Drug reference

Paromomycin

Aminoglycoside · Antiprotozoal

Also known as HUMATIN

AminoglycosideAntiprotozoalATC null

CDSCO approvedSchedule H1

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Used in pregnant women for giardiasis to avoid potential mutagenic effects of other drugs

FDA category + note

Top interactionssee all 12 →

AtracuriumSevereDatabaseDDInter
CisatracuriumSevereDatabaseDDInter
DoxacuriumSevereDatabaseDDInter
MetocurineSevereDatabaseDDInter

Mechanism

Paromomycin is a nonabsorbed aminoglycoside. It acts as an effective luminal agent, particularly for eradicating Entamoeba histolytica trophozoites within the gut lumen.

Indications

Visceral leishmaniasis (unresponsive to antimonial alone)Eradication of Entamoeba histolytica trophozoites residing within the gut lumen (after nitroimidazole treatment for amebic colitis or amebic liver abscess)Treatment of asymptomatic individuals infected with Entamoeba histolyticaGiardiasis (in pregnant women to avoid possible mutagenic effects of other drugs)Intestinal colonization with E. histolytica (drug of choice for intestinal colonization)Amebic colitis (in combination with metronidazole)Amebic liver abscess (in combination with metronidazole)CryptosporidiosisGiardiasisCutaneous leishmaniasis (topical formulations)Visceral leishmaniasis (parenteral administration, alone or in combination with antimony compounds)protozoan parasites (including E. histolytica, Giardia lamblia, Trichomonas vaginalis, Cryptosporidium and Leishmania)hepatic encephalopathy (oral, as alternative to neomycin for antibacterial activity in the gut)visceral leishmaniasis (parenterally)Intestinal protozoal infections (amoebiasis, giardiasis, cryptosporidiosis)Asymptomatic cyst passersChronic amoebic colitisAcute amoebic dysentery (with metronidazole to eradicate luminal cycle)Hepatic amoebiasis (with metronidazole to eradicate luminal cycle)Giardiasis (alternative drug, especially during 1st trimester of pregnancy)Trichomonas vaginitis (topical)Dermal leishmaniasis (topical)Visceral Leishmaniasis (Kala-azar, i.m. route for resistant cases, in combinations)Hepatic coma (substitute for neomycin)Preoperative preparation of bowel (substitute for neomycin)Visceral Leishmaniasis (VL) (in India as 11 mg/kg IM daily for 21 days; in sub-Saharan Africa in combination with pentavalent antimonial)Cutaneous Leishmaniasis (CL) (for L. aethiopica, 16 mg/kg daily)Diffuse Cutaneous Leishmaniasis (DCL) (14 mg/kg daily in combination with sodium stibogluconate in Ethiopia)Post-kala-azar dermal leishmaniasis (PKDL) (in combination therapy)

Dosing

Adult: l INDICATIONS AND DOSE Visceral leishmaniasis (specialist use only) ▶ BY INTRAVENOUS INJECTION, OR BY INTRAMUSCULAR INJECTION Adult: 20 mg/kg daily for 28 days Cutaneous leishmaniasis (specialist use only) ▶ ▶ BY INTRAVENOUS INJECTION, OR BY INTRAMUSCULAR INJECTION ▶ Adult: 20 mg/kg daily for 20 days Heart disease (withdraw if conduction disturbances occur) . mucocutaneous disease .…
Pediatric: Oral: 10 mg/kg TDS for 7 days (for amoebiasis/giardiasis/cryptosporidiosis).

Pharmacokinetics

Bioavailability

Low (nonabsorbed orally)

Contraindications

pregnancy
perforated eardrum (ear drops)

Side effects

Common

Abdominal pain and crampingEpigastric painNauseaVomitingSteatorrheaDiarrheaRash (rarely)Headache (rarely)nausea (g.i.t.)vomiting (g.i.t.)abdominal cramps (g.i.t.)diarrhoea (g.i.t.)rashes (rarely)ototoxicity (2% recipients, i.m. route)reversible elevation of serum transaminase (i.m. route)injection site pain (i.m. route)gi disturbances (oral dosing only)hepatotoxicityreversible ototoxicity

Serious