Last Updated June 10, 2016
Aminoglycoside bacteriocidal antibiotic
1 g/3 mL
Indication: treatment of tuberculosis in combination with other antituberculosis drugs, including multidrug-resistant tuberculosis; also infections caused by many Gram-negative bacteria.
Mechanism of action: inhibition of protein synthesis through binding 30S ribosomal unit, causing cell death.
Pharmacokinetics: widely distributed throughout body; half-life 2-3 hours (may be longer with renal impairment).
Adult Dose: 15 mg/kg/day, maximum 1.5 g/day.
Use in Renal or Hepatic Insufficiency: Renal impairment: glomerular filtration rate < 30 mL/min, 12-15 mg/kg 2-3 times/week.*
Use in Pregnancy and Breastfeeding†: Pregnancy Category D. Can cross placenta, potential for foetal ototoxicity.
Excreted in low amounts in breast milk.
Use in Children: 15-30 mg/kg/day, maximum 1.0 g/day injected intramuscularly.*
Contraindicated in patients with hypersensitivity to kanamycin or other aminoglycosides.*
Not indicated for long-term therapy due to toxicity.
Can cause vestibular toxicity (heralded by headache, nausea, vomiting, disequilibrium) and cochlear toxicity (heralded by loss of high-frequency hearing); patients should be monitored to avoid irreversible damage.
Increased risk of severe neurotoxic reactions, including ototoxicity, optic nerve dysfunction, and peripheral neuritis, in patients with renal impairment.
Renal function should be monitored frequently during administration.
Use with caution in patients with Parkinsonism or myasthenia gravis.
Respiratory paralysis due to neuromuscular blockade may occur, especially when used soon after anaesthesia or muscle relaxants.†
Should not be given with concomitant diuretics due to increased toxicity.
Concomitant use of aminoglycosides and beta-lactam–type antibiotic may cause mutual inactivation.
Ototoxicity potentiated by concomitant administration of ethacrynic acid, furosemide, mannitol, and possibly other diuretics.
Avoid concurrent or sequential use of other neurotoxic and/or nephrotoxic drugs, including neomycin, amikacin, gentamicin, cephaloridine, paromomycin, viomycin, polymyxin B, colistin, tobramycin, and cyclosporine.
Renal impairment: increased risks of ototoxicity, nephrotoxicity, and neuromuscular blockade.
Geriatric: may require reduced dose due to renal impairment
Infants: Use with caution in premature and neonatal infants due to renal immaturity.
See above for pregnancy and lactation.
Ototoxicity (auditory and sometimes vestibular), nephrotoxicity, neuromuscular blockade, rash, drug fever, headache, paresthesia, nausea, vomiting, diarrhoea, malabsorption syndrome with prolonged therapy.
*Recommendation of the Aurum Institute.
†Information from US prescribing information.