [online]. St. Louis, MO. Wolters Kluwer Clinical Drug Information, Inc. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed 21/10/2014.
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