Kanamycin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IM/IV Susceptible infections 15 mg/kg in 2-4 divided doses for 7-10 days. Max: 1.5 g/day. Intraperitoneal Peritonitis or peritoneal contamination during surgery Instill reconstituted 500 mg into the peritoneal cavity. Max: 1.5 g/day. Irrigation Irrigation of body cavities Instill 0.25% soln into body cavities. Max: 1.5 g/day. Inhalation Susceptible infections 250 mg 2-4 times/day by nebulisation. Max: 1.5 g/day.
Dosage Details
Inhalation/Respiratory
Susceptible Gram-negative infections, Susceptible staphylococcal infections
Adult: 250 mg 2-4 times daily by nebulisation. Max: 1.5 g daily.

Intraperitoneal
Peritonitis or peritoneal contamination during surgery
Adult: Instill reconstituted 500 mg into the peritoneal cavity through a polyethylene catheter sutured into the wound at closure. Max: 1.5 g daily.

Irrigation
Irrigation of body cavities
Adult: Instill 0.25% soln into abscess cavities, pleural space, peritoneal or ventricular cavities. Max: 1.5 g daily.

Parenteral
Susceptible Gram-negative infections, Susceptible staphylococcal infections
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.
MonitoringParameters
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

Chemical Structure Image
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)

Storage
Store between 20-25°C.
MIMS Class
References
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.

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