Gentamicin

(jen ta mye' sin)

PCI  : Contraindicated in pregnancy

LCaution when used during lactation : Caution when used during lactation

Molecule Info

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Indication(s) & Dosage

Intramuscular route
Susceptible infections
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Biliary tract infections
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Brucellosis
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Cat scratch disease
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Cystic fibrosis
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Endocarditis
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Endometritis
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Gastroenteritis
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Granuloma inguinale
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Listeriosis
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Meningitis
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 


Otitis externa
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 


Intramuscular
Pelvic inflammatory disease
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 


Intramuscular
Peritonitis
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Intramuscular
Plague
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 


Pneumonia
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Septicaemia
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Skin infections
Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Urinary tract infections

Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days.
Child: â‰¤2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr. 

Prophylaxis of surgical infections
Adult: 120 mg before induction of anaesthesia, in combination with penicillin, vancomycin or teicoplanin .

Ophthalmic

Superficial ophthalmic infections
Adult: Instil 1-2 drops of a 0.3% soln into the infected eye/s every 4 hr or up to 2 drops every hr in severe infections. Alternatively, apply a small amount of 0.3% oint bid-tid into the affected eye. 

Topical/Cutaneous
Bacterial skin infections
Adult: As a 0.1% cream; Apply to the affected area 3-4 times daily.

Special Populations: Renal impairment: Increase the interval between doses keeping serum creatinine levels as a guide. In patients on dialysis an 8 hr dialysis reduces serum levels of gentamicin by 50%. At the end of each session give 1-1.7 mg/kg for adults and 2 mg/kg for children. For IV use, each dose of gentamicin diluted with 50-100 mL of IV fluids given over 20 min. Duration 7-10 days.

Renal impairment: Haemodialysis: Administer dose after dialysis session and monitor levels.

CrCl (ml/min)

Dosage Recommendation

≥60

Administer every 8 hr.

40-60

Administer every 12 hr.

20-40

Administer every 24 hr.

<20

Loading dose, monitor levels.

Overdosage

Haemodialysis may be useful in the removal of gentamicin from the blood, and is important if renal function is, or becomes compromised. Rate of removal is lower by peritoneal dialysis compared to haemodialysis.

Contraindications

History of hypersensitivity to aminoglycoside; pregnancy; hepatic impairment, perforated ear drum.

Special Precautions

Concurrent use of neuromuscular blocking agents; myasthenia gravis, parkinsonism; conditions predisposing to ototoxicity and nephrotoxicity; lactation. Monitor plasma concentrations of gentamicin in patients receiving high doses or prolonged courses, in infants, elderly, patients with renal impairment, cystic fibrosis or significant obesity. Monitor auditory and renal functions.

Adverse Drug Reaction(s)

Dizziness or vertigo; acute renal failure, interstitial nephritis, acute tubular necrosis; electrolyte imbalances; transient elevation of serum bilirubin and aminotransferases; purpura; nausea, vomiting; convulsions, mental depression, hallucinations. Atrophy or rat necrosis at inj sites.
Potentially Fatal: Nephrotoxicity, ototoxicity and neuromuscular blockade (may unmask or aggravate myasthaenia gravis).

Drug Interactions

Synergistic with ampicillin, benzylpenicillin and other β-lactam antibiotics. Increased risk of severe respiratory depression when used concurrently with anaesthetics or opioids. May reduce renal clearance of zalcitabine and induce hypocalcaemia when used with biphosphonates. Not to be used with agalsidase alfa or beta as it may inhibit α-galactosidase activity.
Potentially Fatal: Increased incidence of ototoxicity when combined with ethacrynic acid and furosemide. Cephalosporins, ciclosporin, cisplatin, vancomycin, hydrocortisone and indometacin potentiate nephrotoxicity. Potentiates neuromuscular blocking agents.

Pregnancy Category (FDA)

ROUTE(S) : OPHTH / OTIC / TOPICAL

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

ROUTE(S) : PARENT.

Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Storage

Intramuscular: Store at 15-30°C. Ophthalmic: Store at 2-30°C.Topical/Cutaneous: Store at 2-30°C.

Pharmacology

Gentamicin is an aminoglycoside that binds to 30s and 50s ribosomal subunits of susceptible bacteria disrupting protein synthesis, thus rendering the bacterial cell membrane defective.
Absorption: Poorly absorbed from the GI tract (oral); rapid (IM); systemic absorption from denuded skin and burns (topical) and from wounds, body cavities, joints (instillation, irrigation).
Distribution: Diffuse mainly into the extracellular fluids; but only small amounts enter the CSF even when the meninges are inflamed. Poorly diffused (Ophthalmic), readily diffused (perilymph of the inner ear). Crosses the placenta and enters the breast milk. Accumulates mainly in the kidneys.
Excretion: Via the urine by glomerular filtration (virtually unchanged); 2-3 hr (elimination half-life).

