Neomycin

Drug #770

Neomycin is an aminoglycoside antibiotic. The aminoglycosides are the compound containing characteristic amino sugars joined to a hexose nucleus in glycoside linkage Neomycin (Sulphate) is derived from cultures of Streptomyces fradiae. Although bioavailability after oral administration is poor, neomycin is administered orally in patients with hepatic coma or portal-systemic encephalopathy. Neomycin (Sulphate) is most often used topically as an antiinfective. Neomycin is not indicated for the treatment of systemic infections because it can cause irreversible ototoxicity. Neomycin was approved by the FDA in 1952. Neomycin is bactericidal in action. It inhibits bacterial protein synthesis through irreversible binding to the 30 S ribosomal subunit of susceptible bacteria. Neomycin is actively transported into the bacterial cell where it binds to receptors present on the 30 S ribosomal subunit. This binding interferes with the initiation complex between the messenger RNA (mRNA) and the subunit. As a result, abnormal, nonfunctional proteins are formed due to misreading of the bacterial DNA. Eventually, susceptible bacteria die because of the lack of functional protein.

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Primary Characteristics

Neomycin is also known as Neomycin (Sulphate).

It is of Semi Synthetic origin and belongs to Aminoglycosides.

It belongs to Antibacterial (Proetin synthesis inhibitor) pharmacological group on the basis of mechanism of action.

Molecular Weight: 711.7 · Solubility in Water: 1 in 1 · Solubility in Alcohol: very slightly soluble · Non-proprietary name: Neomycin.

Pharmacokinetics

Absorption: Neomycin has an oral bioavailability is 2%.

Distribution: Neomycin has a volume of distribution is 0.25 l/kg. plasma protein binding is 20%.

Elimination: plasma half-life is 2 hr, renal excretion is 1%.

Indications

Neomycin is primarily indicated in conditions like Decontamination of digestive tract, Hepatic coma, Hepatic encephalopathy, Pre-operative bowel sterilization, Sepsis, Skin infections, Superficial infections.

Neomycin is also indicated for secondary conditions like Acute bacterial enteritis, Bladder infections, Hypercholesterolaemia, Wounds management.

Contraindications

Neomycin is contraindicated in conditions like Allergy, Myasthenia gravis, Parkinsonism, Intestinal obstruction, Perforation of eardrum, Renal impairment.

Dosage

Neomycin's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
1 g	1 g	Every 4h	PO	2 or 3 days before surgery.
8 g	8 g	Every 24h	PO	For 5-6 days. Frequency may be increased upto 4 times if needed.
0.35 %	0.35 %	—	Topical	1-4 times as required.
Paediatric Dosage (20kg)
500 mg	500 mg	—		2 or 3 days before surgery for children 6 to 12 years.
100 mg/kg	100 mg/kg	—	PO	In divided doses for hepatic encephalophathy.
0.5 %	0.5 %	—	Topical	As required
Neonatal Dosage (3kg)
0.5 %	0.5 %	—	Topical	As required

Drug Interactions

Unknown12 interactions

4 interactions

Major3 interactions

Moderate2 interactions

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Neomycin in overdosage may give rise to further complications which include Urticaria , Angioneurotic edema, Ototoxicity , Blood dyscrasias , blood dyscrasias.

Neomycin produces potentially life-threatening effects which include Anaphylactic shock, Renal failure, Superinfection, Skeletal muscle paralysis. Careful monitoring is needed with proper medical management.

The signs and symptoms that are produced after acute overdosage of Neomycin are Nausea & vomiting, Permanent deafness.

Neomycin is known to cause more or less tolerable side effects which are usually transient. These include Azotemia, Contact dermatitis, Cylindruria, Diarrhea, Headache, Lethargy, Pruritus , Pyuria, Skin rash, Steatorrhea, Tinnitus, Vertigo.

Warnings / Precautions

Neomycin should be used with caution in patients who are sensitive to aminoglycosides, renal disease or renal impairment, patients with dehydration and in elderly patients. Patient with pre-existing tinnitus, vertigo or subclinical high frequency hearing impairrment should be closely monitored for sign of ototoxicity during therapy with neomycin. Take appropriate measures in case of secondary infections. Parenteral use of neomycin or its use for irrigation of wound or serouse cartities is no longer recommended.

Interference in Pathology

Neomycin may interfere in the diagnosis of Urinary Analysis Of Aminoacid .

Available Brands

Click on a strength to view available brands.

Single Ingredient

Cream

0.5 %w/w

Oint

0.5 %w/w 5 mg

Tabs

500 mg

Multi-Ingredient Combinations

Aerosol

165000 IU

Cream

0.1 %w/w 0.35 %w/w 0.5 %w/w 0.5 gm 25 IU/g 25 mg 2500 IU 2500 IU/g 3500 IU/g

Cream

0.25 %w/w

Drops

0.5 %w/v

E and E Drops

0.5 %w/v

Ear Drops

0.35 %w/v 0.5 %w/v 3400 IU/ml

Eye Drops

0.3 %w/v 0.35 %w/v 340000 IU/ml 3500 IU/ml

Eye Drops

0.5 %w/v

Eye Oint

0.35 %w/w 0.5 %w/w 3400 IU/g 3500 IU/g

Gel

Inj

Lotion

Nasal Drops

Oint

0.2 %0.25 %w/w 0.5 gm 2500 IU 2500 IU/g 3.5 mg/g

Oint

0.5 %w/w 2.5 mg/g

Powder

0.35 %w/w 0.5 %w/w

Vag Tabs

100 mg

Storage Conditions

Neomycin should be stored Oint, Cream.

Drug Classification

1.13.2.1 — Antibacterials, topical
2.28 — Otic drugs

Manufacturers

Manufacturers of Neomycin in Pakistan: