Drug reference

Neomycin

Aminoglycoside · Antibacterial

Also known as Neomycin sulfate

AminoglycosideAntibacterialATC null

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

There is a risk of auditory or vestibular nerve damage in the infant when aminoglycosides are used in the second and third trimesters of pregnancy.

FDA category + note

Top interactionssee all 12 →

AtracuriumSevereDatabaseDDInter
BacitracinSevereDatabaseDDInter
Botulinum Toxin Type ASevereDatabaseDDInter
Botulinum Toxin Type BSevereDatabaseDDInter

Mechanism

Neomycin is a bactericidal aminoglycoside active against some Gram-positive and many Gram-negative organisms. It reduces the bacterial population of the colon.

Indications

Infections of the skin or mucous membranesBowel sterilisation before surgeryHepatic comainfected wound (topical)ulcers (topical)burn (topical)external ear infections (topical)conjunctivitis (topical)preparation of bowel before surgery (oral)hepatic coma (oral, to suppress intestinal flora and diminish NH3 production)

Dosing

Adult: Bowel sterilisation before surgery: 1 g by mouth every 1 hour for 4 hours, then 1 g every 4 hours for 2–3 days. Hepatic coma: Up to 4 g daily by mouth in divided doses usually for 5–7 days.
Renal adjustment: Avoid due to risk of ototoxicity and nephrotoxicity.
Hepatic adjustment: Manufacturer advises caution (increased risk of ototoxicity and nephrotoxicity).
Max dose: Up to 4 g daily (for hepatic coma). Side effects increase after a cumulative dose of 100 g, which should only be exceeded in exceptional circumstances.

Pharmacokinetics

Bioavailability

Poorly absorbed after oral administration, but small amounts may be absorbed from the gut in patients with hepatic failure or inflammatory bowel disease.

Excretion

excreted unchanged by kidney (small absorbed amounts)

Contraindications

Intestinal obstruction
Myasthenia gravis
systemic use (too toxic)
impaired renal function
applied to serous cavities (risk of apnoea)
pregnancy
perforated eardrum (ear drops)
antidiarrhoeal formulations (banned in India)

Side effects

Common

DiarrhoeaGastrointestinal disordersNauseaOral disordersSuperinfectionVomitingMorphological abnormalities in intestinal mucosaSteatorrhoeaMalabsorption syndromerashes (topical)damaging effect on intestinal villimalabsorption syndrome (with diarrhoea and steatorrhoea)

Serious