Amikacin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IM/IV Severe gm-ve infections 15 mg/kg/day as a single or in 2 divided doses. Max: 1.5 g/day. Uncomplicated UTI 7.5 mg/kg/day in 2 divided doses.
Dosage Details
Parenteral
Severe Gram-negative infections
Adult: 15 mg/kg daily as a single or in 2 divided doses, by IM inj, IV inj over 2-3 min or IV infusion over 30-60 min. Max: 1.5 g/day. Usual treatment duration: 7-10 days.
Child: Neonates: Initial loading dose of 10 mg/kg followed by 7.5 mg/kg 12 hrly. Premature infants: 7.5 mg/kg 12 hrly. 4 wk to 12 yr 15-20 mg/kg as a single or in 2 divided doses. Doses may be given by IM inj, IV inj over 3-5 min or IV infusion over 1-2 hr.

Parenteral
Uncomplicated urinary tract infections
Adult: 7.5 mg/kg daily in 2 divided doses by IM inj, slow IV inj over 2-3 min or IV infusion over 30-60 min.
Renal Impairment
Doses should be adjusted either by administering normal doses at prolonged intervals or by administering reduced doses at fixed intervals based on the patient's CrCl or serum creatinine values.
Reconstitution
IV infusion: For adults, add 500 mg of amikacin to 100-200 mL of compatible IV fluid (e.g. NaCl 0.9%, dextrose 5%). For pediatric patients, the vol of diluent depends on the prescribed dosage.
Contraindications
Hypersensitivity to amikacin and other aminoglycosides. Myasthenia gravis.
Special Precautions
Patient w/ pre-existing hearing or vestibular damage, muscular disorder (e.g. parkinsonism). Renal impairment. Premature and neonatal infants. Pregnancy and lactation.
Adverse Reactions
Neurotoxicity manifested as vestibular and permanent bilateral auditory ototoxicity, skin rash, drug fever, headache, paraesthesia, tremor, nausea and vomiting, eosinophilia, arthralgia, anaemia, hypotension, hypomagnesaemia; macular infarction following intravitreous admin.
Potentially Fatal: Nephrotoxicity, neuromuscular blockade and resp paralysis, Clostridium difficile-associated colitis.
IM/IV/Parenteral: D
Patient Counseling Information
May cause adverse reactions which may impair ability to drive or operate machinery.
MonitoringParameters
Monitor renal function, appropriately timed peak and trough concentrations, vital signs, temperature, wt, input and output, hearing parameters.
Overdosage
Symptoms: Nephrotoxicity, ototoxicity, neuromuscular blockade and resp arrest. Management: May perform peritoneal dialysis, haemodialysis or arteriovenous haemofiltration to reduce amikacin serum levels. In newborn infants, exchange transfusion may be considered. Neuromuscular blockade and resp arrest may be treated by application of ionic Ca (e.g. as gluconate or lactobionat in 10-20% soln).
Drug Interactions
Additive effect w/ other neurotoxic, ototoxic or nephrotoxic agents (e.g. bacitracin, cisplatin, amphotericin B, ciclosporin, tacrolimus, cefaloridine, paromomycin, viomycin, polymyxin B, colistin, vancomycin, and other aminoglycosides). Enhanced toxicity w/ rapidly acting diuretics (e.g. furosemide, ethacrynic acid). Increased creatinine serum level w/ cephalosporins. Indomethacin may increase the plasma concentration of amikacin in neonates. Increased risk of hypocalcaemia w/ biphosphonates. Increased risk of nephrotoxicity and possibly ototoxicity w/ platinum compounds. Increased risk of neuromuscular blockade and consequent resp depression w/ anaesth or muscle relaxants (e.g. ether, halothane, d-tubocurarine, succinylcholine decamethonium, atracurium, rocuronium, vecuronium).
Action
Description: Amikacin is an aminoglycoside antibiotic which is active against a broad spectrum of gm-ve organisms. It inhibits protein synthesis in susceptible bacteria by binding to 30S ribosomal subunits.
Pharmacokinetics:
Absorption: Rapidly absorbed (IM). Time to peak plasma concentration: 1 hr (IM); over 30 min (IV).
Distribution: Detected in body tissues and fluids. Crosses the placenta but does not readily penetrate into CSF, substantial penetration of the blood-brain barrier was reported in childn w/ meningitis. Volume of distribution: 0.25 L/kg. Plasma protein binding: ≤11%.
Excretion: Via glomerular filtration in the urine (94-98%). Plasma half-life: Approx 2-3 hr.
Chemical Structure

Chemical Structure Image
Amikacin

Source: National Center for Biotechnology Information. PubChem Database. Amikacin, CID=37768, https://pubchem.ncbi.nlm.nih.gov/compound/Amikacin (accessed on Jan. 20, 2020)

Storage
Store between 15-30°C.
MIMS Class
References
Amikacin Sulfate Injection, Solution (Teva Parenteral Medicines, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 15/10/2014.

Anon. Amikacin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 15/10/2014.

Buckingham R (ed). Amikacin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 15/10/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Amikacin Sulfate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 15/10/2014.

Disclaimer: This information is independently developed by MIMS based on Amikacin 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
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