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kanamycin (Rx)Brand and Other Names:Kantrex

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 75mg/2mL
  • 500mg/2mL
  • 1g/3mL
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Susceptible Infections

IV Administration: 5-7.5 mg/kg/dose divided q8-12hr; not to exceed 15 mg/kg/day divided q6-12hr; administer slowly  

IM Administration: 5-7.5 mg/kg/dose divided q8-12hr; not to exceed 15 mg/kg/day IM divided q12hr at equally divided intervals; continuously high blood levels are desired; daily dose of 15 mg/kg may be given divided q6-8hr

Aerosol: 250 mg q6-12hr by nebulization

Renal Impairment

CrCl 50-80 mL/min: give 60-90% of usual dose or give q8-12hr

CrCl 10-50 mL/min: give 30-70% of usual dose or give q12hr

CrCl <10 mL/min: give 20-30% of usual dose or give q24-48hr

Monitor

Peak (15-30 mg/L)

Trough (5-10 mg/L)

See adult dosing

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Interactions

Interaction Checker

kanamycin and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Agranulocytosis

            Anorexia

            Diarrhea

            Dyspnea

            Edema

            Elevated BUN

            Enterocolitis

            Headache

            Incr salivation

            Muscle cramps

            Muscle weakness

            Nausea

            Nephrotoxicity

            Neurotoxicity

            Ototoxicity

            Pruritus

            Pseudotumor cerebri

            Rash

            Tinnitus

            Thrombocytopenia

            Tremor

            Vertigo

            Weakness

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            Warnings

            Black Box Warnings

            Neurotoxicity, manifested as both bilateral auditory and vestibular ototoxicity, can occur in patients with preexisting renal damage and in patients with normal renal function treated at higher doses and/or for periods longer than those recommended. High-frequency deafness usually occurs first and can be detected only by audiometric testing. Vertigo may occur and may be evidence of vestibular injury

            Aminoglycosides are potentially nephrotoxic. Risk is greater in patients with impaired renal function and in those who receive high doses or prolonged therapy. Rarely, nephrotoxicity may not become apparent until the first few days after cessation of therapy

            Use with caution in premature infants and neonates because of renal immaturity and the resulting prolongation of serum half-life of the drug

            Neuromuscular blockade and respiratory paralysis have been reported following parenteral injection, topical instillation (as in orthopedic and abdominal irrigation or in local treatment of empyema), and oral use of aminoglycosides, especially when given soon after anesthesia or muscle relaxants. If blockage occurs, calcium salts may reverse these phenomena, but mechanical respiratory assistance may be necessary

            Avoid concurrent or sequential use of neurotoxic and/or nephrotoxic drugs including other aminoglycosides (eg, amikacin, streptomycin, neomycin, kanamycin, gentamicin, puromomycin

            Cumulative listing of drugs to avoid from all aminoglycoside package inserts includes amphotericin B, bacitracin, cephaloridine, cisplatin, colistin, polymyxin B, vancomycin, and viomycin. Avoid potent diuretics (eg, ethacrynic acid, furosemide) because they increase risk of ototoxicity. When administered intravenously, diuretics may enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue

            Contraindications

            Documented hypersensitivity

            Cautions

            Auditory toxicity more common with kanamycin than with streptomycin and capreomycin; monthly audiometry is recommended while patients are being treated with this drug; vestibular toxicity is rare; renal toxicity occurs at a frequency similar to that of capreomycin; regular monitoring of serum creatinine recommended

            Renal impairment

            Myasthenia gravis

            Vestibular/cochlear implant

            Nephrotoxic agents

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            Pregnancy & Lactation

            Pregnancy Category: D

            Lactation: usually compatible

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Metabolism: unknown

            Excretion: urine

            Mechanism of Action

            Bactericidal

            Aminoglycoside contain 1 or 2 amino sugars linked to an aminocyclitol nucleus. Nucleus is 2-deoxystreptamine. Bactericidal and believed to inhibit protein synthesis by binding to 30 S ribosomal subunit.

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            Administration

            IV Incompatibilities

            Do not mix with other drugs

            IV Preparation

            For adults, IV infusions are prepared by adding 500 mg of kanamycin to 100-200 mL of usual IV infusion fluid such as NS or D5W or by adding 1 g of the drug to 200-400 mL of diluent

            IV/IM Administration

            Administer by deep IM injection, or IV infusion

            May administer by intraperitoneal instillation, irrigation, or inhalation

            Infuse over 30-60 min

            Storage

            Store <40°C, preferably between 15-30°C

            Protect from freezing

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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