Streptomycin Side Effects
Some side effects of streptomycin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to streptomycin: intramuscular powder for solution, intramuscular solution
Along with its needed effects, streptomycin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking streptomycin:More common
- Black, tarry stools
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest pain
- dizziness or lightheadedness
- feeling of constant movement of self or surroundings
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- painful or difficult urination
- sensation of spinning
- shortness of breath
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- swollen glands
- unusual bleeding or bruising
- unusual tiredness or weakness
- Back, leg, or stomach pains
- bleeding gums
- bloody or cloudy urine
- blurred vision
- change in vision
- dark urine
- difficulty with breathing
- difficulty with swallowing
- dry mouth
- fast heartbeat
- general body swelling
- impaired vision
- loss of appetite
- muscle weakness
- pain in lower back or side
- pale skin
- pinpoint red spots on the skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- skin rash
- tightness in the chest
- yellowing of the eyes or skin
- Change in the frequency of urination or amount of urine
- increased thirst
- swelling of the feet or lower legs
Some side effects of streptomycin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Hives or welts
- redness of the skin
- Impaired vision
For Healthcare Professionals
Applies to streptomycin: compounding powder, intramuscular powder for injection
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 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.
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 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.
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.
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 side effects have included nausea and vomiting, which should be evaluated as possible signs of vestibular ototoxicity.
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