paromomycin (Rx)

Brand and Other Names:Humatin

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 250mg

Intestinal Amebiasis (E. Histolytica)

25-35 mg/kg/day PO divided q6hr for 5-10 days  

Effective in acute and chronic but not extraintestinal

Hepatic Coma (Adjunctive)

4 g PO qDay in divided doses for 5-6 days

Diantomoeba Fragilis

20-30 mg/kg/day PO divided q8hr

Tapeworm (T. saginata/T. solium/D. latum/D. caninum)

11 mg/kg PO divided q15min for 4 doses

Dwarf Tapeworm

45 mg/kg/dose PO qDay for 5-7 days

Cutaneous Leishmaniasis (Orphan)

Treatment of cutaneous leishmaniasis (Old World and New World)

Sponsor

  • The Surgeon General, Dept. of the Army; USAMRMC; 504 Scott Street; Ft. Detrick; MD

Dosage Forms & Strengths

capsule

  • 250mg

E. Histolytica

25-35 mg/kg/day divided q8hr PO for 7 days OR

750 mg/m²/day divided q6hr PO for 5 days

Dientamoeba Fragilis

25-30 mg/kg/day PO divided q8hr for 7 days  

Intestinal Amebiasis

25-35 mg/kg/day PO divided q8hr for 5-10 days  

Tapeworm (Hymenolepis nana)

45 mg/kg PO qDay for 5-7 days  

Tapeworm (T. saginata/T. solium/D. latum/D. caninum)

11 mg/kg PO divided q15min for 4 doses  

Dwarf Tapeworm

45 mg/kg/dose PO qDay for 5-7 days

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Interactions

Interaction Checker

and paromomycin

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            Contraindicated (0)

              Serious - Use Alternative (21)

              • atracurium

                paromomycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • axicabtagene ciloleucel

                paromomycin, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • BCG vaccine live

                paromomycin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • brexucabtagene autoleucel

                paromomycin, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • bumetanide

                bumetanide, paromomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • ciltacabtagene autoleucel

                paromomycin, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • cisatracurium

                paromomycin increases effects of cisatracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • ethacrynic acid

                ethacrynic acid, paromomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • furosemide

                furosemide, paromomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • idecabtagene vicleucel

                paromomycin, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • lisocabtagene maraleucel

                paromomycin, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • onabotulinumtoxinA

                paromomycin increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • pancuronium

                paromomycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • quinidine

                quinidine will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

              • rapacuronium

                paromomycin increases effects of rapacuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • rocuronium

                paromomycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • succinylcholine

                paromomycin increases effects of succinylcholine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • tisagenlecleucel

                paromomycin, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              • torsemide

                torsemide, paromomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • typhoid vaccine live

                paromomycin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • vecuronium

                paromomycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              Monitor Closely (52)

              • amikacin

                amikacin and paromomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • amiodarone

                amiodarone will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • amphotericin B deoxycholate

                amphotericin B deoxycholate and paromomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

              • bazedoxifene/conjugated estrogens

                paromomycin will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • carboplatin

                carboplatin and paromomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • cidofovir

                cidofovir and paromomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

              • cisplatin

                cisplatin and paromomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • clarithromycin

                clarithromycin will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • clotrimazole

                clotrimazole will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • conjugated estrogens

                paromomycin will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • contrast media (iodinated)

                contrast media (iodinated) and paromomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • digoxin

                paromomycin will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

              • dronedarone

                dronedarone will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                paromomycin and elvitegravir/cobicistat/emtricitabine/tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • erythromycin base

                erythromycin base will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin lactobionate

                erythromycin lactobionate will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin stearate

                erythromycin stearate will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • estradiol

                paromomycin will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estrogens conjugated synthetic

                paromomycin will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estropipate

                paromomycin will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • ethinylestradiol

                paromomycin will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • felodipine

                felodipine will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • fosphenytoin

                fosphenytoin will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • indinavir

                indinavir will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ioversol

                ioversol and paromomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • ketoconazole

                ketoconazole will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • lapatinib

                lapatinib will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • levoketoconazole

                levoketoconazole will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                paromomycin will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.

