Nelin

Netilmicin sulfate

Septicemia, complicated UTI, infections of lower resp tract, biliary tract, skin & soft tissue, bone & joint, intra-abdominal (including peritonitis) & CNS (including meningitis). Initial therapy in suspected or confirmed gm -ve infection. In combination w/ carbenicillin or ticarcillin for life-threatening infections caused by Pseudomonas aeruginosa.

IM/IV Adult 4-6 mg/kg daily given in 3 equal doses every 8 hr, 2 equal doses every 12 hr or once daily. Adult weighing 50-90 kg 300 mg once daily, 150 mg every 12 hr or 100 mg every 8 hr, 40-50 kg 200 mg once daily or 100 mg every 12 hr. Life-threatening infections Up to 7.5 mg/kg daily in 3 equal doses every 8 hr. May be reduced to ≤6 mg/kg daily w/in 48 hr. Childn 6-7.5 mg/kg daily or 2-2.5 mg/kg every 8 hr. Treatment duration for all patients: 7-14 days. Renal impairment Adjusted total daily dose: 1 dose at 24 hr intervals, or as 2 or 3 equally divided doses at 12 hr or 8 hr intervals, respectively. Max: 3.25 mg/kg each interval dose. Patients on hemodialysis 2 mg/kg at the end of each dialysis period.

Hypersensitivity & serious toxic reaction to netilmicin or other aminoglycosides.

Allergic-type reactions including anaphylactic symptoms & life-threatening or less severe asthmatic episodes. Discontinue if renal impairment or ototoxicity occurs. Greater risk of nephrotoxicity in patients w/ renal impairment, receiving high dose or prolonged therapy, concurrently using other nephrotoxic agents, frequent dosing, depleted K & decreased intravascular vol. Neurotoxicity; neuromuscular blockage. Preexisting hearing loss; neuromuscular disorders eg, myasthenia gravis, parkinsonism, or infant botulism. Monitor renal & 8th cranial nerve function during therapy, particularly for patients w/ known or suspected reduced renal function & in those renal function is initially normal but develop signs of renal dysfunction; drug serum conc. Hydrate well during treatment. Avoid concomitant use w/ other nephrotoxic, ototoxic or neurotoxic drugs. Extemporaneous admixtures w/ β-lactam antibiotics. Pregnancy & lactation. Premature infants & neonates. Elderly.

Headache, encephalopathy, fever, disorientation, neuromuscular blockage, paresthesia, convulsion, muscle twitching, myasthenia gravis-like syndrome, numbness, peripheral neuropathy, skin tingling; vomiting, diarrhea; anemia, eosinophilia, leukopenia, thrombocytopenia; rash, itching; oliguria, proteinuria, casts, red & white cells in urine; dizziness, tinnitus, vertigo, visual disturbances/blurred vision; apnea, inj site pain/irritation, hypotension, severe pain induration & hematomas, prolonged PT, hyperkalemia, palpitation, immature circulating WBCs, leukemoid reaction, nystagmus, Fanconi-like syndrome w/ aminoaciduria & metabolic acidosis; increased alkaline phosphatase, AST or ALT, bilirubin, serum creatinine & BUN, decreased CrCl.

Increased risk of nephrotoxicity w/ cephalosporins, enflurane, methoxyflurane, vancomycin. Concomitant use w/ IV indomethacin; penicillins. Increased auditory toxicity w/ loop diuretics. Enhanced effects of depolarizing & non-depolarizing neuromuscular blockers. Increased risk of resp paralysis & renal dysfunction w/ polypeptide antibiotics.

Aminoglycosides

J01GB07 - netilmicin ; Belongs to the class of other aminoglycosides. Used in the systemic treatment of infections.

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