Paromomycin Sulfate
Pronouncation: (par-oh-moe-MY-sin SULL-fate)Class: Amebicide, Aminoglycoside
Trade Names:
Humatin
- Capsules 250 mg
Pharmacology
Feedback for Paromomycin Sulfate
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Inhibits production of protein in bacteria, causing bacterial cell death.
Pharmacokinetics
Absorption
Poorly absorbed orally.
Elimination
Feces (100% unchanged).
Indications and Usage
Treatment of acute and chronic intestinal amebiasis. Adjunctive therapy in management of hepatic coma.
Unlabeled Uses
Treatment of other parasitic infections.
Contraindications
Intestinal obstruction; extraintestinal amebiasis; hypersensitivity to aminoglycosides.
Dosage and Administration
Intestinal AmebiasisAdults and Children
PO 25 to 35 mg/kg/day in 3 divided doses with meals for 5 to 10 days.
Hepatic ComaAdults
PO 4 g/day in divided doses at regular intervals for 5 to 6 days.
Storage/Stability
Store at room temperature in a tight container.
Drug Interactions
DigoxinMay reduce rate and extent of digoxin absorption; this may be offset by decreased digoxin metabolism.
MethotrexateDecreased absorption of methotrexate.
Neuromuscular blockersIncreased action of both depolarizing and nondepolarizing neuromuscular blocking agents, may prolong need for respiratory support.
Neurotoxic, nephrotoxic, or ototoxic medications (eg, polypeptide antibiotics)Additive adverse effects may occur with concurrent or sequential administration of medications with similar toxic profiles.
Laboratory Test Interactions
None well documented.
Adverse Reactions
GI
Nausea; vomiting; abdominal cramps; anorexia; epigastric burning; pruritus ani; diarrhea.
Miscellaneous
Malabsorption syndrome.
Precautions
WarningsNeurotoxicityManifests as both auditory and vestibular ototoxicity, and primarily occurs in patients with pre-existing renal damage or with prolonged therapy. Partial or total irreversible deafness may continue to develop after drug is stopped. Other features of neurotoxicity include paresthesias, twitching, and seizures. NephrotoxicityUsually reversible. Paromomycin is teratogenic in pregnancy. Closely monitor renal and eighth nerve function in patients with suspected renal function impairment. Monitor peak and trough concentrations. Renal function impairment requires dosage adjustments. |
Pregnancy
Category D .
Lactation
Excreted in breast milk.
Superinfection
Prolonged or repeated therapy may result in bacterial or fungal overgrowth of nonsusceptible organisms and secondary infections.
Muscular disorders
Patients with muscular disorders such as myasthenia gravis or parkinsonism may have worsening of their disease because of potential effect of aminoglycosides on neuromuscular junction.
Overdosage
Symptoms
Neurotoxicity, nephrotoxicity, ototoxicity.
Patient Information
- Stress to patient the importance of taking full course of therapy.
- Emphasize to patient the importance of personal hygiene, especially handwashing.
- Explain to patient the symptoms of superinfection and ask patient to watch for symptoms if on prolonged therapy.
- Instruct patient to report the following symptoms to health care provider: ringing in ears, hearing impairment, or dizziness.
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Amebiasis, Giardiasis, Dog Tapeworm, Taenia saginata (beef tapeworm), Dientamoeba fragilis, Cryptosporidiosis, Hymenolepis nana (Dwarf Tapeworm), Taenia solium (pork tapeworm), Fish Tapeworm, Hepatic Coma
