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neomycin Images

Generic Name: neomycin

Brand Names: Mycifradin, Neomycin Sulfate, Neo-Tab, Neo-Fradin, Neo-Rx

There is an FDA Alert for this drug. Click here to view it.

    Neurotoxicity and Ototoxicity
  • Neurotoxicity (manifested as both auditory and vestibular ototoxicity) can occur, even at recommended doses.
  • Risk of eighth-cranial nerve impairment is increased in patients with preexisting renal damage and in those with normal renal function who receive doses higher or treatment longer than recommended.
  • Aminoglycoside-induced ototoxicity is irreversible, usually bilateral, and may be partial or total.
  • Patients developing cochlear damage may not have symptoms during aminoglycoside treatment to warn them of eighth-cranial nerve toxicity and total or partial, irreversible, bilateral deafness may occur after drug discontinued.

  • Potentially nephrotoxic, even at recommended doses.
  • Nephrotoxicity develops principally in patients with preexisting renal damage and in those with normal renal function who receive doses higher or treatment longer than recommended.

    Patient Monitoring
  • Patients should be under close clinical observation because of potential toxicities.
  • Oral neomycin is absorbed systemically; toxic reactions may occur.
  • Closely monitor renal and eighth-cranial nerve function. Perform serial, vestibular, and audiometric tests and tests of renal function, particularly in high-risk patients.
  • Advanced age and dehydration may increase risk of toxicity.

    Neuromuscular Blockade
  • Neuromuscular blockage and respiratory paralysis reported with oral neomycin.
  • Concomitant use of an aminoglycoside with anesthesia and muscle-relaxing drugs may cause neuromuscular blockade with respiratory paralysis.
  • Consider possibility of neuromuscular blockade and respiratory paralysis when administering aminoglycosides, especially if used concurrently with anesthetics or neuromuscular-blocking agents (e.g., tubocurarine, succinylcholine, decamethonium) or in patients receiving massive transfusions of citrate-anticoagulated blood. (See Specific Drugs under Interactions.)
  • Calcium salts may reduce manifestations if blockade occurs; may require mechanical respiratory assistance.

  • Avoid concurrent and/or sequential use of other systemic, topical, or oral neurotoxic or nephrotoxic drugs, particularly other aminoglycosides (including paromomycin), amphotericin B, bacitracin, cisplatin, colistin, polymyxin B, vancomycin, and viomycin (not commercially available in the US). (See Interactions.)
  • Avoid concurrent use of potent diuretics (e.g., ethacrynic acid, furosemide) since diuretics themselves may cause ototoxicity and IV diuretics enhance toxicity by altering serum and tissue aminoglycoside concentrations. (See Interactions.)

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