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      For You News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
      Drugs & Diseases

      neomycin PO (Rx)

      Brand and Other Names:Neo-Fradin, Myciguent, more...Mycifradin
      • Print

      Dosing & Uses

      AdultPediatric

      Dosage Forms & Strengths

      tablet

      • 500mg

      oral solution

      • 25mg/mL

      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

      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

      Next:

      Interactions

      Interaction Checker

      and neomycin PO

      No Results

         activity indicator 
        No Interactions Found
        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

              Minor

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                 activity indicator 

                Contraindicated (7)

                • amikacin

                  amikacin and neomycin PO both increase nephrotoxicity and/or ototoxicity. Contraindicated.

                • amphotericin B deoxycholate

                  amphotericin B deoxycholate and neomycin PO both increase nephrotoxicity and/or ototoxicity. Contraindicated.

                • cidofovir

                  cidofovir and neomycin PO both increase nephrotoxicity and/or ototoxicity. Contraindicated.

                • contrast media (iodinated)

                  contrast media (iodinated) and neomycin PO both increase nephrotoxicity and/or ototoxicity. Contraindicated.

                • ioversol

                  ioversol and neomycin PO both increase nephrotoxicity and/or ototoxicity. Contraindicated.

                • tacrolimus

                  neomycin PO and tacrolimus both increase nephrotoxicity and/or ototoxicity. Contraindicated.

                • teicoplanin

                  neomycin PO and teicoplanin both increase nephrotoxicity and/or ototoxicity. Contraindicated.

                Serious - Use Alternative (25)

                • acyclovir

                  acyclovir and neomycin PO both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

                • atracurium

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

                • BCG vaccine live

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

                • bumetanide

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

                • capreomycin

                  capreomycin and neomycin PO both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

                • cephaloridine

                  cephaloridine and neomycin PO both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

                • cholera vaccine

                  neomycin PO, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

                • cisatracurium

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

                • colistin

                  colistin and neomycin PO both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

                • ethacrynic acid

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

                • furosemide

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

                • gentamicin

                  gentamicin and neomycin PO both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

                • incobotulinumtoxinA

                  neomycin PO increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

                • onabotulinumtoxinA

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

                • pancuronium

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

                • polymyxin B

                  neomycin PO and polymyxin B both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

                • quinidine

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

                • rapacuronium

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

                • rimabotulinumtoxinB

                  neomycin PO, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

                • rocuronium

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

                • succinylcholine

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

                • tobramycin

                  neomycin PO and tobramycin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

                • torsemide

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

                • typhoid vaccine live

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

                • vecuronium

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

                Monitor Closely (66)

                • abobotulinumtoxinA

                  neomycin PO increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Aminoglycosides may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

                • adefovir

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

                • amiodarone

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

                • bazedoxifene/conjugated estrogens

                  neomycin PO 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 neomycin PO both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • cisplatin

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

                • clarithromycin

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

                • clotrimazole

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

                • conjugated estrogens

                  neomycin PO 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.

                • cyclosporine

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

                • digoxin

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

                  neomycin PO decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                • dronedarone

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

                • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                  neomycin PO 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 neomycin PO by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

                • erythromycin ethylsuccinate

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

                • erythromycin lactobionate

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

                • erythromycin stearate

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

                • estradiol

                  neomycin PO 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

                  neomycin PO 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

                  neomycin PO 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

                  neomycin PO 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 neomycin PO by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

                • foscarnet

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

                • fosphenytoin

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

                • indinavir

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

                • ketoconazole

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

                • levoketoconazole

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

                • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                  neomycin PO 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 neomycin PO by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

                • magnesium supplement

                  magnesium supplement, neomycin PO. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Each enhance the neuromuscular blocking effect of the other; may have negative respiratory effects.

