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amikacin

Pronunciation

Generic Name: amikacin (am E kay sin)
Brand Name: Amikin, Amikin Pediatric

What is amikacin?

Amikacin is an antibiotic. It fights bacteria in the body.

Amikacin is used to treat severe or serious bacterial infections.

Amikacin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about amikacin?

If you are injecting amikacin at home, your healthcare provider will give you detailed instructions on how and where to inject the medication. If you do not understand these directions, do not attempt to inject the medication. Contact your healthcare provider for further instructions.

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Amikacin may cause damage to the kidneys and/or nerves. Kidney function and drug levels in the blood may be monitored with blood tests during treatment. Tell your doctor if you experience hearing loss, dizziness, numbness, skin tingling, muscle twitching, or seizures which may be signs of nerve damage.

What should I discuss with my healthcare provider before using amikacin?

Do not use amikacin without first talking to your doctor if you have

  • sulfite sensitivity;

  • kidney disease;

  • hearing loss or loss of balance due to ear problems;

  • Parkinson's disease; or

  • a neuromuscular disorder such as myasthenia gravis.

You may not be able to use amikacin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Do not use amikacin without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Do not use amikacin without first talking to your doctor if you are breast-feeding a baby.

How should I take amikacin?

If you are injecting amikacin at home, your healthcare provider will give you detailed instructions on how and where to inject the medication. If you do not understand these directions, do not attempt to inject the medication. Contact your healthcare provider for further instructions.

Do not use any amikacin that is discolored, has particles in it, or looks different from your previous doses. Throw away any unused amikacin after the amount of time determined by your pharmacist or doctor.

Adequate hydration is important during treatment with amikacin. Fluids may be administered intravenously during treatment.

It is important that the medication be given on a regular schedule and for the entire amount of time prescribed by your doctor.

Amikacin may cause damage to the kidneys and/or nerves. Kidney function and drug levels in the blood may be monitored with blood tests during treatment. Tell your doctor if you experience hearing loss, dizziness, numbness, skin tingling, muscle twitching, or seizures which may be signs of nerve damage.

Dispose of used needles and syringes in a puncture resistant container out of the reach of children.

Your healthcare provider will store amikacin as directed by the manufacturer or give you detailed storage instructions if you are storing the medication at home.

What happens if I miss a dose?

Contact your doctor if a dose is missed.

What happens if I overdose?

Contact your doctor or seek emergency medical attention if an overdose is suspected. An overdose of the medication may result in damage to the kidneys or hearing loss, dizziness, numbness, skin tingling, muscle twitching, or seizures (which may be signs of nerve damage).

What should I avoid while taking amikacin?

There are no restrictions on food, beverages, or activity while taking amikacin unless otherwise directed by your doctor.

Amikacin side effects

If you experience any of the following serious side effects, stop taking amikacin and seek emergency medical attention:

  • an allergic reaction (shortness of breath; closing of the throat; hives; swelling of the lips, face, or tongue; rash; or fainting);

  • little or no urine;

  • decreased hearing or ringing in the ears;

  • dizziness, clumsiness, or unsteadiness;

  • numbness, skin tingling, muscle twitching, or seizures; or

  • severe watery diarrhea and abdominal cramps.

Other, less serious side effects may be more likely to occur. Continue to take amikacin and talk to your doctor if you experience

  • increased thirst;

  • loss of appetite;

  • nausea or vomiting;

  • a rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Amikacin dosing information

Usual Adult Dose for Bacteremia:

15 to 22.5 mg/kg/day IV or IM in 1 to 3 divided doses, depending on severity of infection (initial maximum of 1.5 g/day, then adjust dose based on desired serum levels)

Usual Adult Dose for Intraabdominal Infection:

15 to 22.5 mg/kg/day IV or IM in 1 to 3 divided doses, depending on severity of infection (initial maximum of 1.5 g/day, then adjust dose based on desired serum levels)

Usual Adult Dose for Joint Infection:

15 to 22.5 mg/kg/day IV or IM in 1 to 3 divided doses, depending on severity of infection (initial maximum of 1.5 g/day, then adjust dose based on desired serum levels)

Usual Adult Dose for Osteomyelitis:

15 to 22.5 mg/kg/day IV or IM in 1 to 3 divided doses, depending on severity of infection (initial maximum of 1.5 g/day, then adjust dose based on desired serum levels)

Usual Adult Dose for Pneumonia:

15 to 22.5 mg/kg/day IV or IM in 1 to 3 divided doses, depending on severity of infection (initial maximum of 1.5 g/day, then adjust dose based on desired serum levels)

Usual Adult Dose for Skin or Soft Tissue Infection:

15 to 22.5 mg/kg/day IV or IM in 1 to 3 divided doses, depending on severity of infection (initial maximum of 1.5 g/day, then adjust dose based on desired serum levels)

Usual Adult Dose for Cystic Fibrosis:

Higher doses may be required for the treatment of Pseudomonas aeruginosa pulmonary infections in cystic fibrosis patients. Dosing should be individualized and based on serum concentrations. Doses of up to 35 mg/kg/day once daily by IV infusion or in divided doses every 6 to 8 hours have been reported.

