Adult, childn & infant 15 mg/kg/day divided into 2-3 equal doses administered at equally divided intervals ie, 7.5 mg/kg 12 hrly or 5 mg/kg 8 hrly. Max: 1.5 mg/day for heavier wt classes. Premature 7.5 mg/kg every 12 hr. Newborn 10 mg/kg as loading dose then 7.5 mg/kg 12 hrly thereafter. Infant >2 wk & childn 7.5 mg/kg every 12 hr or 5 mg/kg every 8 hr. Doses are given IM. Usual treatment duration: 7-10 days. Max total daily dose: 15-20 mg/kg.
Contraindications
Hypersensitivity.
Special Precautions
Concurrent or serial use of other ototoxic or nephrotoxic drugs systemically or topically; cephalosporins. Patient should be well hydrated; kidney function should be assessed prior to starting therapy. If signs of renal irritation (casts, WBC, RBC or albumin) appears, hydration should be increased. Reduce dose if other signs of renal dysfunction occurs (eg, decreased CrCl, urine specific gravity, increased BUN, creatinine or oliguria). Discontinue if azotemia increases or progressive decrease in urine output occurs. Possible occurrence of neuromuscular blockade or resp paralysis when co-administered w/ anesth or neuromuscular blockers. Muscular disorders eg, myasthenia gravis or parkinsonism. Cross-allergenicity w/ other aminoglycosides. Overgrowth of nonsusceptible organisms. Co-administration w/ β-lactam antibiotics (penicillins or cephalosporins). Avoid use w/ potent diuretics (ethacrynic acid or furosemide). Pregnancy & lactation. Premature & neonatal infants. Elderly.
Adverse Reactions
Hearing loss, loss of balance, high-frequency deafness. Acute muscular paralysis, apnea. Elevation of serum creatinine, albuminuria, presence of red & white cells, casts, azotemia, oliguria. Rarely, skin rash, drug fever, headache, paresthesia, tremor, nausea, vomiting, eosinophilia, arthralgia, anemia, hypotension, hypomagnesia.
Other potentially nephrotoxic or ototoxic drugs. Rapidly acting diuretics particularly those administered IV eg, furosemide, ethacrynic acid. IP use not recommended w/ anaesth or muscle-relaxing drugs (including ether, halothane, α-tubocurarine, succinylcholine, decamethonium). Indomethacin. Penicillin-type drugs.
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