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gentamicin

Pronunciation

Generic Name: gentamicin (GEN ta MYE sin)
Brand Name: Garamycin, Cidomycin, Septopal

What is gentamicin?

Gentamicin is an antibiotic that fights bacteria.

Gentamicin is used to treat severe or serious bacterial infections.

Gentamicin may also be used for purposes not listed in this medication guide.

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

Gentamicin can harm your kidneys, and may also cause nerve damage or hearing loss, especially if you have kidney disease or use certain other medicines.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Tell your doctor about all your medical conditions and all the medicines you are using. If you need surgery, tell the surgeon ahead of time that you are using gentamicin.

What should I discuss with my healthcare provider before taking gentamicin?

You should not use this medicine if you are allergic to gentamicin or similar antibiotics such as amikacin, kanamycin, neomycin, paromomycin, streptomycin, or tobramycin.

To make sure gentamicin is safe for you, tell your doctor if you have:

  • kidney disease;

  • asthma or sulfite allergy;

  • myasthenia gravis;

  • a nerve-muscle disorder;

  • a nervous system disorder such as Parkinson's disease;

  • an electrolyte imbalance (low levels of calcium, potassium, or magnesium in your blood); or

  • if you are dehydrated.

Do not use gentamicin if you are pregnant. It could harm the unborn baby. Use effective birth control to prevent pregnancy during treatment.

It is not known whether gentamicin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take gentamicin?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended. Gentamicin is usually given for 7 to 10 days.

Gentamicin is injected into a muscle, or into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Do not use gentamicin if it has changed colors or has particles in it. Call your pharmacist for new medication.

Do not mix gentamicin with other medicines in a syringe or IV bag.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Gentamicin will not treat a viral infection such as the flu or a common cold.

Drink plenty of liquids while you are taking gentamicin. This will help keep your kidneys working properly.

While using gentamicin, you may need frequent blood or urine tests. Your hearing, kidney function, and nerve function may also need to be checked.

If you need surgery, tell the surgeon ahead of time that you are using gentamicin.

Store this medicine at room temperature away from moisture and heat.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of gentamicin.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking gentamicin?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Gentamicin side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • hearing loss, or a roaring sound in your ears;

  • severe or ongoing dizziness;

  • weak or shallow breathing;

  • numbness or tingly feeling;

  • twitching, muscle tightness or contraction;

  • seizure (convulsions);

  • severe stomach pain, diarrhea that is watery or bloody;

  • fever, blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;

  • kidney problems--little or no urinating; painful or difficult urination; swelling in your feet or ankles; feeling tired or short of breath;

  • signs of an electrolyte imbalance--confusion, weakness, bone pain, increased urination; or

  • increased pressure inside the skull--severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes.

Side effects may be more likely in older adults.

Common side effects may include:

  • vision problems;

  • nausea, vomiting, loss of appetite, weight loss;

  • a light-headed feeling, like you might pass out;

  • itching or rash;

  • pain where the medicine was injected;

  • headache, mood changes; or

  • joint pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Gentamicin dosing information

Usual Adult Dose for Bacteremia:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: 14 days, depending on the site, nature, and severity of the bacteremia

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Bacterial Endocarditis Prophylaxis:

1.5 mg/kg (maximum 120 mg) IV or IM once within 30 minutes of starting the procedure

Comments: For high risk patients, in addition to gentamicin, ampicillin 2 g is given IV or IM 30 minutes prior to the procedure, followed by ampicillin 1 g IV/IM or amoxicillin 1 g orally 6 hours later. In penicillin-allergic patients, vancomycin 1 g is infused IV 1 to 2 hours prior to the procedure.

Usual Adult Dose for Bacterial Infection:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours, or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: 7 to 21 days, depending on the nature and severity of the infection

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Brucellosis:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: For the first 2 to 3 weeks of antibiotic therapy

Comments: Oral doxycycline or sulfamethoxazole/trimethoprim should be continued for at least 6 weeks.

