Neomycin warnings. Neomycin Oral: Comprehensive Guide to Uses, Side Effects, and Warnings

08.09.202328.06.2023 by alexxlab

What are the primary uses of neomycin oral. How does neomycin work in the body. What are the most common side effects of neomycin. What serious warnings are associated with neomycin use. How should neomycin be used safely during pregnancy.

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Understanding Neomycin: An Overview of This Powerful Antibiotic

Neomycin is a potent antibiotic belonging to the aminoglycoside class of drugs. It’s primarily available as an oral tablet in its generic form, as there is no brand-name version currently on the market. This medication plays a crucial role in preventing and treating various bacterial infections, particularly those affecting the intestines. Additionally, it’s utilized in the management of hepatic coma, a severe condition characterized by loss of brain function due to liver problems.

Primary Uses of Neomycin Oral

Are you curious about the specific applications of neomycin oral? This antibiotic serves several important purposes:

Prevention and treatment of intestinal bacterial infections
Pre-operative prophylaxis before certain surgical procedures
Management of hepatic coma

In the case of hepatic coma, neomycin’s effectiveness stems from its ability to reduce ammonia levels in the blood by eliminating bacteria in the gut that produce this compound.

The Mechanism of Action: How Neomycin Works in the Body

Understanding how neomycin functions within the body is crucial for appreciating its therapeutic effects. As an aminoglycoside antibiotic, neomycin operates by targeting bacterial cells in two primary ways:

Bactericidal action: It kills susceptible bacteria by interfering with their protein synthesis.
Growth inhibition: Neomycin prevents the further proliferation of bacterial populations.

In patients suffering from hepatic coma, neomycin’s action is particularly noteworthy. By eliminating ammonia-producing bacteria in the intestines, it helps reduce the overall ammonia load on the impaired liver, potentially improving brain function.

Common Side Effects: What to Expect When Taking Neomycin

While neomycin is an effective antibiotic, it’s not without potential side effects. Patients should be aware of the more common adverse reactions that may occur during treatment:

Nausea
Vomiting
Diarrhea

These gastrointestinal disturbances are typically mild and often resolve on their own within a few days to weeks. However, if these symptoms persist or worsen, it’s important to consult a healthcare provider promptly.

Serious Warnings: Understanding the Risks Associated with Neomycin Use

The FDA has issued several black box warnings for neomycin, indicating potentially severe risks associated with its use. These warnings underscore the importance of careful patient selection and monitoring during treatment.

Toxicity Concerns

Can neomycin cause organ damage? Unfortunately, yes. Even at prescribed dosages, neomycin carries the risk of harming the kidneys, ears, and nervous system, including the brain. Patients with pre-existing kidney problems are at an elevated risk of renal damage. Notably, ototoxicity (ear damage or hearing loss) may manifest even after discontinuation of the drug.

Neuromuscular and Respiratory Risks

Neomycin use has been associated with severe neuromuscular blockade, potentially leading to muscle weakness and respiratory difficulties. This risk may be amplified when neomycin is combined with other medications known to cause similar effects.

Interactions with Other Aminoglycosides

The concurrent use of neomycin with other aminoglycoside antibiotics can result in additive toxicity. To mitigate this risk, a minimum one-week interval is recommended between courses of neomycin and other aminoglycosides.

Special Populations: Considerations for Seniors and Pregnant Women

Certain groups require extra caution when considering neomycin treatment:

Elderly Patients

Older adults may be more susceptible to the adverse effects of neomycin. Careful dosing and monitoring are essential in this population.

Pregnancy Considerations

Is neomycin safe during pregnancy? The answer is a resounding no. Neomycin use during pregnancy can pose serious risks to the developing fetus, potentially leading to pregnancy loss. Women who become pregnant while taking neomycin should immediately inform their healthcare provider.

Proper Use and Adherence: Maximizing Neomycin’s Effectiveness

To ensure optimal therapeutic outcomes and minimize the risk of antibiotic resistance, patients must adhere to the prescribed neomycin regimen. This includes:

Completing the full course of treatment, even if symptoms improve
Taking the medication exactly as directed by the healthcare provider
Avoiding premature discontinuation or skipping doses

Failure to follow these guidelines may result in prolonged infection and the potential development of antibiotic-resistant bacteria.

