Neomycin ointment instructions for use. How to use the antibiotic neomycin in the treatment of diseases of various etiologies

Neomycin passes through the bacterial cell membrane and binds to specific receptor proteins on the 30S ribosomal subunit. Neomycin disrupts the synthesis of the matrix and transport RNA complex and stops the formation of proteins (has a bacteriostatic effect). When using higher concentrations (more by 1 - 2 orders of magnitude), neomycin has a damaging effect on the cytoplasmic membranes of microbial cells with rapid further death of the microorganism (bactericidal effect). Neomycin is active against some gram-negative and gram-positive microorganisms, including Streptococcus pneumoniae, Salmonella spp., Staphylococcus spp., Shigella spp., Escherichia coli, Corynebacterium diphtheriae, Proteus spp., Bacillus anthracis. Resistance to neomycin in microorganisms develops slowly. Neomycin has no effect on pathogenic fungi, anaerobic microflora, or viruses.

After oral administration, neomycin is poorly absorbed (3%) and acts almost only on the intestinal microflora. When neomycin is applied to small areas of entire skin, systemic absorption is minimal, but if the drug is applied to damaged areas of the skin, a large surface area, or areas of skin covered with granulations, neomycin is rapidly absorbed. The maximum concentration when taken orally is achieved within 0.5 - 1.5 hours. Neomycin binds to plasma proteins up to 10%. It penetrates poorly into bones, the central nervous system, muscles, breast milk, adipose tissue and bile. Neomycin penetrates the placental barrier. Not metabolized. The half-life of neomycin is 2–4 hours. The unabsorbed drug is excreted in the feces, and the absorbed drug is excreted by the kidneys. If the functional state of the kidneys is impaired, accumulation of neomycin in the blood plasma is possible. When administered intramuscularly, neomycin is absorbed completely and quickly.
Since neomycin is almost not absorbed after oral administration, it was previously used in the treatment of pathologies of the gastrointestinal tract (enterocolitis, enteritis, dysentery), for preoperative preparation for surgical interventions on the digestive tract (for partial sanitation of the intestine).

In hepatic coma, prolonged suppression of intestinal flora is possible after taking neomycin at a dose of 1 g every 6 to 8 hours; this, together with limiting protein intake, helps reduce ammonia intoxication. Neomycin inhibits the reabsorption of bile acids and cholesterol, causes a moderate decrease in the content of low-density lipoproteins, but neomycin does not affect the content of triglycerides. In ophthalmology, it can be used for local treatment of eye pathologies (for example, conjunctivitis), instilling a neomycin solution (33 mg/ml) into the conjunctival sac.

Indications

Infectious and inflammatory pathology of the skin, which is caused by sensitive microorganisms, including furunculosis, pyoderma, contagious impetigo, infected eczema, infected wounds, infected ulcers, infected frostbite and 1st and 2nd degree burns.

Method of administration of neomycin and dose

Neomycin is used topically: applied 1 – 3 times a day to the affected areas of the skin.
Neomycin currently has limited use due to high toxicity (nephro-, neuro- and ototoxicity. The method and frequency of local use depend on the dosage form and the concentration of neomycin in it. Long-term use of neomycin should be avoided due to increased cross-sensitivity to other aminoglycosides and the risk of developing skin sensitization.

Contraindications for use

Hypersensitivity (including to other aminoglycosides); for external use: large affected area, violation of skin integrity, trophic ulcers, weeping at the site of application, combined use with other nephro- and ototoxic drugs, children's age.

Restrictions on use

If it is necessary to use on large areas of skin (there is a risk of ototoxicity, especially in elderly patients, children and in patients with impaired renal function) - myasthenia gravis, damage to the 8th pair of cranial nerves, parkinsonism syndrome, dehydration, botulism, renal failure, thoracic feeding, pregnancy.

Use during pregnancy and breastfeeding

During pregnancy, neomycin can be used only for health reasons. When absorbed systemically, neomycin can have nephro- and ototoxic effects on the fetus. It is not known whether neomycin is excreted in breast milk.

