Careful Administration: It is desirable to avoid using the product in the following patients but, if its use is unavoidable, it should be administered with caution: Patients who or whose blood relatives have deafness due to aminoglycosides or other causes; Patients with renal disorders; Patients with liver disorders; Newborns, prematures; Patients who are not taking adequate oral feedings or are receiving parenteral feeding, elderly patients and patients who are not in good general condition. (Vitamin K deficiency may occur. Close clinical observation is required); Patients with myasthenia gravis; Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people.
The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than non-asthmatic people.
General Precautions: It is recommended to confirm the susceptibility and administer only minimum period requiring treatment, in order to prevent the emergence of resistant strains.
In the intravenous infusion, it should be administered over a period of 30 minutes or more, in order to avoid occurrence of adverse reactions. After completion of the infusion, it is desirable to monitor the serum levels.
Use in Elderly: Attention should be paid to the following points in elderly patients. Doses and dosage interval should be adjusted according to the condition of the elderly patients.
1) Amikacin sulfate is excreted primarily in the kidneys, but sometimes elderly patients may have reduced renal function and high serum levels are maintained for a long period. There is a fear of damaging the eighth cranial nerve of the kidneys because of this reason.
2) The bleeding tendency associated with symptoms of vitamin K deficiency may occur.