              • loratadine

                loratadine will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • mestranol

                paromomycin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • methotrexate

                paromomycin decreases levels of methotrexate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Paromomycin may decrease intestinal absorption of methotrexate or interfere with enterohepatic circulation by inhibiting bowel flora and suppressing metabolism of the drug by bacteria.

              • nefazodone

                nefazodone will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • neomycin PO

                neomycin PO and paromomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

              • nicardipine

                nicardipine will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nifedipine

                nifedipine will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • oxaliplatin

                oxaliplatin and paromomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • phenobarbital

                phenobarbital will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • phenytoin

                phenytoin will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • quercetin

                quercetin will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • rifampin

                rifampin will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ritonavir

                ritonavir will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • sirolimus

                sirolimus will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • St John's Wort

                St John's Wort will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • streptozocin

                paromomycin and streptozocin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • tacrolimus

                tacrolimus will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

                paromomycin and tacrolimus both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • teicoplanin

                paromomycin and teicoplanin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • tobramycin inhaled

                tobramycin inhaled and paromomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

              • tolvaptan

                tolvaptan will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • trazodone

                trazodone will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • verapamil

                verapamil will increase the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              Minor (76)

              • aceclofenac

                aceclofenac increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • acemetacin

                acemetacin increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • acyclovir

                acyclovir and paromomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • adefovir

                adefovir and paromomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • aspirin

                aspirin increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • aspirin rectal

                aspirin rectal increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • aztreonam

                aztreonam, paromomycin. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Combination may be used synergistically against Pseudomonas spp. and Enterobacteriaceae.

              • balsalazide

                paromomycin will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • biotin

                paromomycin will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium acetate

                paromomycin decreases levels of calcium acetate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium carbonate

                paromomycin decreases levels of calcium carbonate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium chloride

                paromomycin decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium citrate

                paromomycin decreases levels of calcium citrate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium gluconate

                paromomycin decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • capreomycin

                capreomycin and paromomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • celecoxib

                celecoxib increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • cephaloridine

                cephaloridine and paromomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • clotrimazole

                clotrimazole decreases levels of paromomycin by unknown mechanism. Minor/Significance Unknown.

              • colistin

                colistin and paromomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • cordyceps

                cordyceps decreases toxicity of paromomycin by unspecified interaction mechanism. Minor/Significance Unknown.

              • cyanocobalamin

                paromomycin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • diclofenac

                diclofenac increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • diflunisal

                diflunisal increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • etodolac

                etodolac increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • fenoprofen

                fenoprofen increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • fluconazole

                fluconazole decreases levels of paromomycin by unknown mechanism. Minor/Significance Unknown.

              • flurbiprofen

                flurbiprofen increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • foscarnet

                foscarnet and paromomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • gentamicin

                gentamicin and paromomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • ibuprofen

                ibuprofen increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • ibuprofen IV

                ibuprofen IV increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • indomethacin

                indomethacin increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • ketoconazole

                ketoconazole decreases levels of paromomycin by unknown mechanism. Minor/Significance Unknown.

              • ketoprofen

                ketoprofen increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • ketorolac

                ketorolac increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • ketorolac intranasal

                ketorolac intranasal increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • levoketoconazole

                levoketoconazole decreases levels of paromomycin by unknown mechanism. Minor/Significance Unknown.

              • lornoxicam

                lornoxicam increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • magnesium chloride

                paromomycin decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.

              • magnesium citrate

                paromomycin decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.

              • magnesium hydroxide

                paromomycin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • magnesium oxide

                paromomycin decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.

              • magnesium sulfate

                paromomycin decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.

              • meclizine

                meclizine, paromomycin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Ototoxicity of aminoglycoside may be masked.

              • meclofenamate

                meclofenamate increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • mefenamic acid

                mefenamic acid increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • meloxicam

                meloxicam increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • methoxyflurane

                methoxyflurane and paromomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • miconazole vaginal

                miconazole vaginal decreases levels of paromomycin by unknown mechanism. Minor/Significance Unknown.

