Heparin
Contraindicated
Textbook
Incompatibility and potential loss of drug effect.
Do not mix in the same syringe/infusion bottle.
Source: KDT 7e · p58
Drug reference
Streptomycin
Aminoglycoside antibiotic · Antibiotic
Also known as Streptomycin sulfate
START
TB: 15 mg/kg IM once daily (max 1 g)
TYPICAL MAX
1 g/day (≤750 mg if elderly/low weight)
STOP IF
New vertigo/hearing loss or rising creatinine
WATCH
Audiometry/vestibular, renal function, drug levels
CDSCO approvedSchedule HJan AushadhiNPPA price-controlledATC J01GA01
KDIGO 2024 + manufacturer label
- ONSET
- 30min · absorption
- PEAK
- 1.5h · Tmax IM
- t½
- 3h · t½
- DURATION
- 1d · once-daily
EXCRETION
Renal — glomerular filtration, unchanged
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Contraindicated — documented fetal ototoxicity.
FDA category + note
Top interactionssee all 12 →
- HeparinContraindicatedTextbookKDT 7e · p58
- FurosemideSevereTextbook-citedKDT 7e · p949
- Competitive BlockersSevereTextbookKDT 7e · p347-359
- AtracuriumSevereDatabaseDDInter
Available in India
4 branded formulations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Binds the 30S ribosomal subunit, causing misreading of mRNA and inhibition of bacterial protein synthesis; bactericidal, concentration-dependent, with activity against Mycobacterium tuberculosis and selected Gram-negatives.
Indications
Tuberculosis (combination, second-line)Plague / tularaemiaBrucellosis (with doxycycline)Enterococcal endocarditis (synergy, with penicillin)
Dosing
- Adult
- TB: 15 mg/kg IM once daily (max 1 g; ≥60 y or <50 kg: 500–750 mg). Endocarditis synergy: 7.5 mg/kg IM q12h.
- Pediatric
- 20–40 mg/kg/day IM (max 1 g/day).
- Renal adjustment
- Extend interval / reduce dose; follow levels (CrCl-dependent). Highly nephro/ototoxic in impairment.
- Hepatic adjustment
- No specific adjustment.
- Geriatric
- Reduce dose (≤750 mg); higher oto/nephrotoxicity risk.
- Max dose
- 1 g/day (lower if elderly/low weight/renal impairment)
Pharmacokinetics
Onset
Bactericidal levels within 1 h (IM)
Peak effect
1–2 h (Tmax IM)
Duration
~12–24 h (interval per renal function)
Half-life
2–4.7 h (markedly prolonged in renal failure)
Bioavailability
IM ~100% (negligible oral)
Protein binding
~34%
Metabolism
Not metabolised
Excretion
Renal — glomerular filtration, unchanged
Contraindications
- Aminoglycoside hypersensitivity
- Myasthenia gravis
- Pre-existing severe vestibular/auditory damage
- Pregnancy (ototoxic to fetus)
Side effects
Common
Vestibular disturbance (vertigo)TinnitusInjection-site painRashParaesthesia
Serious
- Irreversible ototoxicity (vestibular > cochlear)
- Nephrotoxicity
- Neuromuscular blockade/apnoea
- Anaphylaxis
Pregnancy & lactation
Pregnancy
Contraindicated — documented fetal ototoxicity.
Lactation
Poor oral absorption by infant; generally considered compatible.
Drug interactions
Furosemide
Severe
Textbook-cited
Ototoxicity (hearing loss) and nephrotoxicity
Avoid concurrent use; if unavoidable, monitor renal function and audiometry
Source: KDT 7e · p949
Competitive Blockers
Severe
Textbook
Potentiate competitive blockers; prolonged apnoea.
The dose of competitive blocker should be reduced in patients receiving high doses of these antibiotics.
Source: KDT 7e · p347-359
Atracurium
Severe
Database
Clinical effect not specified
Source: DDInter
Bacitracin
Severe
Database
Clinical effect not specified
Source: DDInter
Botulinum Toxin Type A
Severe
Database
Clinical effect not specified
Source: DDInter
Botulinum Toxin Type B
Severe
Database
Clinical effect not specified
Source: DDInter
Bumetanide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Capreomycin
Severe
Database
Clinical effect not specified
Source: DDInter
Cidofovir
Severe
Database
Clinical effect not specified
Source: DDInter
Cisatracurium
Severe
Database
Clinical effect not specified
Source: DDInter
Cisplatin
Severe
Database
Additive oto/nephrotoxicity
Avoid concurrent use
Source: Kimi deep-research + Cla
Related guidelines
Extrapulmonary tuberculosis
ICMR · Infectious Diseases · 2022
Infective endocarditis prevention
ADA_DENTAL · Dentistry · 2015
Infective endocarditis prevention
NICE · Cardiology / Dentistry · 2008
Infective endocarditis prevention
AHA · Cardiology / Dentistry · 2007
Pulmonary tuberculosis
RNTCP · Infectious Disease · 2023
Other Aminoglycoside antibiotic drugs
Ask House about Streptomycin
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20