Brand and Other Names:
- Classes: Aminoglycosides
Dosing & Uses
Dosage Forms & Strengths
powder for injection
1-2 g/day IM divided q6-12hr; no more than 2 g/day
Twice weekly therapy: 25-30 mg/kg IM 2 times/week; no more than 1.5 g/day
1-2 g IM in divided doses for 7-10 days or until patient is afebrile for 5-7 days
1 g IM q12hr for 7 days, THEN 500 mg q12hr for 7 days, concomitant with penicillin
If >60 years old, 500 mg q12hr for entire 14 days
1 g IM q12hr for 2 weeks, THEN 500 mg q12hr for 4 weeks, concomitant with penicillin
1 g IM qDay/BID for 1 week, THEN qDay for 1 week in conjunction with doxycycline or tetracycline
Load: 1 g IM, THEN
CrCl: 50-80 mL/min: 7.5 mg/kg IM q24hr
CrCl: 10-50 mL/min: 7.5 mg/kg IM q24-72hr
CrCl <10 mL/min: 7.5 mg/kg IM q72-96hr
Hemodialysis: 50-75% of initial loading dose at end of dialysis period
Dosage Forms & Strengths
powder for injection
Twice wekly therapy: 20-40 mg/kg IM 2 times/week; no more than 1.5 g/day
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Difficulty in breathing
Black Box Warnings
May cause nephrotoxicity and neurotoxicity. Avoid concurrent use of nephrotoxic/neurotoxic drugs.
May cause neuromuscular blockade and respiratory paralysis, especially when given after anesthesia or muscle relaxants. Use the parenteral form only where appropriate audiometric and laboratory testing facilities are available.
Hypersensitivity to streptomycin or other aminoglycosides; severe hypersensitivity to sulfites
Concomitant live bacterial vaccines
For tuberculosis, do not exceed 120 g total over course of Tx; discontinue in case of toxicity or organism resistance
For endocarditis, discontinue in case of ototoxicity
Reduce dosage in case of renal impairment: serum conc. should not exceed 20-25 mcg/mL
Pregnancy & Lactation
Pregnancy Category: D
Lactation: enters breast milk (AAP Committee states compatible w/ nursing)
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.
Absorption: IM: well absorbed; not absorbed from gut
Distribution: to extracellular fluid including serum, abscesses, ascitic, pericardial, pleural, synovial, lymphatic, & peritoneal fluids; crosses placenta; small amounts enter breast milk
Protein Bound: 34%
Half-life elimination: newborns: 4-10 hr; adults: 2-4.7 hr, prolonged with renal impairment
Peak Plasma Time: within 1 hr
Excretion: urine (90% as unchanged drug); feces, saliva, sweat, & tears (<1%)
Mechanism of Action
Interferes with normal bacterial protein synthesis by binding to the 30S ribosomal subunits
Syringe: penicillin G
Additive: amobarbital, amphotericin B, chlorothiazide, heparin, methohexital, norepinephrine, pentobarbital, phenobarbital, phenytoin, sodium bicarbonate
Syringe: ampicillin(?), heparin
Dissolve powder with 4.2, 3.2, or 1.8 mL of SWI to prepare 200 mg/mL, 250 mg/mL, or 400 mg/mL
IM: inject deep IM into large muscle mass
IV: not recommended; has been administered intravenously 12-15 mg/kg in 100 mL of NS over 30-60 min
Injection: store at 2-8°C
Powder: store at room temp & protect from light
Reconstituted soln stable for 1 wk at room temp; protect from light
Exposure to light causes darkening of solution without apparent loss of potency
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