Neomycin, Oral Tablet

Medically reviewed by University of Illinois-Chicago, Drug Information Group on July 22, 2017Written by University of Illinois-Chicago, Drug Information Group on November 25, 2017

Highlights for neomycin

  1. Neomycin oral tablet is only available as a generic drug. There is no brand-name version available.
  2. Neomycin comes only as a tablet you take by mouth.
  3. Neomycin oral tablet is used to prevent or treat intestinal bacterial infections. It’s also used to treat hepatic coma.

Important warnings

FDA Warnings

  • This drug has black box warnings. These are the most serious warnings from the Food and Drug Administration (FDA). Black box warnings alert doctors and patients about drug effects that may be dangerous.
  • Toxicity warning: This drug can harm your kidneys, ears, and nervous system, including your brain. This can happen even if you take this drug at the dosage your doctor prescribes. Your risk of kidney damage is even greater if you already have kidney problems. Ear damage or hearing loss can start after you stop taking this drug. Your doctor will make sure you’re a good candidate for this drug before prescribing it for you.
  • Muscle and breathing problems warning: This drug can cause you to lose your muscle function. It can also cause breathing trouble or make you unable to breathe. Your risk of these issues may be higher if you also take other drugs that can cause these side effects.
  • Treatment with other aminoglycosides warning: Taking this drug with other aminoglycoside antibiotics can increase your side effects. This can be dangerous. Wait at least one week between taking this drug and other aminoglycosides.
  • Seniors, dehydration, and diuretics warning: Seniors and people who are dehydrated have a higher risk of side effects from this drug. You shouldn’t take this drug with certain diuretics (water pills). When diuretics are given intravenously (through a vein), they may cause neomycin to build up in your body to dangerous levels. Taking diuretics with neomycin can further increase your risk of ear issues.

Other warnings

  • Medication completion warning: It’s important to finish the entire course of this drug as prescribed by your doctor. Don’t stop taking it or skip doses, even if you start to feel better. Doing so could cause your infection to last longer. You could also develop resistance to the medication. This means if you get a bacterial infection in the future, you may not be able to treat it with neomycin.
  • Pregnancy use warning: You shouldn’t use this drug during pregnancy. It can seriously harm or even end your pregnancy. If you become pregnant while taking this drug, tell your doctor right away.

What is neomycin?

Neomycin is a prescription drug. It comes as an oral tablet.

Neomycin oral tablet is only available as a generic drug. It doesn’t have a brand-name version.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Neomycin oral tablet is used to prevent or treat bacterial infections in the intestines. It’s given before certain surgeries. It’s also used to treat hepatic coma, which is the loss of brain function due to a liver problem. Hepatic coma happens when your liver can’t remove ammonia from your blood.

How it works

Neomycin belongs to a class of drugs called aminoglycosides. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

For people with an infection, neomycin works by killing bacteria and stopping it from growing in your body. This treats your infection or stops an infection from forming in the first place.

People with hepatic coma can’t remove ammonia from their blood. Neomycin works by killing bacteria in their gut, which releases ammonia.

Neomycin side effects

Neomycin oral tablet doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects of neomycin can include:

  • nausea
  • vomiting
  • diarrhea

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Brain or nervous system damage. Symptoms can include:
    • numbness
    • skin tingling
    • muscle twitching
    • shaking
  • Ear damage and hearing loss
  • Kidney damage. Symptom can include:
    • confusion
    • fatigue
    • thirst
    • making less urine than normal
  • Muscle weakness
  • Breathing trouble

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Neomycin may interact with other medications

Neomycin oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with neomycin are listed below.

Drugs you should not use with neomycin

Do not take these drugs with neomycin. When used with neomycin, they can cause dangerous effects in your body. Examples of these drugs include:

  • Oral or topical aminoglycosides
    • These include paromomycin, bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin, and viomycin. Taking these drugs with neomycin can cause increased side effects that harm your kidneys and muscles.
  • Diuretics such as ethacrynic acid or furosemide
    • These drugs and neomycin can each cause ear or hearing problems. Taking them together can further increase your risk of hearing problems.

