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streptomycin (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 1g
more...

Moderate-Severe Infections

1-2 g/day IM divided q6-12hr; no more than 2 g/day

Tuberculosis

Daily therapy: 15 mg/kg IM qDay; no more than 1 g/day 

Twice weekly therapy: 25-30 mg/kg IM 2 times/week; no more than 1.5 g/day

Tularemia

1-2 g IM in divided doses for 7-10 days or until patient is afebrile for 5-7 days

Plague

15 mg/kg IM q12hr for minimum 10 days 

Streptococcal Endocarditis

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

Enterococcal Endocarditis

1 g IM q12hr for 2 weeks, THEN 500 mg q12hr for 4 weeks, concomitant with penicillin

Brucellosis

1 g IM qDay/BID for 1 week, THEN qDay for 1 week in conjunction with doxycycline or tetracycline

Renal Impairment

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

  • 1g

injectable solution

  • 400mg/mL
more...

Moderate to Severe Infections

20-40 mg/kg/day IM divided q6-12 hr  

Tuberculosis

Daily therapy: 20-40 mg/kg IM qDay; no more than 1 g/day 

Twice wekly therapy: 20-40 mg/kg IM 2 times/week; no more than 1.5 g/day

Plague

15 mg/kg IM q12hr for minimum 10 days; no more than 2 g/day 

Brucellosis

>8 years old: 20 mg/kg IM divided q12hr during 7-14 days of tetracycline or co-trimoxazole therapy; no more than 1 g/day 

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Interactions

Interaction Checker

streptomycin 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

            Hypotension

            Neurotoxicity

            Drowsiness

            Headache

            Drug fever

            Paresthesia

            Skin rash

            Nausea

            Vomiting

            Eosinophilia

            Anemia

            Arthralgia

            Weakness

            Tremor

            Ototoxicity (auditory)

            Ototoxicity (vestibular)

            Nephrotoxicity

            Difficulty in breathing

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            Warnings

            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.

            Contraindications

            Hypersensitivity to streptomycin or other aminoglycosides; severe hypersensitivity to sulfites

            Concomitant live bacterial vaccines

            Cautions

            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

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            Pregnancy & Lactation

            Pregnancy Category: D

            Lactation: enters breast milk (AAP Committee states compatible w/ nursing)

            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

            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

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            Administration

            IV Compatibilities

            Additive: bleomycin

            Syringe: penicillin G

            Y-site: esmolol

            IV Incompatibilities

            Additive: amobarbital, amphotericin B, chlorothiazide, heparin, methohexital, norepinephrine, pentobarbital, phenobarbital, phenytoin, sodium bicarbonate

            Syringe: ampicillin(?), heparin

            IV Preparation

            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

            IV/IM Administration

            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

            Storage

            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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            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.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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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            Select a class to view formulary status for similar drugs

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