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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › AMINOGLYCOSIDE ANTIBACTERIALS › Other aminoglycosides
neomycin
J01GB05
Forms & Strengths
- Tablet: 500 mg
- Topical Ointment: 3.5 mg/g
- Topical Cream: 3.5 mg/g
- Topical Solution: 0.1%
Adult Dosing
- Hepatic encephalopathy: 4 g to 12 g daily orally in divided doses for 5 to 6 days
- Preoperative bowel preparation: 1 g orally at 1 PM, 2 PM, and 10 PM on the day preceding surgery
- Topical: Apply to affected area 1 to 4 times daily
Pediatric Dosing
- Hepatic encephalopathy (Children > 1 month): 50 to 100 mg/kg/day orally in divided doses every 6 hours
- Infection/Topical (Children > 2 years): Apply topical preparations 1 to 4 times daily
Indications
- Suppression of intestinal microflora (preoperative bowel preparation)
- Adjunctive therapy in hepatic coma (hepatic encephalopathy)
- Treatment of minor skin infections caused by susceptible organisms
Mechanism of Action
- Aminoglycoside antibiotic that binds to the 30S ribosomal subunit of susceptible bacteria
- Inhibits protein synthesis and misreads genetic code, leading to bacterial cell death
- Poorly absorbed from the gastrointestinal tract, exerting its primary anti-infective effects locally in the lumen
Contraindications
- Hypersensitivity to neomycin or other aminoglycosides
- Intestinal obstruction (when used orally)
- Use on large, denuded, or damaged skin areas due to systemic absorption risks
- Pre-existing clinical or subclinical eighth cranial nerve damage or renal impairment (systemic/parenteral exposure)
Adverse Reactions
- Ototoxicity (auditory and vestibular damage, permanent in some cases)
- Nephrotoxicity (particularly with prolonged use or systemic absorption)
- Neuromuscular blockade and respiratory paralysis (with systemic exposure or high-dose peritoneal lavage)
- Contact dermatitis and hypersensitivity reactions (common with topical application)
- Clostridium difficile-associated diarrhea (with oral administration)
Drug Interactions
- Potent diuretics (e.g., ethacrynic acid, furosemide): Increased risk of ototoxicity
- Neuromuscular blocking agents: Enhanced neuromuscular blockade and prolonged respiratory depression
- Other nephrotoxic or ototoxic drugs (e.g., amphotericin B, cisplatin, vancomycin): Additive toxicity risks
- Oral anticoagulants (e.g., warfarin): Decreased absorption of vitamin K by suppressing gut flora, potentially enhancing anticoagulant effect
Curated Content: Needs Vetting Before Put to Clinical Use