Neomycin

(nee oh mye' sin)

PCIContraindicated in pregnancy

LCaution when used during lactationCaution when used during lactation

Molecule Info

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Indication(s) & Dosage

Preoperative intestinal antisepsis
Adult: 1 g every hr for 4 doses then every 4 hr for 2-3 days; or 1 g at 1 PM, 2 PM and 11 PM on the day before surgery as an adjunct to mechanical cleansing of the intestine and in combination with oral erythromycin; or 6 g/day divided every 4 hr for 2-3 days.
Child: 90 mg/kg/day divided every 4 hr for 2 days; or 25 mg/kg at 1 PM, 2 PM and 11 PM on the day before surgery as an adjunct to mechanical cleansing of the intestine and in combination with erythromycin base.
Renal impairment: Dose modification required.

Adjunct in hepatic encephalopathy
Adult: 4-12 g daily in divided doses for 5-7 days.
Child: 50-100 mg/kg/day in divided doses every 6-8 hr or 2.5-7 g/m2/day divided every 4-6 hr for 5-6 days. Max: 12 g/day.
Renal impairment: Dose modification required.

Chronic hepatic insufficiency
Adult: 4 g/day for an indefinite period.
Renal impairment: Dose modification required.

Otic/Aural
Otic infections
Adult: Per ml solution contains neomycin sulfate 3.5 mg, polymyxin B sulfate 10,000 units and hydrocortisone acetate 10 mg: Instill 4 drops into the affected ear(s) 3 or 4 times daily. Treatment duration should be limited to 10 consecutive days. 
Ophthalmic
Susceptible ophthalmic infections
Adult: Per ml solution contains neomycin sulfate 3.5 mg, polymyxin B sulfate 10,000 units and dexamethasone 1 mg: Instill 1-2 drops into the affected eye(s) 4-6 times daily, up to hrly admin in severe cases. 
Topical/Cutaneous
Skin infections
Adult: Per g cream contains neomycin sulfate 3.5 mg, polymyxin B sulfate 10,000 units and hydrocortisone acetate 5 mg: Apply onto affected area 2-4 times daily as needed. May gently rub cream into affected areas if conditions permit. 
Child: In combination with anti-infectives: Apply ointment or cream to affected area 1-3 times/day. In combination with corticosteroids and other anti-infectives: Apply ointment or cream to affected area 2-4 times/day. As irrigation: Topical solutions of 0.1-1% have been used.