ATC Classification

S01AA11 - gentamicin; Belongs to the class of antibiotics. Used in the treatment of eye infections. 
D06AX07 - gentamicin; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases. 
S02AA14 - gentamicin; Belongs to the class of antiinfectives used in the treatment of ear infections. 
J01GB03 - gentamicin; Belongs to the class of other aminoglycosides. Used in the treatment of systemic infections. 
S03AA06 - gentamicin; Belongs to the class of antiinfectives used in ophthalmologic and otologic preparations.

 Gentamicin Injection/Ophthalmic

Search Google: Gentamicin

Brand/Product Info


Total Products : 24                        
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
EGEN Edruc Limited Gentamicin 80mg/2ml Injection 5 amps: 47.50 MRP
G-GENTAMICIN Drop Gonoshasthaya Pharmaceuticals Ltd Gentamicin 0.3% eye/ear drop Eye/Ear Drop 10ml: 25.10 MRP
G-GENTAMICIN Inj Gonoshasthaya Pharmaceuticals Ltd Gentamicin 40mg/2ml, 80mg/2ml Injection 40mg x25's & 80mg x10's: 150.50 & 90.30 MRP
G-GENTAMICIN Ointment Gonoshasthaya Pharmaceuticals Ltd Gentamicin 0.3% Ointment Ointment 25gm: 19.72 MRP
GENACYN 20 Square Pharmaceuticals Ltd. Gentamicin 20mg/2 ml IM/IV Injection 2x5's: 61.10 MRP
GENACYN 80 Square Pharmaceuticals Ltd. Gentamicin 80mg/2 ml IM/IV Injection 2x5's: 101.80 MRP
GENACYN DROP Square Pharmaceuticals Ltd. Gentamicin 0.3% Eye/Ear Drops 10 ml: 32.12 MRP
GENACYN OINT Square Pharmaceuticals Ltd. Gentamicin 0.1% Ointment 10 gm: 12.09 MRP
GENTA Drop Renata Limited Gentamicin 0.3% eye/ear drop Eye/Ear Drop 10ml: 31.93 MRP
GENTACIN The Acme Laboratories Ltd. Gentamicin 0.3% ointment Eye Ointment 3.5gm: 9.75 MRP
GENTASOL Techno Drugs Gentamicin 80mg/2ml Injection 10 amps: 95.00 MRP
GENTIN Opso Saline Ltd. Gentamicin 0.3% eye/ear drop Eye/Ear drop 10ml: 31.37 MRP
GENTIN Cream Opsonin Pharma Limited Gentamicin 0.3% cream Cream 10gm: 11.00 MRP
GENTIN Drop Opso Saline Ltd. Gentamicin 0.3% eye/ear drop Eye Drop 10ml: 31.37 MRP
GENTIN Injection Opsonin Pharma Limited Gentamicin 20mg/2ml,80mg/2ml Injection 25 amps each: 150.00 & 250.00 MRP
GENTIN Ointment Opso Saline Ltd. Gentamicin 0.3% ointment Eye Ointment 3gm: 9.03 MRP
GENTO Drop Gaco Pharmaceutical Ltd. Gentamicin 0.3% eye/ear drop Eye/Ear Drop 10ml: 31.50 MRP
GENTO Eye Oint Gaco Pharmaceutical Ltd. Gentamicin 0.3% ointment Eye Ointment 5gm: 10.10 MRP
GENTO Ointment Gaco Pharmaceutical Ltd. Gentamicin 0.3% Ointment Ointment 5gm: 9.10 MRP
IGEN ACI Ltd. Gentamicin 0.3% eye/ear drop Eye/Ear Drop 10ml: 32.02 MRP
INTAMYCIN Incepta Pharmaceuticals Limited Gentamicin USP 80mg/2ml as Gentamicin Sulfate Injection 10's: 100 MRP
MONAMYCIN Amico Laboratories Ltd. Gentamicin 0.3% cream Cream 15gm: 16.75 MRP
OPTIMYCIN Aristopharma Ltd. Gentamicin 80mg/2ml Injection 10 amps: 100.00 MRP
RECIN Drop Reman Drug Laboratories Ltd. Gentamicin 0.3% eye/ear drop Eye/Ear Drop 10ml: 35.00 MRP

Gen. MedInfo

IMPORTANT WARNING:

Gentamicin can cause severe hearing and kidney problems. Before administering gentamicin, tell your doctor what prescription and nonprescription medications you are taking, especially diuretics ('water pills'), cisplatin (Platinol), amphotericin (Amphotec, Fungizone), other antibiotics, and vitamins.

If you experience any of the following symptoms, call your health care provider immediately: dizziness, vertigo, ringing in the ears, hearing loss, numbness, muscle twitching or weakness, difficulty breathing, decreased urination, rash, itching, or sore throat.

 

About Gentamicin Injection/Ophthalmic

Your doctor has ordered gentamicin, an antibiotic, to help treat your infection. The drug will be either injected into a large muscle (such as your buttock or hip) or added to an intravenous fluid that will drip through a needle or catheter placed in your vein for at least 30 minutes, one to three times a day.

Gentamicin eliminates bacteria that cause many kinds of infections, including lung, skin, bone, joint, stomach, blood, and urinary tract infections. This medication is sometimes prescribed for other uses; ask your doctor for more information.

Ophthalmic gentamicin is used to treat certain eye infections. Gentamicin is in a class of medications called antibiotics. It works by killing the bacteria that cause infection.

Your health care provider may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.

Gentamicin Ophthalmic:

Ophthalmic gentamicin comes as a solution (liquid) to instill in the eyes and as an eye ointment to apply to the eyes. The eye drops are usually instilled every 4 to 8 hours and the eye ointment is usually applied two to four times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part that you do not understand. Use gentamicin eye drops or eye ointment exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

To instill the eye drops, follow these steps:

  1. Wash your hands thoroughly with soap and water.

  2. Check the dropper tip to make sure that it is not chipped or cracked.

  3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.

  4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.

  5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.

  6. Brace the remaining fingers of that hand against your face.

  7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.

  8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.

  9. Place a finger on the tear duct and apply gentle pressure.

  10. Wipe any excess liquid from your face with a tissue.

  11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.

  12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.

  13. Wash your hands to remove any medication.

To apply the eye ointment, follow these steps:

  1. Wash your hands thoroughly with soap and water.

  2. Use a mirror or have someone else apply the ointment.

  3. Avoid touching the tip of the tube against your eye or anything else. The ointment must be kept clean.

  4. Tilt your head forward slightly.

  5. Holding the tube between your thumb and index finger, place the tube as near as possible to your eyelid without touching it.

  6. Brace the remaining fingers of that hand against your cheek or nose.

  7. With the index finger of your other hand, pull the lower lid of your eye down to form a pocket.

  8. Place a small amount of ointment into the pocket made by the lower lid and the eye. A 1/2-inch (1.25-centimeter) strip of ointment usually is enough unless otherwise directed by your doctor.

  9. Gently close your eyes and keep them closed for 1 to 2 minutes to allow the medication to be absorbed.

  10. Replace and tighten the cap right away.

  11. Wipe off any excess ointment from your eyelids and lashes with a clean tissue. Wash your hands again.

Precautions

Before administering gentamicin,
  • tell your doctor if you are allergic to amikacin, gentamicin, kanamycin, neomycin, netilmicin, streptomycin, tobramycin or any other drugs.
  • tell your doctor what prescription and nonprescription medications you are taking, especially diuretics ('water pills'), cisplatin, amphotericin, other antibiotics, and vitamins.
  • tell your doctor if you have or have ever had kidney disease, vertigo, hearing loss, ringing in the ears, myasthenia gravis, or Parkinson's disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking gentamicin, call your doctor immediately. Gentamicin can harm the fetus.

Administering your medication

Before you administer gentamicin, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.

It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason because your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

Side effects

Gentamicin occasionally causes side effects. To reduce this risk, your health care provider may adjust your dose based on your blood test results. Follow the directions in the IMPORTANT WARNING section for the symptoms listed there and tell your health care provider if any of the following symptoms are severe or do not go away:

  • upset stomach
  • vomiting
  • fatigue
  • pale skin

Storing your medication

Your health care provider probably will give you a several-day supply of gentamicin at a time. If you are receiving gentamicin intravenously (in your vein), you probably will be told to store it in the refrigerator or freezer.

Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature. 

If you are told to store additional gentamicin in the freezer, always move a 24-hour supply to the refrigerator for the next day's use.

Do not refreeze medications.

If you are receiving gentamicin intramuscularly (in your muscle), your health care provider will tell you how to store it properly.

Store your medication only as directed. Make sure you understand what you need to store your medication properly.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury

This medication may cause other side effects.  Consult your doctor if you have any unusual problems while taking this.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to this medicine.

Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

 Ref: MedlinePlus, U.S. Natl. Library of Medicine 


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.