Side effects of neomycin

Allergic reactions: contact dermatitis (rash, itching, hyperemia, skin irritation, swelling);
when neomycin is absorbed from a large surface, a systemic effect is possible: digestive system: nausea, increased activity of liver transaminases, vomiting, hyperbilirubinemia, stomatitis, hypersalivation;
blood and circulatory system: increased or decreased blood pressure, leukopenia, anemia, granulocytopenia, thrombocytopenia, reticulocytopenia;
nervous system and sensory organs: neurotoxicity (paresthesia, muscle twitching, epileptic seizures, numbness), drowsiness, headache, neuromuscular blockade (weakness, difficulty breathing), ototoxicity (hearing loss, sensation of congestion or tinnitus), labyrinthine and vestibular disorders (unsteadiness and gait instability, nausea, dizziness, vomiting), irreversible deafness;
genitourinary system: nephrotoxicity - increased or decreased frequency of urination, polyuria or oliguria, thirst, sediment in the urine, increased plasma creatinine and urea, proteinuria;
allergic reactions: itching, skin rash, fever, eosinophilia, angioedema;
others: hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, hyperthermia, weight loss, development of superinfection.

Interaction of neomycin with other substances

When absorbed systemically, neomycin can potentiate the effects of indirect anticoagulants (by reducing the formation of vitamin K by intestinal flora), reduce the effects of fluorouracil, cardiac glycosides, methotrexate, vitamins B12 and A, phenoxymethylpenicillin, oral contraceptives, chenodeoxycholic acid (increases the secretion of cholesterol by bile). Neomycin is incompatible with kanamycin, streptomycin, monomycin, viomycin, gentamicin and other nephro- and ototoxic antibiotics (the likelihood of developing toxic complications increases). Drugs that block neuromuscular transmission, nephrotoxic and ototoxic agents (including capreomycin or other aminoglycosides), inhaled general anesthetics (including halogenated hydrocarbons), citrate preservatives, polymyxins with transfusion of large quantities of preserved blood increase the likelihood of developing neuromuscular blockade transmission, as well as nephro- and ototoxic effects.

Overdose

In case of an overdose of neomycin, neuromuscular conduction decreases (respiratory arrest is possible). Required: adults are administered intravenously anticholinesterase drugs (prozerin), calcium preparations (calcium gluconate 10% 5 - 10 ml, calcium chloride 10% 5 - 10 ml); before the administration of proserin, 0.5 - 0.7 mg of atropine is administered intravenously at the beginning, 1.5 - 2 minutes after the increase in heart rate, 3 ml of a 0.05% solution (1.5 mg) of proserin is administered intravenously, if the effect of this dose is insufficient, the dose is repeated the same dose of prozerin is administered (if bradycardia develops, an additional injection of atropine is given); children are given calcium supplements; in case of respiratory depression - artificial ventilation; neomycin can be eliminated by hemodialysis and peritoneal dialysis (less effective than hemodialysis).

Trade names of drugs with the active substance neomycin

Combined drugs:
Bacitracin + Neomycin: Baneocin®;
Bacitracin + Neomycin + Polymyxin B: Triasept;
Hydrocortisone + Natamycin + Neomycin: Pimafucort®;
Dexamethasone + Neomycin: Dexona;
Dexamethasone + Neomycin + Polymyxin B: Maxitrol, Polydexa;
Dexamethasone + Neomycin + Polymyxin B + Phenylephrine: Polydexa with phenylephrine;
Clostebol + Neomycin: Trofodermin®;
Lidocaine + Neomycin + Polymyxin B: Anauran;
Neomycin + Nystatin + Polymyxin B: Polygynax, Polygynax Virgo;
Neomycin + Fluocinolone acetonide: Flucort N, Flucinar® N,
Neomycin + Fluocinolone acetonide + Lidocaine: Nefluan;
Betamethasone + Neomycin: Betnovate®-N;
Ornidazole + Neomycin + Prednisolone + Econazole: Elzhina®.

The bactericidal antibiotic Neomycin ®, which belongs to the second generation of aminoglycosides, has a significant difference from other drugs in the group. It is the only one used for oral administration in tablet form. At the same time, it also has other dosage forms that are prescribed for the treatment of superficial infections, which is due to the peculiarities of its pharmacokinetics and pharmacodynamics.

Before using a medicine, be sure to familiarize yourself with the list of indications, restrictions and other characteristics so that antibiotic therapy does not harm the body.

A characteristic feature of all aminoglycosides is their high toxicity to the organs of hearing and kidneys. This effect is due to the ability of antibiotics to accumulate in the renal cortex and fluid of the inner ear. And with Neomycin ® this effect is especially pronounced, which requires constant medical monitoring of the condition of the relevant organs and completely eliminates self-medication.