Administration May be taken with or without food.
Overdosage Rare due to poor oral absorption. Symptoms: Ototoxicity, nephrotoxicity, neuromuscular toxicity. Treatment: Single acute overdose: Maintain urine output of at least 3 ml/kg/hr during the acute treatment phase. Haemodialysis is preferred over peritoneal dialysis in patients with normal renal function. Chelation with penicillin may be useful.
Contraindications Do not use for intestinal disinfection if there is intestinal obstruction. Hypersensitivity to aminoglycosides. Infants <1 yr. Inflammatory or ulcerative GI disease (oral). Pregnancy. Not to be used topically or for urological purposes in doses >1 g daily or urologically for >10 days. Extensive skin damage or perforation of the eardrum (otic application). Do not admin parenterally or as peritoneal lavage.
Special Precautions Kidney or liver disease; neuromuscular disorders (e.g. myasthenia gravis, parkinsonism); impaired hearing (pre-existing vertigo, tinnitus, hearing loss). Monitor auditory and renal function in patients with additional risk factors. Monitor patients on high doses or prolonged courses. Elderly, dehydrated patients. Avoid prolonged use. Lactation.
Adverse Drug Reaction(s) Oral: Nausea, diarrhoea, vomiting, irritation or soreness of the mouth or rectal area; dyspnoea, eosinophilia, nephrotoxicity, neurotoxicity, ototoxicity (auditory and vestibular). Topical: Contact dermatitis.
Potentially Fatal: Neuromuscular blockade and respiratory paralysis.
Drug Interactions Synergistic effects with penicillins. Additive toxicity with neurotoxic, ototoxic or nephrotoxic drugs. May decrease absorption of digoxin and methotrexate. May increase effects of oral anticoagulants. Please consult detailed drug interactions before prescribing. 
Pregnancy Category (FDA)
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.
Storage Ophthalmic: Store at 15-30°C (59-86°F). Oral: Store at 20-25°C (68-77°F). Otic/Aural: Store at 15-30°C (59-86°F). Topical/Cutaneous: Store at 15-30°C (59-86°F).
Pharmacology Neomycin is an aminoglycoside antibiotic. It binds to 30S ribosomal subunits of bacterial ribosome thus inhibiting protein synthesis and generating errors in genetic code transcription causing cell death. It acts against many gram-negative aerobes and some gram-positive aerobes. It lacks activity against fungi, viruses and most anaerobic bacteria.
Absorption: Poorly absorbed from the GI tract; increased in the presence of damaged or inflamed mucosa. Absorption may occur from the peritoneum, respiratory tract, bladder, wounds, and inflamed skin.
Distribution: Low levels in intestinal wall and muscles.
Excretion: Via faeces (about 97% of an oral dose unchanged); via urine (active form). Half-life: 2-3 hr; 12-24 hr in adults with severe renal impairment.
ATC Classification D06AX04 - neomycin; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases. 
B05CA09 - neomycin; Belongs to the class of antiinfectives used as irrigating solutions. 
J01GB05 - neomycin; Belongs to the class of other aminoglycosides. Used in the treatment of systemic infections. 
S02AA07 - neomycin; Belongs to the class of antiinfectives used in the treatment of ear infections. 
A07AA01 - neomycin; Belongs to the class of antibiotics. Used for the treatment of intestinal infections. 
R02AB01 - neomycin; Belongs to the class of antibiotics used in throat preparations. 
S03AA01 - neomycin; Belongs to the class of antiinfectives used in ophthalmologic and otologic preparations. 
A01AB08 - neomycin; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth. 
S01AA03 - neomycin; Belongs to the class of antibiotics. Used in the treatment of eye infections.

Brand/Product Info


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Gen. MedInfo

Neomycin Topical

Why is Neomycin prescribed?

Neomycin, an antibiotic, is used to prevent or treat skin infections caused by bacteria. It is not effective against fungal or viral infections.

Neomycin is sometimes prescribed for other uses; ask your doctor for more information.

How should Neomycin be used?

Neomycin comes in cream and ointment that is applied to the skin. Neomycin usually is used one to three times a day. Follow the directions on your prescription label carefully, and ask your doctor to explain any part you do not understand. Use neomycin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Thoroughly clean the infected area, allow it to dry, and then gently rub the medication in until most of it disappears. Use just enough medication to cover the affected area. You should wash your hands after applying the medication.

Do not apply neomycin to a child's diaper area, especially if the skin is raw, unless directed to do so by a doctor. If you are directed to apply neomycin to a child's diaper area, do not use tightly fitting diapers or plastic pants. They can increase the absorption of the drug, which can cause harmful effects.

Apply only small amounts of neomycin to scrapes, cuts, burns, sores, and wounds, and do not apply it more frequently than directed. Neomycin can be absorbed into the body through broken skin and cause kidney problems and hearing difficulty.

What special precautions to follow?

Before using neomycin,

  • inform your doctor if you are allergic to neomycin or any other drugs.
  • inform your doctor what prescription and nonprescription medications you are taking, including vitamins.
  • inform your doctor if you have or have ever had kidney disease.
  • inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using neomycin, call your doctor.

What to do if I forget a dose?

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one.

What side effects can Neomycin cause?

Neomycin may cause side effects. If you experience any of the following symptoms, call your doctor immediately:

  • irritation

  • burning

  • redness

  • rash

  • itching

  • hearing difficulty

  • decreased urination

In case of overdose, consult your doctor. If the victim has collapsed or is not breathing, consult local medical emergency services.

What other information to know?

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

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:  U.S. National 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.