Monitoring and Management: Ensuring Safe Neomycin Use

Given the potential for serious side effects, close monitoring is crucial during neomycin treatment. Healthcare providers should consider the following measures:

Regular assessment of kidney function
Audiometric testing to detect early signs of hearing loss
Vigilant observation for signs of neuromuscular blockade
Careful evaluation of concurrent medications to avoid dangerous interactions

Patients should be educated about the signs and symptoms of serious adverse reactions and instructed to seek immediate medical attention if they occur.

Alternatives and Complementary Approaches: Broadening Treatment Options

While neomycin is effective for certain conditions, its potential risks may necessitate consideration of alternative treatments in some cases. Healthcare providers may explore other antibiotic options or complementary therapies depending on the specific infection or condition being treated.

For hepatic encephalopathy, for instance, other approaches might include:

Lactulose therapy to reduce ammonia absorption
Dietary modifications to limit protein intake
Probiotics to promote beneficial gut bacteria

The choice of treatment should always be individualized based on the patient’s specific circumstances, medical history, and risk factors.

Future Perspectives: Ongoing Research and Development in Antibiotic Therapy

As antibiotic resistance continues to pose a global health challenge, research into new antimicrobial agents and treatment strategies remains crucial. While neomycin continues to play an important role in certain clinical scenarios, ongoing studies are exploring:

Novel antibiotic formulations with improved safety profiles
Targeted delivery systems to enhance efficacy and reduce systemic toxicity
Combination therapies to combat resistant bacterial strains
Alternative approaches to managing conditions like hepatic encephalopathy

These advancements may eventually lead to more effective and safer alternatives to traditional antibiotics like neomycin, particularly for high-risk patient populations.

Patient Education: Empowering Individuals for Better Health Outcomes

Effective patient education is paramount when it comes to neomycin use. Healthcare providers should ensure that patients understand:

The importance of adherence to the prescribed regimen
Potential side effects and when to seek medical attention
The risks of antibiotic resistance and how to prevent it
Proper storage and handling of the medication
Any lifestyle modifications or precautions necessary during treatment

By fostering open communication and providing comprehensive information, healthcare professionals can help patients make informed decisions about their treatment and actively participate in their care.

Neomycin in the Context of Antimicrobial Stewardship

The responsible use of antibiotics like neomycin is a key component of antimicrobial stewardship programs. These initiatives aim to optimize antibiotic use while minimizing the development of resistance and reducing adverse effects. In the context of neomycin, this may involve:

Reserving its use for situations where its benefits clearly outweigh the risks
Implementing protocols for appropriate dosing and duration of therapy
Conducting regular audits of neomycin prescribing practices
Providing ongoing education for healthcare providers on best practices in antibiotic use

By integrating neomycin use into broader antimicrobial stewardship efforts, healthcare systems can help ensure that this powerful antibiotic remains effective for future generations while minimizing potential harm to patients.

Navigating Insurance Coverage and Cost Considerations for Neomycin Treatment

While neomycin is available as a generic medication, which often translates to lower costs compared to brand-name drugs, patients may still face financial considerations when prescribed this antibiotic. Several factors can influence the accessibility and affordability of neomycin treatment:

Insurance coverage and formulary status
Out-of-pocket costs, including copayments or deductibles
Availability of patient assistance programs
Potential need for additional monitoring tests or follow-up care

Healthcare providers and patients should discuss these financial aspects to ensure that cost does not become a barrier to necessary treatment. In some cases, exploring alternative medications or treatment approaches may be warranted if neomycin proves financially burdensome.

The Role of Pharmacists in Neomycin Therapy Management

Pharmacists play a crucial role in ensuring the safe and effective use of neomycin. Their expertise can contribute significantly to patient care in several ways:

Medication review to identify potential drug interactions
Patient counseling on proper administration and potential side effects
Collaboration with prescribers to optimize dosing regimens
Monitoring for adverse reactions and therapeutic effectiveness
Providing guidance on proper storage and handling of the medication

By leveraging the knowledge and skills of pharmacists, healthcare teams can enhance the overall quality of care for patients receiving neomycin therapy.

Neomycin in Special Clinical Scenarios: Beyond Standard Indications

While neomycin is primarily used for intestinal infections and hepatic encephalopathy, it may also find application in other clinical scenarios. Some less common but noteworthy uses include:

Topical preparations for skin infections (not covered in this article on oral neomycin)
Part of bowel preparation regimens before certain surgical procedures
Management of small intestinal bacterial overgrowth (SIBO) in select cases
Potential role in treating certain antibiotic-resistant infections when other options are limited

These applications underscore the versatility of neomycin, but also highlight the need for careful consideration of its use given the associated risks. Healthcare providers should weigh the potential benefits against the risks in each individual case.