Neomycin ® recipe in Latin

Looks like this:
Rp.: Neomycinum 0.1
D.t.d. No. 10.
S. Intramuscularly twice a day.

Composition and antimicrobial activity

The active substance is a composition of several varieties of this antibiotic neomycin (A, B and C), which are produced by the actinomycete Streptomyces fradiae.

Aminoglycoside antibiotics are the second open group after penicillins, which today has three generations of ABPs. The first of them was obtained back in 1944, and it was then used to treat any infections caused by susceptible pathogens. This approach provoked an increase in bacterial resistance to the drug and the need to find more effective drugs. As a result, several more aminoglycosides were isolated, which today are prescribed only in difficult cases.

Neomycin ® sulfate is active against Staphylococcus spp., pneumococci, Escherichia coli and diphtheria coli, Salmonella spp., Shigella, Bacillus anthracis and Proteus. Since the medicine only works in the presence of oxygen, it is not advisable to use it against intracellular and anaerobic microorganisms. Pathogenic bacteria are destroyed by disrupting the structural connection of RNA and blocking protein synthesis.

Pharmacological group of neomycin ®

Aminoglycosides.

Release form of neomycin ®

In pharmacology it is used in the form of a chemical compound - a salt of sulfuric acid - neomycin sulfate. It is a powdery, white substance that is highly soluble in water. The following types of dosage forms are produced from it:

Tablets containing 0.1 or 0.25 g of antibiotic and additional formative ingredients.
A spray intended for local external use, which is a suspension with an amount of antibiotic of 11.72 mg per gram. The composition also includes lecithin, sorbitan triopeate, propellant and isopropyl myristate. Available in aerosol cans with a spray nozzle of 16 or 32 g.
Neomycin ointment, also used externally, contains 0.5 or 2% of the active ingredient. The medication is sold in tubes of 15 and 30 g.
Neomycin sulfate powder for the preparation of injection solution. Glass vials with rubber caps contain 0.2 or 0.5 grams of antibiotic.

The active substance is used to produce some other dosage forms (for example, dexamethasone eye drops or suppositories), but they are sold under different trade names. All these drugs are described in detail below in the corresponding section.

Indications

The list of diseases that can be treated with a given antimicrobial agent is determined by the spectrum of activity and its dosage form.

For tablets

When used internally, the drug is not absorbed through the mucous membranes of the gastrointestinal tract and, accordingly, does not penetrate into the blood. This property allows it to be used for antibiotic therapy of superficial infections of the digestive system. But most often, the tablet dosage form is prescribed for contamination (that is, sterilization) of the gastrointestinal tract before surgery in the relevant area.

For aerosol and ointment

Local application is the main purpose of Neomycin ®. When applied to intact epidermis, the antibacterial compound practically does not penetrate under the skin and into the bloodstream. But if the drug is used to treat damaged areas, then absorption into the blood is ensured with a subsequent systemic effect, which is important to consider.

Neomycin ® sulfate is indicated for the following infections caused by pathogens susceptible to the drug:

burns and frostbite (1st and 2nd degree, infected);
ulcerations with the formation of pus;
furunculosis;
eczema;
pyoderma;
impetigo.

The drug is not suitable for the treatment of abscesses and other purulent lesions without oxygen access to them.

For powder

Before intramuscular administration, the powdered product is diluted directly in the bottle with sterile saline or novocaine according to the instructions. Injections are prescribed in case of pneumonia, catarrhal infections of the upper respiratory tract, genitourinary organs, meningoencephalitis and some other diseases.

Neomycin ® dosages

Neomycin ® ointment is applied to the affected areas in a thin layer twice a day. The aerosol is used 1 to 3 times, and before each use the can is shaken vigorously until the components are completely mixed. Sprays onto the skin from a distance of no more than 20 cm for three seconds. The average course of antibiotic therapy is a week or two.

Neomycin ® is the only one from the group of aminoglycoside antibiotics that is used orally. Most often it is prescribed at the stage of preoperative preparation (when surgical intervention in the abdominal cavity is planned). A 1-2-day course helps to sterilize the intestines and reduce the risk of complications in the postoperative period.

Adults need to drink 0.1 grams of antibiotic four times a day at equal intervals. For children, the formula is 4 mg per kilogram of weight, divided by 2 times.

Contraindications

For topical drugs, an absolute contraindication is hypersensitivity to aminoglycosides and auxiliary ingredients of the drug. Those drugs that act systemically are prohibited if the patient has renal failure, intestinal obstruction and hearing diseases. Neomycin ® during pregnancy can be used exclusively for health reasons, taking into account possible teratogenic effects (damage to the auditory nerves and urinary system of the fetus). Breastfeeding should be temporarily suspended if this drug is prescribed.

