Streptomycin Side Effects

Please note - some side effects for Streptomycin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Streptomycin - for the Consumer

Streptomycin

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Streptomycin:

Abnormal skin sensation around the face; feeling of whirling motion; fever; swelling.

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); decreased urination; dizziness; headache; hearing loss; hives; lightheadedness; loss of balance; muscle weakness; nausea; numbness or tingling; ringing or roaring in the ears; skin rash or itching; vaginal irritation or discharge; vomiting.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Streptomycin Side Effects - for the Professional

Streptomycin

The following reactions are common: vestibular ototoxicity (nausea, vomiting, and vertigo); paresthesia of face; rash; fever; urticaria; angioneurotic edema; and eosinophilia.

The following reactions are less frequent: cochlear ototoxicity (deafness); exfoliative dermatitis; anaphylaxis; azotemia; leucopenia; thrombocytopenia; pancytopenia; hemolytic anemia; muscular weakness; and amblyopia.

Vestibular dysfunction resulting from the parenteral administration of Streptomycin is cumulatively related to the total daily dose. When 1.8 to 2 g/day are given, symptoms are likely to develop in the large percentage of patients - especially in the elderly or patients with impaired renal function - within four weeks. Therefore, it is recommended that caloric and audiometric tests be done prior to, during, and following intensive therapy with Streptomycin in order to facilitate detection of any vestibular dysfunction and/or impairment of hearing which may occur.

Vestibular symptoms generally appear early and usually are reversible with early detection and cessation of Streptomycin administration. Two to three months after stopping the drug, gross vestibular symptoms usually disappear, except from the relative inability to walk in total darkness or on very rough terrain.

Although Streptomycin is the least nephrotoxic of the aminoglycosides, nephrotoxicity does occur rarely.

Clinical judgment as to termination of therapy must be exercised when side effects occur.

Side Effects by Body System - for Healthcare Professionals

General

Common side effects of streptomycin have included vestibular toxicity (nausea, vomiting, vertigo), paresthesia of the face, rash, fever, urticaria, angioneurotic edema, and eosinophilia. Side effects may be more likely and more severe in patients with underlying renal insufficiency.

Nervous system

Nervous system side effects have included eighth cranial nerve toxicity, which typically affects the vestibular system, but may also affect the auditory component. Streptomycin has more vestibulotoxicity than cochlear toxicity. Vestibulotoxicity is usually reversible with early detection and discontinuation of streptomycin. Cochlear toxicity is often irreversible.

A large percentage of patients receiving daily doses of 1.8 to 2 grams are likely to develop symptoms of vestibular toxicity within 4 weeks, especially the elderly or renally impaired.

Scotomas, presenting as blind spots, and peripheral neuritis have been reported.

Previous exposure to aminoglycosides, concomitant use of other potentially ototoxic agents (such as aspirin), and advanced age may provide additional risk of ototoxicity. If symptoms of dizziness, ataxia, tinnitus, vertigo, headache, or decreased hearing occur, alternate therapy should be considered. Baseline and monthly auditory testing should be considered during chronic use of streptomycin, such as in the case of tuberculosis therapy, since ototoxicity may be detected before it becomes clinically evident.

Streptomycin has been reported to possess neuromuscular blocking properties. Extremely high doses of streptomycin have allegedly resulted in lethal neuromuscular blockade.

Hypersensitivity

Two reported cases of streptomycin hypersensitivity have involved acute renal failure. In one patient hemolytic anemia was also present and antibodies to streptomycin were detected. Each of these patients had received streptomycin prior to the reaction.

Hypersensitivity side effects have been reported infrequently. Cases of anaphylaxis, erythema multiforme, Stevens Johnson syndrome, toxic epidermal necrolysis, pruritus, urticaria, eosinophilia, and rash have been attributed to immune-mediated hypersensitivity reactions to streptomycin. Hypersensitivity myocarditis has also been reported.

Renal

Renal side effects have included nephrotoxicity, azotemia, and renal electrolyte wasting. Nephrotoxicity is less common than with other aminoglycosides. Streptomycin-induced nephrotoxicity may be more likely in patients with preexisting renal insufficiency.

Risk factors for the development of streptomycin nephrotoxicity include preexisting renal insufficiency, advanced age, concomitant use of other potentially nephrotoxic drugs, and previous exposure to aminoglycoside therapy. Acute renal failure has also occurred as part of an immune-mediated reaction.

Hematologic

Aplastic anemia has been reported in patients receiving streptomycin in combination with other antituberculous drugs. Implication of streptomycin as the offending agent is difficult.

The development of a streptomycin-specific antibody directed against red blood cells has been reported, but no hemolysis occurred.

Hematologic side effects have included hypersensitivity-associated eosinophilia, and rarely, aplastic anemia, leukopenia, thrombocytopenia, pancytopenia, and hemolytic anemia.

Other

Rechallenge with streptomycin reproduced fevers and shaking chills in a patient who had otherwise begun to recover from tuberculosis, was HIV-negative, and who had no other source of infection.

Other side effects have included a rare case of recurrent fever and shaking chills. Streptomycin is a potent sensitizer and often causes local irritation in ocular tissues.

Gastrointestinal

Gastrointestinal side effects have included nausea and vomiting, which should be evaluated as possible signs of vestibular ototoxicity.

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