Dosing & Uses
Dosage Forms & Strengths
powder for injection
- 1g
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
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (18)
- atracurium
streptomycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- bacitracin
streptomycin and bacitracin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Avoid concurrent use of bacitracin with other nephrotoxic drugs
- BCG vaccine live
streptomycin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated.
- bumetanide
bumetanide, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- cholera vaccine
streptomycin, 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
streptomycin increases effects of cisatracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- ethacrynic acid
ethacrynic acid, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- furosemide
furosemide, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- incobotulinumtoxinA
streptomycin increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- onabotulinumtoxinA
streptomycin increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- pancuronium
streptomycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- quinidine
quinidine will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
- rapacuronium
streptomycin increases effects of rapacuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- rocuronium
streptomycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- succinylcholine
streptomycin increases effects of succinylcholine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- torsemide
torsemide, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- typhoid vaccine live
streptomycin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated.
- vecuronium
streptomycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
Monitor Closely (63)
- abobotulinumtoxinA
streptomycin increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Aminoglycosides may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- amikacin
amikacin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- amiodarone
amiodarone will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- amphotericin B deoxycholate
amphotericin B deoxycholate and streptomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- bazedoxifene/conjugated estrogens
streptomycin 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 streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- cidofovir
cidofovir and streptomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- cisplatin
cisplatin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- clarithromycin
clarithromycin will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- clotrimazole
clotrimazole will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- conjugated estrogens
streptomycin 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 streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- cyclosporine
cyclosporine and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- deferasirox
deferasirox, streptomycin. Other (see comment). Use Caution/Monitor. Comment: Acute renal failure has been reported during treatment with deferasirox. Coadministration of deferasirox with other potentially nephrotoxic drugs, including aminoglycosides, may increase the risk of this toxicity. Monitor serum creatinine and/or creatinine clearance in patients who are receiving deferasirox and nephrotoxic drugs concomitantly.
- dienogest/estradiol valerate
streptomycin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.
- digoxin
streptomycin 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 streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
streptomycin 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 streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- erythromycin stearate
erythromycin stearate will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- estradiol
streptomycin 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
streptomycin 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
streptomycin 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.
- felodipine
felodipine will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- fosphenytoin
fosphenytoin will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- indinavir
indinavir will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- ioversol
ioversol and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- ketoconazole
ketoconazole will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- levoketoconazole
levoketoconazole will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- loratadine
loratadine will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- magnesium supplement
magnesium supplement, streptomycin. 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
streptomycin 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.
- nefazodone
nefazodone will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- neomycin PO
neomycin PO and streptomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- nicardipine
nicardipine will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- nifedipine
nifedipine will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- nilotinib
nilotinib will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- oxaliplatin
oxaliplatin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- peramivir
streptomycin 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 streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- phenytoin
phenytoin will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- prabotulinumtoxinA
streptomycin 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 streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- rifampin
rifampin will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- rimabotulinumtoxinB
streptomycin, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Aminoglycosides may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- ritonavir
ritonavir will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- sirolimus
sirolimus will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
streptomycin 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 streptomycin 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 streptomycin 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.
- St John's Wort
St John's Wort will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- streptozocin
streptomycin and streptozocin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- tacrolimus
tacrolimus will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
streptomycin and tacrolimus both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. - teicoplanin
streptomycin and teicoplanin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- tenofovir DF
streptomycin and tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
streptomycin increases levels of tenofovir DF by decreasing elimination. Use Caution/Monitor. - tobramycin inhaled
tobramycin inhaled and streptomycin 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 streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- trazodone
trazodone will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- trimagnesium citrate anhydrous
streptomycin, trimagnesium citrate anhydrous. Either increases effects of the other by Other (see comment). Use Caution/Monitor. Comment: Coadministration of aminoglycosides with magnesium may increase risk of neuromuscular weakness and paralysis.
- verapamil
verapamil will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- voclosporin
voclosporin, streptomycin. 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.
Minor (77)
- aceclofenac
aceclofenac increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- acemetacin
acemetacin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- acyclovir
acyclovir and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- adefovir
adefovir and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- aspirin
aspirin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- aspirin rectal
aspirin rectal increases levels of streptomycin 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 streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- aztreonam
aztreonam, streptomycin. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Combination may be used synergistically against Pseudomonas spp. and Enterobacteriaceae.
- balsalazide
streptomycin will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- biotin
streptomycin 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
streptomycin decreases levels of calcium acetate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- calcium carbonate
streptomycin decreases levels of calcium carbonate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- calcium chloride
streptomycin decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- calcium citrate
streptomycin decreases levels of calcium citrate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- calcium gluconate
streptomycin decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- capreomycin
capreomycin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- celecoxib
celecoxib increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- cephaloridine
cephaloridine and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- clotrimazole
clotrimazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.
- colistin
colistin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- cordyceps
cordyceps decreases toxicity of streptomycin by unspecified interaction mechanism. Minor/Significance Unknown.
- cyanocobalamin
streptomycin 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 streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- diflunisal
diflunisal increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- entecavir
streptomycin, 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 streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- fenoprofen
fenoprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- fluconazole
fluconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.