Side effect

Negative reactions from the digestive system such as anorexia, nausea, vomiting, and diarrhea may occur. If hearing impairment (tinnitus) or renal excretory function occurs, the medication is discontinued. Allergic reactions, photodermatoses, dysbacteriosis and candidiasis are also possible.

Neomycin ® during pregnancy and breastfeeding

Considering the high toxicity of neomycin ® , the drug can only be used for health reasons, in the absence of a safe alternative.

Breastfeeding is temporarily stopped during treatment.

Compatibility of neomycin ® and alcohol

All aminoglycosides are strictly incompatible with alcoholic beverages. Alcohol leads to a significant increase in the nephrotoxic and ototoxic effects of neomycin ® and also increases the load on the liver.

Neomycin ® analogues

Foreign and domestic manufacturers offer quite a lot of drugs based on neomycin ®. These include:

Baneocin ®– powder or ointment for the treatment of infected lesions of the epidermis and the prevention of postoperative complications. produced in Switzerland by the pharmaceutical concern Sandoz ®.
– ear drops containing, in addition to the antibiotic, polymyxin sulfate ® and lidocaine ®. Indicated for otitis media, it has an anti-inflammatory and analgesic effect. Produced in Italy.
Polygynax ®– suppositories for local intravaginal use with neomycin ®, polymyxin B ® and nystatin ®. The last component has a preventive effect against yeast-like fungi.
– another vaginal suppository for the treatment of vaginitis and other infections, which, in addition to the antimicrobial agent, includes the antifungal nystatin ® and the antihistamine prednisolone. Like the previous drug, it is produced in France.
– nasal spray with neomycin ® and phenylephrine ®. It affects the disease comprehensively, fighting its cause and reducing the symptoms of a runny nose due to its vasoconstrictor effect.
Neomycin with dexamethasone ®– eye drops, often prescribed by ophthalmologists in the case of conjunctivitis and other superficial infections of the organs of vision.

There are other drugs produced by pharmaceutical companies in different countries that can replace Neomycin ®. But it is absolutely impossible to do this on your own, since all the specific features of the drugs and the patient himself must be taken into account. In addition, only in a medical facility can the specific causative agent of the disease be identified and adequate treatment prescribed.

Neomycin is an aminoglycoside antibiotic that is prescribed as part of the treatment of various infections. The medicine is a complex of compounds that have antibacterial activity. Neomycin is synthesized by the radiant fungus Streptomyces fradiae.

Composition, release form, packaging

The antibiotic is released in the form:

Powder in bottles of 0.5 g (50,000 units);
Tablets of 0.1 and 0.25 g;
Ointments for external use, with the concentration of the active substance - 0.5% and 2%. Available in tubes of 30 and 15 g;
Aerosol. The drug is a homogeneous white suspension.

Manufacturer

The aerosol is produced by the Polfa pharmaceutical plant, Poland.

Neomycin in ointment form is produced by Nizhpharm, Russia.

Forms of release of Neomycin

Indications

The medicine in the form of an aerosol and ointment is used topically to treat various infections. Neomycin is also widely used to prevent the development of eye infections after surgery.

Tablets are taken orally for the treatment of diseases of the digestive tract of infectious and inflammatory origin, for sterilization of the intestines before surgery. allows you to effectively treat the following pathologies:

Neomycin should not be prescribed in the following cases:

Availability of aminoglycosides;
Hypersensitivity to ingredients;
Damage to the skin surface, development of trophic ulcers when used topically;
Age under 6 years;
Obstructive conditions (COPD, bronchial asthma);
Pathological processes in the intestines and kidneys when taken orally.

The medicine is used with caution in the following groups of patients:

Elderly patients;
Against the background of dehydration;
and breastfeeding women;
Against the background of botulism.

Mechanism of action

The medicine has a bacteriostatic effect. Neomycin is able to penetrate the bacterial cell through the membrane. There, the antibiotic binds to certain receptor proteins on the 30S ribosomal subunit. As a result, the production of matrix and transport RNA is disrupted, and protein synthesis stops.

The use of Neomycin in high concentrations leads to damage to the cytoplasmic membrane of microbial cells, which provokes the death of the pathogenic agent. The antibiotic inhibits the activity of:

Corynebacterium diphtheriae;
Escherichia coli;
Bacillus anthracis;
Various strains of salmonella;
Streptococcus pneumoniae;
Staphylococcus;
Proteus spp.

The drug is characterized by the slow development of antibiotic resistance. Neomycin is not active against pathogenic, viral particles, or anaerobic microorganisms.

Instructions for use

When used topically in the form of a cream or ophthalmic or dosage is selected individually, based on the clinical picture and age group of the patient.

The tablets are taken orally. Patients over 12 years of age are prescribed 1 g once; in children aged 6 to 12 years, a single dosage is 0.25-0.5 g. The course of treatment is up to 7 days.

Side effects

As part of local administration, the following symptoms appear:

Development .

During oral administration it is possible:

Increased level of bilirubin in the bloodstream;
, anemia;
Numbness of some parts of the body;
Involuntary muscle contractions;
or ;
Development ;
Loss of body weight;
Development of stomatitis or secondary infections;
Decreased levels of calcium and magnesium in the bloodstream;
, apathy, drowsiness.

The antibiotic is nephrotoxic, so thirst, sedimentation and an increase in plasma concentrations of urea and creatinine are possible.

Overdose

Exceeding the therapeutic dosage leads to a decrease in neuromuscular conduction, so respiratory arrest is possible. Treatment of the condition in adults involves the administration of Proserin, calcium supplements, and Atropine. In childhood, overdose is treated by administering calcium supplements and performing artificial ventilation. In some cases, hemodialysis is indicated.

Special instructions

During pregnancy, the use of Neomycin is permitted for health reasons, because the drug has nephro- and ototoxic effects on the fetus. The ability of the drug to be excreted in breast milk has not been established. However, doctors do not prescribe antibiotics during lactation.

Neomycin should be prescribed with caution to people who have pathologies of internal organs or a history of hearing impairment. The antibiotic does not affect the ability to control complex mechanisms or perform work that requires increased concentration.

Drug interactions

With the simultaneous administration of Neomycin and chenodeoxycholic acid, an increased secretion of cholesterol into bile is observed. The antibiotic can reduce the rate of absorption of Methotrexate, drugs from the group of cardiac glycosides, A. This can lead to a decrease in the effectiveness of the listed drugs.

Co-administration of Neomycin leads to a decrease in the synthesis of vitamin K in the intestine. The medicine must not be prescribed while taking Kanamycin, Viomycin, Streptomycin, and other drugs that have oto- and nephrotoxic effects.

Neomycin is an antibacterial drug with an antifungal effect. Available in the form of ointment (2% and 5%), powder and tablets (100 and 250 mg).

Pharmacological action of Neomycin

According to the instructions, Neomycin has a wide spectrum of action against gram-negative and gram-positive microbes. The drug is active against Salmonella, Escherichia, Shigella, dysentery and anthrax bacilli, Proteus, meningococci, pneumococci, enterococci, streptococci and staphylococci.

The effect of Neomycin sulfate does not apply to anaerobic bacteria, pathogenic fungi and viruses.

Neomycin is poorly absorbed from the gastrointestinal tract. It is excreted unchanged from the body through the intestines. With cirrhosis of the liver and inflammation or damage to the intestinal mucosa, absorption increases.

The drug is low-toxic and has the ability to penetrate into the cerebrospinal fluid.

Indications for use of Neomycin

Neomycin sulfate in tablet form is prescribed for the treatment of diseases of the gastrointestinal tract (including enteritis caused by microorganisms resistant to other antibacterial agents), as well as before operations on the digestive tract.

Directions for use and dosage

Neomycin is taken orally in the form of a solution or tablets. A single dose for adults is 100-200 mg, daily - no more than 400 mg. For infants and preschool children, the dose of the drug is prescribed at the rate of 4 mg per 1 kg of child weight. The frequency of administration is 2 times a day. Duration of therapy – 1 week.

For infants, an antibiotic solution is prepared, 1 ml of which contains 4 mg of Neomycin. The dose of the drug should be proportional to the child’s body weight.

To prepare the patient for surgery, the drug should be taken for 2 days.

Neomycin solution and ointment are used externally. The solution is prepared in pure distilled water (5 ml of powder per 1 ml of water). A single dose of the applied product should not exceed 30 ml, and a daily dose should not exceed 50-100 ml. The ointment must be applied to the affected areas of the skin 1-4 times a day. Course duration is 3-5 days.

