neomycin PO (Rx)

Brand and Other Names:Neo-Fradin, Myciguent, more...Mycifradin
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 500mg

oral solution

  • 25mg/mL
more...

Pre-Op Intestinal Antisepsis

1 g PO at 19, 18, and 9 hours pre-op OR

1 g PO q1hr for 4 doses, THEN 1 g q4hr to complete 24 hours of dosing OR

88 mg/kg/day divided PO q4hr for 2-3 days pre-op 

Maximum: Up to 12 grams 24 to 48 hours prior to surgery

Hepatic Encephalopathy

Acute: 4-12 g/day PO divided q6hr for 5-6 days OR 3-6 g/day for 1-2 weeks

Chronic: Up to 4 g/day PO

Diarrhea Caused by Enteropathogenic E.coli

3 g/day PO divided q6hr

Other Indications & Uses

Off-label: reduce LDL

Dosage Forms & Strengths

tablet

  • 500mg

oral solution

  • 25mg/mL
more...

Neonates

Diarrhea, preterm & newborns: 50 mg/kg/day PO divided q6hr 

Children

Hepatic encephalopathy: 50-100 mg/kg/day PO divided q8hr for 5-6 days, no more than 12 g/24 hours 

Bowel prep: 90 mg/kg/day PO divided q4hr for 2-3 days

Diarrhea caused by enteropathogenic E.coli: 50mg/kg/day PO divided q6hr for 2-3days

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Interactions

Interaction Checker

and neomycin PO

No Results

     activity indicator 
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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Diarrhea

            Nausea/vomiting

            Irritation or soreness of mouth or rectal area

            Contact dermatitis (topical)

            <1%

            Dyspnea

            Eosinophilia

            Nephrotoxicity

            Neurotoxicity

            Ototoxicity (auditory, vestibular)

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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

            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, paromomycin

            Cumulative listing of drugs to avoid from all aminoglycoside package inserts includes amphotericin B, bacitracin, cephaloridine, cisplatin, colistin, polymixin 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

            Hypersensitivity

            Ulcerative bowel disease

            Intestinal obstruction

            Cautions

            Renal impairment: reduce dose

            Auditory neurotoxicity, disorder of 8th cranial nerve, myasthenia gravis, Parkinsonism

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: unknown if excreted in breast milk

            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

            Half Life: 3 hr

            Peak Plasma Time: oral: 1-4 hr; IM ~2 hr

            Absorption: oral, percutaneous: poor (3%)

            Vd: 0.36 L/kg

            Metabolism: slightly hepatic

            Excretion

            Feces: 97% of oral dose as unchanged drug

            Urine: 30-50% of absorbed drug as unchanged drug

            Mechanism of Action

            Interferes with bacterial protein synthesis by binding to 30S ribosomal subunits, thus reducing the number of ammonia-producing bacteria in the intestine

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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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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