Usual Adult Dose for Febrile Neutropenia:

Higher doses may be required. Dosing should be individualized and based on serum concentrations. Doses of up to 15 to 30 mg/kg/day IV in 1 to 3 divided doses have been reported in conjunction with a beta-lactam antibiotic (initial maximum of 1.5 g/day, then adjust dose based on desired serum levels).

Usual Adult Dose for Meningitis:

IV or IM: 15 to 22.5 mg/kg/day in 1 to 3 divided doses, depending on severity of infection (initial maximum of 1.5 g/day, then adjust dose based on desired serum levels)
Intrathecal: 0.1 mg per mL of CSF or approximately 2 mg/kg body weight per day has been used to treat gram-negative bacillary meningitis in conjunction with parenteral antibiotics

Usual Adult Dose for Nosocomial Pneumonia:

20 mg/kg /day IV in 1 to 3 divided doses

Initial empiric treatment with broad-spectrum coverage according to the hospital's and/or ICU's antibiogram is recommended if multidrug-resistant organisms are suspected.

Duration: If the causative organism is not Pseudomonas aeruginosa, the duration of treatment should be as short as clinically possible (e.g., as little as 7 days) to reduce the risk of superinfections with resistant organisms.

Usual Adult Dose for Peritonitis:

Peritoneal dialysis-related peritonitis:
CAPD intermittent dosing: 2 mg/kg in 1 exchange/day (based on ideal body weight) intraperitoneally for anuric patients and 2.5 mg/kg/bag for nonanuric patients (investigational)
CAPD continuous dosing: 24 mg/L exchange intraperitoneally for anuric patients and 30 mg/L for nonanuric patients

Maximum dose: 1.5 g/day by all routes

Usual Adult Dose for Tuberculosis -- Active:

15 mg/kg (maximum 1 g) IM or IV every 24 hours

May be given in combination with at least 3 other active drugs for treatment of multi-drug resistant TB, or when the patient is intolerant of first-line agents. AFB smear and culture should be monitored monthly.

Duration: Treatment for TB should generally continue for 18 to 24 months, or for 12 to 18 months after culture results are negative.

Usual Adult Dose for Urinary Tract Infection:

Uncomplicated: 250 mg IV or IM every 12 hours
Amikacin is not recommended for mild to moderate infections.

Usual Pediatric Dose for Febrile Neutropenia:

1 to 18 years: Higher doses may be required. Dosing should be individualized and based on serum concentrations. Doses ranging from 15 to 30 mg/kg/day in 1 to 3 divided doses have been reported in conjunction with a beta-lactam antibiotic.

Usual Pediatric Dose for Cystic Fibrosis:

1 to 18 years: Higher doses and/or more frequent intervals may be required. Dosing should be individualized and based on serum concentrations. Doses of up to 35 mg/kg/day IV in 1 to 3 divided doses have been reported.

Usual Pediatric Dose for Peritonitis:

Peritoneal dialysis-related peritonitis:
17 years or less:
Initial dose: 25 mg/L dialysate intraperitoneally
Maintenance dose: 12 mg/L dialysate

Maximum dose: 1.5 g/day by all routes

Usual Pediatric Dose for Tuberculosis -- Active:

15 to 30 mg/kg (maximum 1 g) IM or IV every 24 hours

May be given in combination with at least 3 other active drugs for treatment of multi-drug resistant TB, or when the patient is intolerant of first-line agents. AFB smear and culture should be monitored monthly.

Duration: Treatment for TB should generally continue for 18 to 24 months, or for 12 to 18 months after culture results are negative.

What other drugs will affect amikacin?

Other drugs, especially those that affect the kidneys, can interact with amikacin resulting in dangerous side effects and/or decreased effectiveness. Do not take any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, without first talking to your doctor during treatment with amikacin.

Where can I get more information?

  • Your pharmacist has additional information about amikacin written for health professionals that you may read.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.03. Revision Date: 2010-12-15, 5:01:39 PM.

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