Interactions that increase your risk of side effects

Increased side effects from neomycin: Taking neomycin with certain medications raises your risk of side effects from neomycin. This is because the amount of neomycin in your body may be increased. Examples of these drugs include:

  • Drugs used to put people to sleep or to relax during surgery such as tubocurarine, succinylcholine, and decamethonium. Taking these drugs with neomycin increases your risk of muscle function loss and breathing problems.

Increased side effects from other drugs: Taking neomycin with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:

  • Warfarin. Taking these drugs together can increase your risk of bleeding.

Interactions that can make your drugs less effective

When other drugs are less effective: When certain drugs are used with neomycin, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples of these drugs include:

  • Penicillin V, oral vitamin B-12, methotrexate, 5-flurouracil, and digoxin. Your doctor may monitor the levels of these drugs in your body if you take any of them with neomycin.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we can not guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Neomycin warnings

This drug comes with several warnings.

Allergy warning

Neomycin can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with intestinal problems: If you have a blockage in your intestines or inflammatory or ulcerative gastrointestinal disease, this drug can increase your risk of intestinal problems. Ask your doctor if this drug is safe for you.

For people with muscular disorders: If you have myasthenia gravis or parkinsonism, this drug may make your muscle weakness worse. Ask your doctor if this drug is safe for you.

Warnings for other groups

For pregnant women: Neomycin is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm it may cause. This drug should only be used if the potential risk to the pregnancy is acceptable given the drug’s potential benefit.

If you become pregnant while taking this drug, call your doctor right away.

For women who are breastfeeding: Neomycin may pass into breast milk and cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: This medication has not been studied in children. It should not be used in children who are younger than 18 years unless it’s absolutely necessary.

How to take neomycin

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

The dosage information below is for the conditions that this drug is most often prescribed to treat. This list may not contain all conditions that your doctor can prescribe this drug for. If you have questions about your prescription, talk with your doctor.

Drug form and strength

Generic: Neomycin

  • Form: oral tablet
  • Strength: 500 mg

Dosage for intestinal bacterial infection

Adult dosage (ages 18–64 years)

Take this drug as prescribed by your doctor before surgery. Your doctor may have you take it for 2–3 days before surgery, or they may have you take it the day before surgery only.

Child dosage (ages 0–17 years)

It has not been confirmed that this drug is safe and effective for use in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for hepatic coma

Adult dosage (ages 18–64 years)

Typical dosage is 8 to 24 tablets (totaling 4–12 g, or 4,000–12,000 mg) four times per day. This dosage is taken every 6 hours for five to six days.

Child dosage (ages 0–17 years)

It has not been confirmed that this drug is safe and effective for use in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Take as directed

Neomycin oral tablet is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your infection may not get better or it may get worse. If you’re taking this drug to prevent an infection, you may get the infection.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

It’s important to finish the entire course of this drug as prescribed by your doctor. Don’t stop taking this drug or skip doses, even if you start to feel better. Doing so could cause your infection to last longer. You could also develop resistance to the medication. This means that if you get a bacterial infection in the future, you may not be able to treat it with neomycin.

If you take too much: Your body doesn’t absorb much of this drug, so it’s unlikely that you can take too much. However, if you do, you may have the following symptoms of an overdose:

  • nervous system or brain damage, with symptoms such as:
    • numbness
    • skin tingling
    • muscle twitching
    • shaking
  • hearing loss
  • kidney damage, with symptoms such as:
    • confusion
    • fatigue
    • thirst
    • not making as much urine as normal

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. If you remember just a few hours before your next scheduled dose, take only one. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: The symptoms of your infection should improve, or you won’t get the infection you’re trying to prevent.

Important considerations for taking neomycin

Keep these considerations in mind if your doctor prescribes neomycin for you.

General

  • You can take this drug with or without food.
  • Take this drug at the time(s) recommended by your doctor.
  • You can cut or crush the tablet.

Storage

  • Store neomycin at room temperature between 68°F and 77°F (20°C and 25°C).
  • Keep this drug in a tightly closed container. Store it away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor should monitor certain health issues while you take this drug. This can help make sure you stay safe during your treatment. These issues include your:

  • Kidney function. Your doctor may do blood tests and urine tests to check how well your kidneys work. If your kidneys aren’t working well, your doctor may lower your dosage of this drug.
  • Hearing. Your doctor may check your hearing before, during, and after your treatment with this drug. If this drug affects your hearing, your doctor may lower your dosage or stop your treatment with this drug.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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