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neomycin sulfate
generic
Black Box Warnings .
Systemic Toxicity Risk
systemic absorption occurs, toxic rxns (neurotoxicity/ototoxicity/nephrotoxicity) at recommended doses; incr. risk nephrotoxicity/ototoxicity if renal impairment; potential for nephrotoxicity, permanent bilateral auditory otoxicity and sometimes vestibular toxicity in normal renal fxn w/ use of higher doses and/or longer duration than recommended; ototoxicity often delayed onset, no cochlear damage sx during tx but eighth nerve destruction and partial/total deafness may occur after tx D/C; monitor serial vestibular/audiometric tests and renal fxn; avoid concurrent and/or sequential nephrotoxic/neurotoxic agents incl. aminoglycosides; avoid concurrent potent diuretics; other risk factors incl. advanced age or dehydration
Neuromuscular Blockade
neuromuscular blockade incl. resp. paralysis possible w/ any route of admin; risk factors: concurrent anesthesia, neuromuscular blockers, or large citrate-anticoag. blood transfusions; calcium salts may reverse sx if blockage occurs, mechanical resp. assistance may be needed
Adult Dosing .
Dosage forms: TAB: 500 mg
infection prophylaxis, colorectal surgery
- [dosing protocols may vary]
- Dose: 1000 mg PO at 1pm, 2pm and 11pm the day before 8am surgery; Info: give w/ erythromycin or metronidazole; use w/ mechanical bowel prep; follow w/ appropriate preop IV antibiotic prophylaxis
hepatic encephalopathy, adjunct tx
- [1000-3000 mg PO q6h x5-6 days]
renal dosing
- [see below]
- renal impairment: no adjustment; Info: consider monitoring serum levels if potential for systemic absorption
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: TAB: 500 mg
infection prophylaxis, colorectal surgery (off-label)
- [1 yo and older]
- Dose: 15 mg/kg/dose PO at 1pm, 2pm and 11pm day prior to 8am surgery; Max: 1000 mg/dose; Info: dosing protocols may vary; give w/ erythromycin or metronidazole; use w/ mechanical bowel prep; follow w/ appropriate preop IV antibiotic prophylaxis
hepatic encephalopathy, adjunct tx (off-label)
- [1 mo-12 yo]
- Dose: 50-100 mg/kg/day PO divided q6-8h x5-6 days; Max: 12 g/day
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: not defined
hepatic dosing
- [not defined]