- flurbiprofen
flurbiprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- foscarnet
foscarnet and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- gentamicin
gentamicin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- ibuprofen
ibuprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- ibuprofen IV
ibuprofen IV increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- indomethacin
indomethacin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- ketoconazole
ketoconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.
- ketoprofen
ketoprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- ketorolac
ketorolac increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- ketorolac intranasal
ketorolac intranasal increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- levoketoconazole
levoketoconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.
- lornoxicam
lornoxicam increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- magnesium chloride
streptomycin decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.
- magnesium citrate
streptomycin decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.
- magnesium hydroxide
streptomycin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium oxide
streptomycin decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium sulfate
streptomycin decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.
- meclizine
meclizine, streptomycin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Ototoxicity of aminoglycoside may be masked.
- meclofenamate
meclofenamate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- mefenamic acid
mefenamic acid increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- meloxicam
meloxicam increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- methoxyflurane
methoxyflurane and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- miconazole vaginal
miconazole vaginal decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.
- nabumetone
nabumetone increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- naproxen
naproxen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- oxaprozin
oxaprozin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- pantothenic acid
streptomycin 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 streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- paromomycin
paromomycin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- pentamidine
pentamidine and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- piperacillin
piperacillin increases effects of streptomycin by pharmacodynamic synergism. Minor/Significance Unknown.
- piroxicam
piroxicam increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- polymyxin B
polymyxin B and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- posaconazole
posaconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.
- pyridoxine
streptomycin 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)
streptomycin 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 streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- salsalate
salsalate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- sulfasalazine
sulfasalazine increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- sulindac
sulindac increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- thiamine
streptomycin 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 streptomycin by altering metabolism. Minor/Significance Unknown. Increased risk in renal impairment.
- tobramycin
streptomycin and tobramycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- tolfenamic acid
tolfenamic acid increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- tolmetin
tolmetin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- vancomycin
streptomycin and vancomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- voriconazole
voriconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.
- zoledronic acid
streptomycin, zoledronic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypocalcemia.
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
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, other antimicrobials#aminoglycosides, or excipients
Cautions
For tuberculosis, do not exceed 120 g total over course of treatment; discontinue in case of toxicity or organism resistance
For endocarditis, discontinue in case of ototoxicity
Reduce dosage in case of renal impairment: serum concentration should not exceed 20-25 mcg/mL
Prescribing streptomycin in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases risk of development of drug-resistant bacteria
Care should be taken by individuals handling Streptomycin for Injection to avoid skin sensitivity reactions; as with all intramuscular preparations, Streptomycin for Injection should be injected well within the body of a relatively large muscle and care should be taken to minimize the possibility of damage to peripheral nerves
Exercise extreme caution in selecting a dosage regimen in the presence of preexisting renal insufficiency; in severely uremic patients a single dose may produce high blood levels for several days and the cumulative effect may produce ototoxic sequelae
When streptomycin must be given for prolonged periods of time alkalinization of the urine may minimize or prevent renal irritation
A syndrome of apparent central nervous system depression, characterized by stupor and flaccidity, occasionally coma, and deep respiratory depression, reported in very young infants in whom streptomycin dosage had exceeded the recommended limits; infants should not receive streptomycin in excess of the recommended dosage
In the treatment of venereal infections such as granuloma inguinale, and chancroid, if concomitant syphilis is suspected, suitable laboratory procedures such as a dark field examination should be performed before the start of treatment, and monthly serologic tests should be done for at least four months
As with other antibiotics, use of this drug may result in overgrowth of nonsusceptible organisms, including fungi; if superinfection occurs, appropriate therapy should be instituted
Patients should be counseled that antibacterial drugs including streptomycin should only be used to treat bacterial infections; they do not treat viral infections (eg, the common cold)
When streptomycin is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed; skipping doses or not completing the full course of therapy may decrease the effectiveness of the immediate treatment and increase the likelihood that bacteria will develop resistance and will not be treatable by streptomycin or other antibacterial drugs in the future
Ototoxicity
- Both vestibular and auditory dysfunction can follow the administration of the drug; the degree of impairment is directly proportional to the dose and duration of administration, to the age of the patient, the level of renal function, and to the amount of underlying existing auditory dysfunction
- Vestibular damage is heralded by headache, nausea, vomiting, and disequilibrium; early cochlear injury is demonstrated by the loss of high-frequency hearing
- Appropriate monitoring and early discontinuation of the drug may permit recovery prior to irreversible damage to the sensorineural cells
- Baseline and periodic caloric stimulation tests and audiometric tests are advisable with extended streptomycin therapy; tinnitus, roaring noises, or a sense of fullness in the ears indicates need for audiometric examination or termination of streptomycin therapy or both
Drug interaction overview
