Adult Dosing
Adjunctive therapy for hepatic encephalopathy
Neo-fradin, neomycin
- 4-12 gm/day PO in divided doses x5-6 days
- Max: 12 gm/day; do not use longer than 2 weeks
Note: Use doses of 4 g/day if less potentially toxic drugs cannot be used for chronic hepatic insufficiency
Preoperative prophylaxis for elective colorectal surgery
Neomycin
- 1 g PO at 19, 18, and 9 hrs prior to surgery; administer with erythromycin
Pediatric Dosing
- Safety and effectiveness in pediatric patients of <18 yrs have not been established
Adjunctive therapy for hepatic encephalopathy [Non-FDA Approved]
- 1 month-12 yrs
- 50-100 mg/kg/day PO divided q6-8 hrs x 5-6 days
- Max dose: 12 g/day
Preoperative prophylaxis for elective colorectal surgery [Non-FDA Approved]
- 2-12 yrs
- 90 mg/kg/day PO divided q4 hrs for 2-3 days
[Outline]
See Supplemental Patient Information
- Neurotoxicity (including ototoxicity) and nephrotoxicity may occur following usage of this drug even at recommended doses [US Black Box Warning]. Risk of hearing loss may occur which may continue even after drug withdrawal
- Aminoglycosides are associated with fetal harm on administration to a pregnant woman
- Increased in the risk of the development of drug-resistant bacteria or a prophylactic indication is unlikely to provide benefit to the patients if this drug is prescribed in the absence of a proven or strongly suspected bacterial infection
- Institute appropriate therapy on overgrowth of nonsusceptible organisms, particularly fungi
- Following irrigation of both small and large surgical fields with minute quantities of neomycin delayed-onset irreversible deafness, renal failure and death (regardless of the status of renal function) have occurred
- Cross-allergenicity is associated with this drug
- This drug is associated with aggravation of muscle weakness as potential curare-like effect on the neuromuscular junction exists
- Nephrotoxicity and/or ototoxicity are associated with this drug. On development of renal insufficiency consider dose reduction or discontinuation of therapy
- Malabsorption syndrome for a variety of substances, including fat, nitrogen, cholesterol, carotene, glucose, xylose, lactose, sodium, calcium, cyanocobalamin and iron are associated with doses of 12 g/day
- This drug is associated with increasing fecal bile acid excretion and reducing intestinal lactase activity
- Perform urinalysis for increased excretion of protein, decreased specific gravity, casts and cells prior to and periodically during therapy. Perform renal function tests such as serum creatinine, BUN or creatinine clearance and tests of the vestibulocochlearis nerve (eighth cranial nerve) function. Perform serial, vestibular and audiometric tests (especially in high-risk patients). Determine creatinine clearance in geriatrics
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Impaired auditory function
- Impaired vestibular function
- Concomitant ototoxic agents
- Concomitant neurotoxic agents
- Neuromuscular disease
- Ulcerative colitis
- Inflammatory bowel disease
- Electrolyte abnormalities
- Dehydration
- Prolonged use
- Neonates
- Infants
- Geriatrics
Supplemental Patient Information
- Apprise patients about the potential hazard to the fetus if neomycin is used during pregnancy, or if the patient becomes pregnant while taking this drug
Pregnancy Category:D
Breastfeeding: Small amounts of aminoglycosides are absorbed by infants but serum levels are far below those attained when treating newborn infections and systemic effects of neomycin are unlikely. Older infants are expected to absorb even less neomycin. Monitor the infant for possible effects on the GI flora. Oral neomycin may result in very low levels in breastmilk and present negligible risk to the infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 1 June 2011). According to manufacturer potential for serious adverse reactions from the aminoglycosides in nursing infants exists and 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.
Pricing data from www.DrugStore.com in U.S.A.
- Neomycin Sulfate 500 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
30 mg = $39.99
90 mg = $115.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
