Formulary
Neomycin sulfate: Indications, Dosing, Side Effects and Interactions
Neomycin sulfate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Neomycin sulfate: Indications, Dosing, Side Effects and Interactions
Neomycin sulfate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Bacterial skin infections**
- **Child** (To The Skin): Apply up to 3 times a day, for short-term use only.
- **Adult** (To The Skin): Apply up to 3 times a day, for short-term use only.
**Bowel sterilisation before surgery**
- **Adult** (By Mouth): 1 g every 1 hour for 4 hours, then 1 g every 4 hours for 2-3 days.
**Hepatic coma**
- **Adult** (By Mouth): Up to 4 g daily in divided doses usually for 5-7 days.
**Bacterial skin infections for neomycin sulfate**
- **Child** (To the skin): Apply up to 3 times a day, for short-term use only.
Cautions
With oral use Avoid prolonged use (in adults) Cautions, further information With oral use in adults: Although neomycin is associated with the same cautions as other aminoglycosides it is generally considered too toxic for systemic use. Large areas With topical use in adults: If large areas of skin are being treated ototoxicity may be a hazard, particularly in the elderly, and in those with renal impairment. Large areas With topical use in children: If large areas of skin are being treated ototoxicity may be a hazard in children, particularly in those with renal impairment.
Contraindications
With oral use Intestinal obstruction (in adults); myasthenia gravis (aminoglycosides may impair neuromuscular transmission) (in adults) With topical use Neonates
Side effects
Frequency not known With oral use Blood disorder (in adults); confusion (in adults); diarrhoea (in adults); drug cross-reactivity (in adults); electrolyte imbalance (in adults); gastrointestinal disorders (in adults); haemolytic anaemia (in adults); nausea (in adults); nephrotoxicity (in adults); nystagmus (in adults); oral disorders (in adults); ototoxicity (in adults); paraesthesia (in adults); superinfection (in adults); vomiting (in adults) With topical use Sensitisation (cross sensitivity with other aminoglycosides may occur) Side-effects, further information Although neomycin is associated with the same side effects as other aminoglycosides, it is poorly absorbed after oral administration.
Interactions
**Other interactions (2):**
- Co-administered drugs that can inhibit CYP3A4 (e.g.
- The extent to which this interaction is clinically relevant depends on the dose and route of administration of the corticosteroids and the potency of the CYP3A4 inhibitor.
Pregnancy
With oral use in adults: There is a risk of auditory or vestibular nerve damage in the infant when aminoglycosides are used in the second and third trimesters of pregnancy.
Hepatic impairment
With oral use in adults: Manufacturer advises caution (increased risk of ototoxicity and nephrotoxicity).
Renal impairment
With oral use in adults: Avoid-risk of ototoxicity and nephrotoxicity. With topical use: Ototoxicity may be a hazard if large areas of skin are treated.
Medicinal forms
Solution,Solution,Cream
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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