- The ototoxic effects are potentiated by the coadministration of ethacrynic acid, mannitol, furosemide, and possibly other diuretics; the vestibulotoxic potential of streptomycin exceeds that of its capacity for cochlear toxicity
Pregnancy & Lactation
Pregnancy
Streptomycin can cause fetal harm when administered to a pregnant woman; because streptomycin readily crosses the placental barrier, caution in use of the drug is important to prevent ototoxicity in the fetus; if this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus
Lactation
Because of the potential for serious adverse reactions in nursing infants from streptomycin, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother
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.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
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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| streptomycin intramuscular - | 1 gram vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
streptomycin intramuscular
STREPTOMYCIN - INJECTION
(strep-toe-MYE-sin)
WARNING: This medication can sometimes cause serious nerve damage, possibly resulting in permanent hearing loss and balance problems. The risk is higher if you have kidney disease, if you are receiving high doses of this medication, if you use this drug for a long time, if you are an older adult (older than 60 years), or if you develop a severe loss of body water (become dehydrated). To reduce the risk of dehydration, drink plenty of fluids while using this medication unless your doctor directs you otherwise. Before starting streptomycin, tell your doctor if you already have kidney or hearing problems.Tell your doctor right away if you notice ringing/roaring in the ears, headache, hearing loss, balance problems, unusual drowsiness, dizziness, vision changes, or numbness/tingling of the skin.Your doctor will monitor your progress to reduce the risk of these side effects and may test your hearing, kidneys, and streptomycin blood level. This medication may be stopped if you develop kidney problems or hearing problems.If possible, you should avoid using any other medications that may harm the kidneys or nerves while using streptomycin (such as cidofovir, cisplatin, cyclosporine, other aminoglycoside antibiotics such as gentamicin/tobramycin, among others).Before having surgery, tell your doctor or dentist that you are using this medication. This drug may affect many of the drugs used during surgery and may increase your risk of side effects.
USES: This medication is used with other medications to treat active tuberculosis (TB) infection if you cannot take other drugs for TB or if you have a type of TB that cannot be treated with other drugs (drug-resistant TB). Streptomycin belongs to a class of drugs known as aminoglycoside antibiotics. It works by killing the organisms that cause the infection.This drug may also be used to treat other serious infections (such as Mycobacterium avium complex-MAC, tularemia, endocarditis, plague) along with other medications.
HOW TO USE: This medication is given by injection, usually into a muscle as directed by your doctor. When you start treatment for TB, it is usually given once a day or as directed by your doctor. It is important to change the location of the injection site daily to avoid problem areas under the skin. If you have any questions about using this medication properly, consult your doctor or pharmacist.Dosage is based on the kind of infection, your weight, medical condition, streptomycin blood levels, and side effects. How often you receive injections and the length of your treatment will depend on the type of infection you have and your response to treatment.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.Medication to treat tuberculosis is usually used for 9 months or longer. After you receive streptomycin daily for 1 to 2 months, your doctor may direct you to receive this medication less often (such as 2 to 3 times a week). Your doctor may direct you to stop using this medication before stopping your other TB medications. It is very important to continue using streptomycin and your other medications exactly as prescribed by your doctor.Do not stop taking this medication (or other TB medicines/antibiotics) even for a short time unless directed to do so by your doctor. Skipping or changing your dose without approval from your doctor may worsen side effects or make the infection (especially TB) more difficult to treat (resistant). If TB becomes resistant to this medication, it might also become resistant to other TB medications.For the best effect, use this antibiotic at evenly spaced times. Be sure to keep all appointments for receiving this drug.Tell your doctor right away if your infection symptoms return (such as fever, chills, body aches) while you are using this medication or after you stop using it.
SIDE EFFECTS: See also Warning section.Nausea, vomiting, stomach upset, or loss of appetite may occur. Pain/irritation/redness may occur at the injection site. 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: muscle weakness, diarrhea that doesn't go away even after stopping this medication, easy bleeding/bruising, fast heartbeat, new signs of infections (such as cough that doesn't go away, high fever), signs of kidney problems (such as change in the amount of urine), unusual tiredness.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: See also Warning section.Before using streptomycin injection, tell your doctor or pharmacist if you are allergic to it; or to other aminoglycoside antibiotics (such as tobramycin, gentamicin); 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: kidney problems, hearing problems, dehydration, a certain muscle problem (myasthenia gravis), burns over a large area of skin, cystic fibrosis.Streptomycin may cause live bacterial vaccines (such as BCG, typhoid vaccine) to not work well. Tell your health care professional that you are using streptomycin before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist that you are taking this medication.Caution is advised when using this drug in older adults because they may have decreased kidney function. Older adults may be more sensitive to the kidney and hearing side effects.Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using streptomycin. Streptomycin may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication. Consult your doctor for more details.This medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also Warning section.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.Some products that may interact with this drug include: amphotericin B, high doses of aspirin/NSAIDs such as ibuprofen/naproxen.If your doctor has directed you to take low doses of aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should continue to take the aspirin. Consult your doctor or pharmacist for more details.
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. Symptoms may include: extreme drowsiness, slow/shallow breathing, inability to move.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as kidney function, hearing tests, streptomycin levels) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.
STORAGE: Store unmixed medication 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 December 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.
Formulary
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- View the formulary and any restrictions for each plan.
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