| name | Neomycin |
| classification | Aminoglycoside antibiotic |
| pharmacokinetics | Neomycin is primarily administered orally or topically, and to a lesser extent intravenously. Oral absorption is variable, and substantial systemic absorption may not occur following oral administration. Significant first-pass metabolism occurs, limiting the systemic bioavailability of orally administered neomycin. Excretion is primarily via the kidneys as unchanged drug and metabolites. Elimination half-life is roughly 2-3 hours. |
| suggested dosage | | oral | Dosage varies greatly depending on the indication and severity of infection. Consult with a physician or pharmacist for specific recommendations. Generally, oral doses range from 250mg to 1 gram, taken several times daily. Topical dosage depends on the specific preparation and site of application. Parenteral doses should be carefully monitored by a healthcare professional. | | notes | Dosage should be tailored to the individual patient, including renal function, age and weight. Adjustments may be necessary. |
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| indications | Neomycin is primarily used for treating intestinal infections, especially for pre-operative bowel preparation. Topical forms are used for localized skin infections. It may also be used in certain cases of serious infections when other antibiotics are not appropriate. |
| safety in pregnancy | Limited data are available on the use of neomycin during pregnancy. Neomycin should be used only when the potential benefit outweighs the potential risk to the fetus. It is generally not considered a first-line drug during pregnancy. |
| safety in breastfeeding | Neomycin is excreted in breast milk in small amounts. The potential risks to the infant are generally considered low. However, use during breastfeeding should be avoided unless the potential benefit to the mother outweighs any potential risks to the infant. |
| side effects | | 1 | Gastrointestinal effects (diarrhea, nausea, vomiting) | | 2 | Ototoxicity (hearing loss, tinnitus) | | 3 | Nephrotoxicity (kidney damage) | | 4 | Allergic reactions (rash, itching, hives) | | 5 | Superinfection (growth of resistant organisms) |
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| alternatives | |
| contraindications | | 1 | Known hypersensitivity to aminoglycosides | | 2 | Severe renal impairment | | 3 | Coexisting ototoxic medications | | 4 | Pre-existing hearing loss | | 5 | Use in patients with severe bowel obstruction, unless it's a life-threatening situation and other options are unavailable. |
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| interactions | Neomycin can interact with several other medications, particularly those affecting kidney function. Consult with a doctor or pharmacist to identify potential drug interactions. |
| warnings and precautions | | 1 | Monitor kidney and hearing function during treatment, especially in patients with pre-existing renal or hearing problems. | | 2 | Closely monitor patients with pre-existing intestinal disease to prevent exacerbating existing conditions | | 3 | Avoid concomitant administration with other nephrotoxic or ototoxic agents. | | 4 | Use with caution in elderly patients due to increased risk of side effects. | | 5 | Use caution with concurrent administration of drugs that may alter renal function, such as diuretics. |
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| additional informations | Neomycin is generally not used as a first-line therapy. Its use is reserved for specific situations where other antibiotic options are not appropriate or effective. Administering neomycin should be under the close supervision of a healthcare professional. |
| patient specific considerations | | age | 25 years (no significant age-related adjustments typically required). | | weight | 70 kg (dosage may still vary based on other factors, like renal function). | | notes | Ensure appropriate monitoring of renal and auditory function due to the potential for toxicity, particularly with longer-term administration. |
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