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Drug Notebook

FDA Alerts

  • Patients should be under close clinical observation because of potential ototoxicity and nephrotoxicity.
  • Neurotoxicity (manifested as both auditory and vestibular ototoxicity) can occur, usually 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 usually is irreversible. Other neurotoxicity manifestations include numbness, skin tingling, muscle twitching, and seizures.
  • Potentially nephrotoxic. Risk of nephrotoxicity is greater in patients with impaired renal function and in those who receive high dosage or prolonged treatment.
  • Monitor renal and eighth-cranial nerve function closely, especially in patients with known or suspected renal impairment at start of treatment and also in those whose renal function is initially normal but develop renal dysfunction during treatment. Evaluate urine for decreased specific gravity and increased excretion of protein, cells, and casts; periodically determine BUN, Scr, and Clcr.
  • Serial audiograms should be obtained, if feasible, in patients old enough to be tested, particularly in high-risk patients. Discontinue or adjust dosage if there is evidence of ototoxicity (dizziness, vertigo, tinnitus, roaring in the ears, hearing loss) or nephrotoxicity. Rarely, changes in eighth-cranial nerve and renal function may not manifest until after the drug is discontinued.
  • Monitor serum gentamicin concentrations, when feasible, to assure adequate concentrations and avoid potentially toxic and prolonged peak concentrations (>12 mcg/mL) and avoid trough concentrations >2 mcg/mL. Excessive peak and/or trough serum concentrations may increase risk of renal and eighth-cranial nerve toxicity. In the event of overdose or toxic reactions, hemodialysis may aid in removal of gentamicin, especially if renal function is, or becomes, compromised. Lower concentrations are removed by peritoneal dialysis compared with hemodialysis.
  • Avoid concurrent and/or sequential use of other neurotoxic or nephrotoxic drugs (systemic or topical), particularly other aminoglycosides, cephaloridine (no longer available in US), viomycin, polymyxin B, colistin, cisplatin, and vancomycin. Other factors that may increase risk of toxicity are advanced age and dehydration.
  • Avoid concurrent use of potent diuretics (e.g., ethacrynic acid, furosemide) since diuretics themselves may cause ototoxicity and may enhance toxicity by altering serum and tissue aminoglycoside concentrations.
  • Aminoglycosides can cause fetal harm when administered to a pregnant woman.

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gentamicin
(jen ta MYE sin)

What is this medicine?
GENTAMICIN (jen ta MYE sin) is an aminoglycoside antibiotic. It is used to treat certain kinds of bacterial infections. It will not work for colds, flu, or other viral infections.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 09/2009. For the most current and up-to-date pricing information, please visit www.drugstore.com. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Gentamicin Sulfate 10MG/ML Solution APP PHARMACEUTICAL50/$125 or 150/$367.47

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What side effects may I notice from receiving this medicine?
Elderly patients are more likely to get serious side effects. Serious side effects with gentamicin include:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • breathing problems
  • changes in hearing
  • confused, dizzy, disoriented
  • fever
  • loss of balance
  • muscle twitch
  • numb, tingling pain
  • redness, blistering, peeling or loosening of the skin, including inside the mouth
  • seizures
  • trouble passing urine or change in the amount of urine
  • unusual bleeding or bruising
  • unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • diarrhea
  • headache
  • nausea, vomiting
  • pain at site where injected

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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How should I use this medicine?
This medicine is for injection into a muscle or infusion into a vein. It is usually given by a health care professional in a hospital or clinic setting.

If you get this medicine at home, you will be taught how to prepare and give this medicine. Use exactly as directed. Take your medicine at regular intervals. Do not take your medicine more often than directed. Take all of your medicine as directed even if you think you are better. Do not skip doses or stop your medicine early.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or healthcare provider to get one.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

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What if I miss a dose?
If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

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What may interact with this medicine?
Do not take this medicine with any of the following medications:

  • cidofovir

This medicine may also interact with the following medications:

  • acyclovir
  • cisplatin
  • colistin
  • cyclosporine
  • diuretics
  • foscarnet
  • ganciclovir
  • medicines used during surgery for sleep or muscle relaxation
  • other antibiotics

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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Who should NOT use this medication?

  • History of hypersensitivity or serious toxic reactions to gentamicin or other aminoglycosides.

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What should I watch for while using this medicine?
Your condition will be monitored carefully while you are receiving this medicine.

Tell your doctor or health care professional if you have any hearing problems or problems passing urine.

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What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:

  • balance problems
  • hearing problems
  • kidney disease
  • myasthenia gravis
  • Parkinson's disease
  • an unusual or allergic reaction to gentamicin, aminoglycosides, other medicines, sulfites, foods, dyes or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

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Can I stop taking the medication if I feel better?
If you have been diagnosed with a disease for which an antibiotic is needed, you must complete the prescribed course of treatment. Even if you start to feel better, do not skip any doses and remember to take the medication until it is all gone.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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