                • mestranol

                  neomycin PO 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

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

                • methoxyflurane

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

                • nefazodone

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

                • nicardipine

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

                • nifedipine

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

                • nilotinib

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

                • oxaliplatin

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

                • paromomycin

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

                • penicillin G aqueous

                  neomycin PO decreases levels of penicillin G aqueous by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                • penicillin VK

                  neomycin PO decreases levels of penicillin VK by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                • pentamidine

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

                • peramivir

                  neomycin PO increases levels of peramivir by decreasing renal clearance. Use Caution/Monitor. Caution when peramivir coadministered with nephrotoxic drugs.

                • phenobarbital

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

                • phenytoin

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

                • prabotulinumtoxinA

                  neomycin PO increases effects of prabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Aminoglycosides may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

                • quercetin

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

                • rifampin

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

                • ritonavir

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

                • sirolimus

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

                • sodium picosulfate/magnesium oxide/anhydrous citric acid

                  neomycin PO decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

                • sodium sulfate/?magnesium sulfate/potassium chloride

                  sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of neomycin PO by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

                • sodium sulfate/potassium sulfate/magnesium sulfate

                  sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of neomycin PO by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

                • sorafenib

                  neomycin PO decreases levels of sorafenib by unknown mechanism. Use Caution/Monitor. AUC decreased by 54% in healthy volunteers.

                • St John's Wort

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

                • streptomycin

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

                • streptozocin

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

                • tacrolimus

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

                • tenofovir DF

                  neomycin PO and tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                  neomycin PO increases levels of tenofovir DF by decreasing elimination. Use Caution/Monitor.

                • tobramycin inhaled

                  tobramycin inhaled and neomycin PO 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 neomycin PO by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

                • trazodone

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

                • vancomycin

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

                • verapamil

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

                • voclosporin

                  voclosporin, neomycin PO. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

                • warfarin

                  neomycin PO increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.

                Minor (65)

                • aceclofenac

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

                • acemetacin

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

                • aspirin

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

                • aspirin rectal

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

                • aztreonam

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

                • balsalazide

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

                • biotin

                  neomycin PO 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

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

                • calcium carbonate

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

                • calcium chloride

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

                • calcium citrate

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

                • calcium gluconate

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

                • celecoxib

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

                • choline magnesium trisalicylate

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

                • clotrimazole

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

                • cordyceps

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

                • cyanocobalamin

                  neomycin PO 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 neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

                • diflunisal

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

                • entecavir

                  neomycin PO, entecavir. Either increases effects of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.

                • etodolac

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

                • fenoprofen

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

                • fluconazole

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

                • flurbiprofen

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

                • ibuprofen

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

                • ibuprofen IV

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

                • indomethacin

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

                • ketoconazole

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

                • ketoprofen

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

                • ketorolac

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

                • ketorolac intranasal

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

                • levoketoconazole

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

                • lornoxicam

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

                • magnesium chloride

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

                • magnesium citrate

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

                • magnesium hydroxide

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

                • magnesium oxide

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

                • magnesium sulfate

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

                • meclizine

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

                • meclofenamate

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

                • mefenamic acid

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

                • meloxicam

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

                • miconazole vaginal

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

                • nabumetone

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

                • naproxen

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

                • oxaprozin

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

                • pantothenic acid

                  neomycin PO 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 neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

                • piperacillin

                  piperacillin increases effects of neomycin PO by pharmacodynamic synergism. Minor/Significance Unknown.

                • piroxicam

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

                • posaconazole

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

                • pyridoxine

                  neomycin PO 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)

                  neomycin PO 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 neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

                • salsalate

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

                • sulfasalazine

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

                • sulindac

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

                • thiamine

                  neomycin PO 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 neomycin PO by altering metabolism. Minor/Significance Unknown. Increased risk in renal impairment.

                • tolfenamic acid

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

                • tolmetin

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

                • vitamin A

                  neomycin PO decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. (Vitamin A).

                • voriconazole

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

                • zoledronic acid

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

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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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                Images

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                Patient Handout

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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.

                Create Your List of Plans

                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.

                View explanations for tiers and restrictions
                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.
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