Usual Adult Dose for Burns - External:

2 to 2.5 mg/kg loading dose, followed by 1.7 to 2 mg/kg IV every 8 hours
Duration of therapy: 10 to 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Cystic Fibrosis:

5 to 10 mg/kg/day in 2 to 4 divided doses
Duration of therapy: Parenteral therapy should be continued for about 14 to 21 days, depending on the nature and severity of the infection and improvement of pulmonary function.

Usual Adult Dose for Endocarditis:

American Heart Association (AHA) recommendations:
Native valve infections due to highly penicillin-susceptible viridans Group streptococci and S bovis (MIC <=0.12 mcg/mL): 3 mg/kg IV or IM once every 24 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 4 weeks

Native valve infections due to relatively penicillin-resistant S viridans and S bovis (MIC >0.12 mcg/mL and <=0.5 mcg/mL): 3 mg/kg IV or IM once every 24 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 4 weeks

Prosthetic valve infections due to S viridans and S bovis: 3 mg/kg IV or IM once every 24 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 6 weeks

Native valve infections due to staphylococci: 1.5 mg/kg IV or IM every 12 hours or 1 mg/kg every 8 hours, in combination with nafcillin, oxacillin, or cefazolin
Duration of therapy: 3 to 5 days; continue other antibiotic for 6 weeks

Prosthetic valve infections due to staphylococci: 1.5 mg/kg IV or IM every 12 hours or 1 mg/kg every 8 hours, in combination with nafcillin or oxacillin, plus rifampin, or vancomycin plus rifampin
Duration of therapy: 2 weeks; continue other antibiotics for at least 6 weeks

Native valve or prosthetic valve infections due to susceptible enterococci: 1 mg/kg IV or IM every 8 hours, in combination with ampicillin, aqueous penicillin G sodium, or vancomycin
Duration of therapy: 4 to 6 weeks; continue other antibiotic for 6 weeks

Native valve or prosthetic valve infections due to penicillin-resistant enterococci: 1 mg/kg IV or IM every 8 hours, in combination with ampicillin-sulbactam or vancomycin
Duration of therapy: 6 weeks

Comments: Refer to current published guidelines for detailed recommendations.

Usual Adult Dose for Endometritis:

2 mg/kg loading dose, followed by 1.5 mg/kg IV or IM every 8 hours
Duration of therapy: Parenteral therapy should be continued for at least 24 hours after the patient has remained afebrile, pain free, and the leukocyte count has normalized.

Usual Adult Dose for Febrile Neutropenia:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours
Duration of therapy: Once the patient is stable, afebrile for 24 hours, and the absolute neutrophil count is greater than 500/mm3, oral antibiotics may be substituted if antibiotic therapy is to be continued.

Usual Adult Dose for Intraabdominal Infection:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: 14 days, depending on the nature and severity of the infection

Comments: Less toxic antibiotics may be substituted once the patient is stable for at least 48 hours.

Usual Adult Dose for Meningitis:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours
Duration of therapy: Parenteral therapy should be continued for at least 1 week after the patient becomes afebrile and cerebrospinal fluid normalizes.

Usual Adult Dose for Osteomyelitis:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: 4 to 6 weeks, depending on the nature and severity of the infection; chronic osteomyelitis may require an additional 1 to 2 months of oral antibiotics

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Pelvic Inflammatory Disease:

2 mg/kg loading dose, followed by 1.5 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Parenteral therapy should be continued for at least 24 hours after clinical improvement and should be followed by oral doxycycline or clindamycin for a total 14 day course.

Usual Adult Dose for Peritonitis:

IV: 2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for about 14 days, depending on the nature and severity of the infection.

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Intraperitoneally in CAPD patients: 0.6 to 0.75 mg/kg intraperitoneally once a day or 16 to 20 mg per every 2 L dialysate

Usual Adult Dose for Plague:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for about 10 to 14 days, depending on the nature and severity of the infection.

