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Netilmicin Side Effects

Applies to netilmicin: injectable solution.


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 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]

One study has shown that hyperbilirubinemia in patients with biliary obstruction was associated with a higher incidence of aminoglycoside nephrotoxicity.[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 side effects may include rare cases of elevated liver function test, the clinical significance of which has not been established.[Ref]


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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.