Long-Term Outcomes and Follow-Up Care After Neomycin Treatment

The effects of neomycin treatment can extend beyond the immediate course of therapy. Patients who have received neomycin may require ongoing monitoring and follow-up care to address potential long-term consequences:

Regular audiological assessments to detect delayed-onset hearing loss
Kidney function monitoring, especially in patients with pre-existing renal issues
Evaluation of gastrointestinal health and microbiome balance
Neurological examinations to assess for any persistent neurotoxic effects

Healthcare providers should develop individualized follow-up plans based on each patient’s risk factors and treatment history. This proactive approach can help identify and address any delayed adverse effects promptly, improving overall patient outcomes.

Integrating Neomycin Use with Holistic Patient Care

While neomycin can be a powerful tool in treating certain infections and conditions, it’s essential to view its use within the context of holistic patient care. This comprehensive approach may involve:

Addressing underlying health conditions that may predispose patients to infections
Implementing lifestyle modifications to support overall health and immune function
Exploring complementary therapies that may enhance treatment efficacy or reduce side effects
Providing psychological support for patients dealing with chronic conditions or complex treatment regimens

By considering the whole patient and not just the infection or condition being treated with neomycin, healthcare providers can optimize outcomes and improve quality of life for their patients.

Side Effects, Dosage, Uses, and More

Highlights for neomycin

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

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.

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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.

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 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. Symptoms 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 cannot 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 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 and other drugs that are toxic to kidneys or nerves.
- 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 and succinylcholine. 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-fluorouracil, 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 cannot 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.

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:

Research in humans has shown adverse effects to the fetus when the mother takes the drug.
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.

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.

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) per day in divided doses 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)

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 cannot 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.

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 seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But 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.

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.

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.

Side Effects, Dosage, Uses, and More

Highlights for neomycin

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

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.

Was this helpful?

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.

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

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 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

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

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 and other drugs that are toxic to kidneys or nerves.
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

Drugs used to put people to sleep or to relax during surgery such as tubocurarine and succinylcholine. 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

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

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 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:

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

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

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.

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

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.

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)

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) per day in divided doses 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)

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 cannot 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.

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

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

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.

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

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.

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.

Neomycin, Polymyxin B, and Dexamethasone

Adult Medication

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Provided by Lexicomp ^® , this document contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Trade names: USA

Maxitrol

Brand names: Canada

Dioptrol; Maxitrol

What is this drug used for?

It is used to treat and prevent eye infections.

What should I tell my doctor BEFORE taking this drug?

If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested.
If you have any of the following health problems: a fungal, TB or viral eye infection.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Tell your doctor and pharmacist about all medicines you take (prescription and over-the-counter, natural products and vitamins) and any health problems you have. You need to make sure that this drug is safe for your conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s advice.

What do I need to know or do while taking this drug?

Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
Be careful while driving or doing other work that requires good vision.
Do not take this drug for longer than the period of time prescribed by your doctor.
With prolonged use, the likelihood of developing cataracts or glaucoma increases. Consult your doctor.
If you take the drug for a long time, check your eye pressure regularly. Consult your doctor.
Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. The benefits and risks for you and your child will need to be discussed.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Call your doctor right away or get medical help if you have any of the following signs or symptoms that could be associated with serious side effects:

Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
Vision changes, eye pain or severe eye irritation.

What are some other side effects of this drug?

Any medicine can have side effects. However, for many people, side effects are either minor or non-existent. Contact your doctor or seek medical attention if these or any other side effects bother you or do not go away:

Eye irritation.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Board.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

All editions:

For the eyes only.
Use exactly as directed, even if symptoms improve.
Wash your hands before and after use.
Do not touch the tip of the vial to the eyes, eyelids or other areas of the skin. This can lead to bacteria in the preparation, which can cause serious vision problems or loss of vision.
Do not wear contact lenses while taking this medicine.

Eye drops:

Shake well before use.
Tilt your head back and inject the medicine into your eye.
Keep eyes closed after use. Press on the inner corner of the eye. Do not let go 1-2 minutes. This helps keep the drug in the eye.

Eye ointment:

Tilt your head back while using.
Gently pull the lower eyelid down and instill the amount prescribed by the doctor.
Look down before you close your eyes.
Release the lower eyelid and keep your eyes closed for 1-2 minutes.