              • nabumetone

                nabumetone increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • naproxen

                naproxen increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • oxaprozin

                oxaprozin increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • pantothenic acid

                paromomycin will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • parecoxib

                parecoxib increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • pentamidine

                paromomycin and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • piroxicam

                piroxicam increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • polymyxin B

                paromomycin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • posaconazole

                posaconazole decreases levels of paromomycin by unknown mechanism. Minor/Significance Unknown.

              • pyridoxine

                paromomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pyridoxine (Antidote)

                paromomycin will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • salicylates (non-asa)

                salicylates (non-asa) increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • salsalate

                salsalate increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • streptomycin

                paromomycin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • sulfasalazine

                sulfasalazine increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • sulindac

                sulindac increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • tenofovir DF

                paromomycin and tenofovir DF both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                paromomycin increases levels of tenofovir DF by decreasing elimination. Minor/Significance Unknown.

              • thiamine

                paromomycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • ticarcillin

                ticarcillin decreases effects of paromomycin by altering metabolism. Minor/Significance Unknown. Increased risk in renal impairment.

              • tobramycin

                paromomycin and tobramycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • tolfenamic acid

                tolfenamic acid increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • tolmetin

                tolmetin increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • vancomycin

                paromomycin and vancomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • voriconazole

                voriconazole decreases levels of paromomycin by unknown mechanism. Minor/Significance Unknown.

              • zoledronic acid

                paromomycin, zoledronic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypocalcemia.

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              Adverse Effects

              1-10%

              Diarrhea

              Abdominal cramps

              Nausea

              Vomiting

              Heartburn

              <1%

              Headache

              Vertigo

              Exanthema

              Rash

              Pruritus

              Steatorrhea

              Secondary enterocolitis

              Eosinophilia

              Ototoxicity

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              Warnings

              Contraindications

              Hypersensitivity, intestinal obstruction

              Cautions

              Prolonged treatment may result in fungal or bacterial superinfection

              Caution in renal impairment or patients with ulcerative bowel lesions

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: does not enter 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

              Mechanism of Action

              Aminoglycoside; interferes with bacterial protein synthesis by binding to 30S ribosomal subunits; has antibacterial against pathogenic organisms in the GI tract

              Pharmacokinetics

              Absorption: Poor

              Excretion: Feces (100% as unchanged drug)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              paromomycin oral
              -
              250 mg capsule
              paromomycin oral
              -
              250 mg capsule
              Humatin oral
              -
              250 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              paromomycin oral

              PAROMOMYCIN - ORAL

              (PAIR-oh-mow-MY-sin)

              COMMON BRAND NAME(S): Humatin

              USES: This medication is used to treat a certain parasite infection of the intestines (amebiasis). This medication is known as an aminoglycoside antibiotic. It works by stopping the growth of parasites in the intestines. This medication is poorly absorbed into the blood so it will not work for infections outside of the intestines.Paromomycin may also be used along with a special diet to treat a certain serious brain problem (hepatic encephalopathy). This condition occurs in people with liver disease and is caused by too much of a certain natural substance (ammonia) in the body. Normally the liver gets rid of the ammonia. Paromomycin helps to treat hepatic encephalopathy by stopping the growth of certain bacteria in your intestines that make ammonia.This antibiotic treats only parasitic and bacterial infections. It will not work for viral infections (such as common cold, flu). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness.

              HOW TO USE: Take this medication by mouth with meals as directed by your doctor, usually 3 times daily (every 8 hours).The dosage is based on your weight, medical condition, and response to treatment.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.

              SIDE EFFECTS: Nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, and heartburn may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: oily stools, ringing/roaring sounds in the ears, hearing loss, dizziness, numb/tingling skin, headache, seizures, muscle weakness.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking paromomycin, tell your doctor or pharmacist if you are allergic to it; or to other aminoglycoside antibiotics (such as gentamicin, tobramycin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: intestinal problems (such as blockage, ulcers).Paromomycin may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using paromomycin before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised November 2022. Copyright(c) 2023 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

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

              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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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.