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient's condition improves, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Pneumonia:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for 14 to 21 days, depending on the nature and severity of the infection.

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Pyelonephritis:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for about 7 to 14 days, depending on the nature and severity of the infection.

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Skin or Soft Tissue Infection:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for at least 10 to 14 days, or until 3 days postacute inflammation, depending on the nature and severity of the infection; for severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Surgical Prophylaxis:

1.5 to 2 mg/kg (maximum 120 mg) IV or IM once at induction of anesthesia

Usual Adult Dose for Tularemia:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for about 10 to 14 days, depending on the nature and severity of the infection.

Comments: Once the patient's condition improves, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Pediatric Dose for Bacterial Infection:

0 to 4 weeks, birthweight <1200 g: 2.5 mg/kg IV or IM every 18 to 24 hours
0 to 1 week, birthweight >=1200 g: 2.5 mg/kg IV or IM every 12 hours
1 to 4 weeks, birthweight 1200 to 2000 g: 2.5 mg/kg IV or IM every 8 to 12 hours
1 to 4 weeks, birthweight >=2000 g: 2.5 mg/kg IV or IM every 8 hours

>1 month: 1 to 2.5 mg/kg IV or IM every 8 hours

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis:

1.5 mg/kg IV or IM once within 30 minutes of starting the procedure

Comments: For high risk patients, in addition to gentamicin, ampicillin 50 mg/kg (maximum 2 g) is given IV or IM 30 minutes prior to the procedure, followed by ampicillin 25 mg/kg IV/IM or amoxicillin 25 mg/kg orally 6 hours later. In penicillin-allergic patients, vancomycin 20 mg/kg IV is infused over 1 to 2 hours instead of ampicillin/amoxicillin.

Usual Pediatric Dose for Endocarditis:

AHA recommendations:
Native valve infections due to highly penicillin-susceptible viridans Group streptococci and S bovis (MIC <=0.12 mcg/mL): 3 mg/kg IV or IM once every 24 hours or 1 mg/kg every 8 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 4 weeks

Native valve infections due to relatively penicillin-resistant S viridans and S bovis (MIC >0.12 mcg/mL and <=0.5 mcg/mL): 3 mg/kg IV or IM once every 24 hours or 1 mg/kg every 8 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 4 weeks

Prosthetic valve infections due to S viridans and S bovis: 3 mg/kg IV or IM once every 24 hours or 1 mg/kg every 8 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 6 weeks

Native valve infections due to staphylococci: 1 mg/kg IV or IM every 8 hours, in combination with nafcillin, oxacillin, or cefazolin
Duration of therapy: 3 to 5 days; continue other antibiotic for 6 weeks

Prosthetic valve infections due to staphylococci: 1 mg/kg every 8 hours, in combination with nafcillin or oxacillin, plus rifampin, or vancomycin plus rifampin
Duration of therapy: 2 weeks; continue other antibiotics for at least 6 weeks

Native valve or prosthetic valve infections due to susceptible enterococci: 1 mg/kg IV or IM every 8 hours, in combination with ampicillin, aqueous penicillin G sodium, or vancomycin
Duration of therapy: 4 to 6 weeks; continue other antibiotic for 6 weeks

Native valve or prosthetic valve infections due to penicillin-resistant enterococci: 1 mg/kg IV or IM every 8 hours, in combination with ampicillin-sulbactam or vancomycin
Duration of therapy: 6 weeks

Comments: Refer to current published guidelines for detailed recommendations.

Usual Pediatric Dose for Surgical Prophylaxis:

2 mg/kg IV once at induction of anesthesia

What other drugs will affect gentamicin?

Gentamicin can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • a diuretic or "water pill"; or

  • any other antibiotic.

This list is not complete. Other drugs may interact with gentamicin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about gentamicin.
  • 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: 2.01. Revision Date: 2015-03-10, 12:20:20 PM.

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