What if I miss a dose of a drug?

Take the missed dose as soon as you can.
If it’s time for your next dose, don’t take the missed dose and then go back to your regular dosing schedule.
Do not use 2 doses or an additional dose at the same time.

How do I store and/or discard this drug?

Store at room temperature.
Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

If your health does not improve or even worsens, see your doctor.
Do not give your medicine to anyone and do not take other people’s medicines.
Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
Some medicines may come with other patient information leaflets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient’s specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications. This information is not a guarantee that a treatment or drug is safe, effective, or approved for a particular patient. UpToDate, Inc. and its subsidiaries disclaim any warranties or liabilities related to this information or its use. The use of this information is subject to the Terms of Use found at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last revision date

2020-09-25

Copyright

Date last updated

Monday, December 12, 2022

Neomycin (Systemic | Memorial Sloan Kettering Cancer Center

Adult Medication

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This document provided by Lexicomp ^® contains all the information you need to know about the drug, including indications, directions for use, side effects, and when you should contact your healthcare provider.

Warning

This drug, even at standard doses, can cause kidney, nerve, and hearing problems such as permanent hearing loss. The risk may increase if you already have kidney or hearing problems and are taking high doses of this drug or using it for a long time. This risk can also be increased in the elderly, infants, and those who are dehydrated. Hearing loss may occur even after you stop taking this drug. If you already have kidney or hearing problems, talk to your doctor. You may need to have kidney and hearing function tests.
Do not use this drug if you are taking or have recently taken other drugs that may cause nerve, kidney, or hearing problems. Such drugs can be amphotericin B, bacitracin, cephaloridine, cisplatin, colistin, cyclosporine, ethacrynic acid, furosemide, paromomycin, polymyxin B, vancomycin, viomycin, or drugs of this kind. There are many other drugs that can cause these problems. If in doubt, consult your doctor or pharmacist.
Muscle problems (muscle weakness) and severe breathing problems have been associated with similar drugs. Patients who already have problems with the nervous system or muscles, such as myasthenia gravis, are at increased risk. The risk is also higher in patients who are taking other drugs, such as sleeping pills or muscle relaxers. If you have any questions, please consult your doctor.

What is this drug used for?

It is used to prevent infections during bowel surgery.
This drug is used to relieve the symptoms of hepatic coma.
This drug may also be used for other indications. Consult your doctor.

What should I tell my doctor BEFORE taking this drug?

If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested.
If you have any of the following health conditions: bowel obstruction, inflammation or ulcers in the gastrointestinal tract (gastrointestinal tract).

This list of drugs and conditions that may interact with this drug is not exhaustive.

What do I need to know or do while taking this drug?

Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
Do not use beyond the prescribed time. A secondary infection may occur.
If the patient is a child, use this drug with caution. Children may have a higher risk of some side effects.
If you are 65 years of age or older, use this drug with caution. You may experience more side effects.
When used during pregnancy, the drug may have a harmful effect on the fetus. If you are pregnant or become pregnant while taking this drug, call your doctor right away.
Tell your doctor if you are breastfeeding. It is necessary to consult whether the drug poses any risk to the child.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Contact your doctor or seek medical attention right away if you have any of the following signs or symptoms that may be associated with serious side effects:

Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
Signs of kidney problems, including not passing urine, changes in the volume of urine, blood in the urine, or rapid weight gain.
Dizziness or fainting.
Ringing in the ears, hearing loss, or any other hearing changes.
Muscle weakness.
With the appearance or aggravation of difficulty breathing.
Unusual sensations of burning, numbness, or tingling.
Twitch.
Balance change.
Seizures.

What are some other side effects of this drug?

Diarrhea, indigestion or vomiting.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Board.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

Drink plenty of non-caffeinated fluids, unless your doctor tells you to drink less fluids.
Keep taking this drug as instructed by your doctor or other health care professional, even if you feel well.

What if I miss a dose of a drug?

Take the missed dose as soon as you can.
If it’s time for your next dose, don’t take the missed dose and then go back to your regular dosing schedule.
Do not take 2 doses or an additional dose at the same time.

How do I store and/or discard this drug?

Store at room temperature in a dry place. Do not store in the bathroom.
Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

If your health does not improve or even worsens, see your doctor.
Do not give your medicine to anyone and do not take other people’s medicines.
Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
Some medicines may come with other patient information leaflets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.