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Netilmicin Side Effects

Applies to netilmicin: injectable solution

General

The most frequent and serious adverse effects of netilmicin are ototoxicity and nephrotoxicity. These adverse effects may be more common and severe in patients with reduced renal function. Netilmicin ototoxicity and nephrotoxicity have been associated with serum trough levels exceeding 2 mcg/mL. Some studies have found the duration of netilmicin therapy and total dose of the drug to also be predisposing factors.[Ref]

Renal

One study has shown that hyperbilirubinemia in patients with biliary obstruction was associated with a higher incidence of aminoglycoside nephrotoxicity.[Ref]

Renal toxicity associated with netilmicin, like other aminoglycosides, occurs in 2% to 10% of patients. Other predisposing factors include advanced age, preexisting renal insufficiency, dehydration, and concomitant use of other potentially nephrotoxic drugs.[Ref]

Nervous system

Neurologic side effects associated with netilmicin may include ototoxicity and rare case of neuromuscular blockade.[Ref]

Ototoxicity from amikacin generally includes loss of auditory function secondary to cochlear hair cell damage and may be irreversible. Damage may also be vestibular.

Rare neurologic adverse effects include neuromuscular blockade, particularly in patients who are predisposed including patients with myasthenia gravis, hypocalcemia, and on concomitant neuromuscular blocking agents.[Ref]

Hepatic

Hepatic side effects may include rare cases of elevated liver function test, the clinical significance of which has not been established.[Ref]

Hypersensitivity

Hypersensitivity reactions include rare cases of eosinophilia, pruritus, fever, rash, and exfoliative dermatitis.[Ref]

References

1. Bhattacharya BK, Gorringe H, Farr MJ "Netilmicin and nephrotoxicity." Lancet 2 (1983): 216-7

2. Greenberg RN, Hansbrough JN, Lorber RR, Miller GH "Netilmicin sulfate as single-agent therapy for pseudomonas infections." South Med J 82 (1989): 715-8

3. Solberg CO, Madsen ST, Digranes A, et al "High dose netilmicin therapy: efficacy, tolerance and tissue penetration." J Antimicrob Chemother 6 (1980): 133-41

4. Bock BV, Edelstein PH, Meyer RD "Prospective comparative study of efficacy and toxicity of netilmicin and amikacin." Antimicrob Agents Chemother 17 (1980): 217-25

5. Gatell JM, SanMiguel JG, Araujo V, et al "Prospective randomized double-blind comparison of nephrotoxicity and auditory toxicity of tobramycin and netilmicin." Antimicrob Agents Chemother 26 (1984): 766-9

6. Noone M, Pomeroy L, Sage R, Noone P "Prospective study of amikacin versus netilmicin in the treatment of severe infection in hospitalized patients." Am J Med 86 (1989): 809-13

7. Lorber RR, Linzmayer MI "Netilmicin in the treatment of pseudomonas bacteremia." Clin Ther 7 (1985): 338-46

8. Hellum KB, Madsen ST, Digranes A, Stokstad S, Solberg CO "High dose netilmicin therapy of severe or chronic infections." Scand J Infect Dis Suppl 23 (1980): 189-94

9. Peddie BA, Bailey RR, Blake E, Summerfield MJ "Netilmicin in the treatment of severe or complicated urinary tract infections." N Z Med J 91 (1980): 378-81

10. Bergeron MG, Lessard C, Ronald A, Stiver G, Van Roogen CE, Chadwick P "Three to eight weeks of therapy with netilmicin: toxicity in normal and diabetic patients." J Antimicrob Chemother 12 (1983): 245-8

11. Desai TK, Tsang TK "Aminoglycoside nephrotoxicity in obstructive jaundice." Am J Med 85 (1988): 47-50

12. Herting RL, Lorber RR, Miller M, Danzig MR "Multicenter comparative evaluation of netilmicin and gentamicin in adult patients." Arzneimittelforschung 31 (1981): 366-70

13. Perera MR, Amirak ID, Noone P "Netilmicin 200 mg twice a day for adult patients with life-threatening infections." Scand J Infect Dis 23 (1980): 186-8

14. Brandenhoff P, Stafanger G, Gammelgaard PA, et al "Netilmicin therapy of patients with septicaemia and other severe infections." Scand J Infect Dis Suppl 23 (1980): 181-5

15. Barza M, Lauermann MW, Tally FP, Gorbach SL "Prospective, randomized trial of netilmicin and amikacin, with emphasis on eighth-nerve toxicity." Antimicrob Agents Chemother 17 (1980): 707-14

16. Bernstein JM, Gorse GJ, Linzmayer MI, et al "Relative efficacy and toxicity of netilmicin and tobramycin in oncology patients." Arch Intern Med 146 (1986): 2329-34

17. Uziel A "Non-genetic factors affecting hearing development." Acta Otolaryngol (Stockh) 421 (1985): 57-61

It is possible that some side effects of netilmicin may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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