Side effects of Neomycin

When administered orally, Neomycin sulfate may cause nausea, diarrhea, vomiting, skin rash, itching, urticaria, and swelling.

Long-term use of the medication can lead to the development of candidiasis.

Neomycin has a damaging effect on kidney tissue and hearing organs.

Contraindications

Neomycin is not prescribed to people with diseases of the auditory nerve and kidneys. The simultaneous use of the drug with antibiotics that have nephrotoxic and toxic effects is contraindicated.

Neomycin should not be taken by women during pregnancy and lactation.

Overdose

In case of an overdose of Neomycin, a decrease in neuromuscular conduction occurs, accompanied by respiratory arrest.

Additional information

Discontinuation of the drug is required if tinnitus, protein in the urine and allergic reactions occur during Neomycin therapy.

The instructions for Neomycin indicate that the drug should be stored in a cool place and protected from direct sunlight.

Dispensed from pharmacies with a doctor's prescription.

Shelf life – 2 years.

2RS,3S,4S,5R)-5-amino-2-(aminomethyl)-6-((2R,3S,4R,5S)-5-((1R,2R,5R,6R)-3,5-diamino -2-((2R,3S,4R,5S)-3-amino-6-(aminomethyl)-4,5-dihydroxytetrahydro-2H-pyran-2-yloxy)-6-hydroxycyclohexyloxy)-4-hydroxy-2- (hydroxymethyl)tetrahydrofuran-3-yloxy)tetrahydro-2H-pyran-3,4-diol

Chemical properties

Neomycin is a group of first generation aminoglycoside antibiotics. This substance is a mixture of various types Neomycin A , WITH And IN , which is produced actinomycete Streptomyces fradiae or related organisms.

Most often in preparations the substance is in the form neomycin sulfate . The chemical compound is a yellowish or white crystalline powder that has no specific odor, is highly soluble in water and poorly soluble in alcohol. The product is insoluble in organic compounds and hygroscopic. Molecular weight = 614.6 grams per mole.

Pharmacological action

Bactericidal , antibacterial .

Pharmacodynamics and pharmacokinetics

Neomycin penetrates the bacterial cell membrane well and interacts with specific receptor proteins , located on 30S subunit of chromosomes . Under the influence of the drug, the process of formation of the complex from mRNA And tRNA , the synthesis of protein molecules is inhibited. Thus, the substance exhibits bacteriostatic properties. If the antibiotic concentration is 1-2 orders of magnitude higher, then the cytoplasmic membranes of microbial cells are irreversibly damaged and the bacteria die.

Neomycin sulfate is active towards gram negative And gram-positive bacteria: Corynebacterium diphtheriae , streptococci , salmonella , staphylococcus , Escherichia coli , Shigella spp. , Bacillus anthracis , Proteus spp. . Tolerance to the action of the drug develops slowly. The medicine has no effect on anaerobic microorganisms, viruses and pathogenic fungi.

After oral administration, the drug is poorly absorbed (less than 3%) and affects only the intestinal microflora, without penetrating into other tissues and organs. After application to the skin surface, provided there is no damage, systemic absorption of the drug is minimal. However, when applying the product to large surfaces, areas with granulation rash , wounds or abrasions, the substance is quickly and well absorbed and penetrates the systemic bloodstream. The maximum concentration after taking the drug orally is achieved within 30 minutes - 1.5 hours. The degree of binding to blood proteins is small - no more than 10%.

Despite the fact that the drug does not penetrate well into bones, adipose tissue, bile, breast milk and the central nervous system, it crosses the placental barrier. Neomycin is not metabolized. The half-life is no more than 4 hours. That small part of the drug that penetrates the blood plasma is excreted by the kidneys, the rest is excreted in the feces.

If the patient has impaired kidney function, the medicine may accumulate in the blood serum. Intramuscular injections of the drug assume rapid and complete absorption of the active component.

Due to the fact that the drug is poorly absorbed when taken orally, it can be used to treat diseases of the gastrointestinal tract and to prepare for surgical interventions.

This drug decreases the level LDL , bile acids And . However, it does not affect the level triglycerides . The drug is also used for instillation into the conjunctival sac.

Indications for use

The drug is used locally and externally:

for infectious and inflammatory diseases associated with bacteria sensitive to the active substance ( contagious impetigo , , furunculosis , ulcers, wounds and burns, frostbite, pyoderma etc.);
for the prevention of complications after eye surgery.

The medicine may be prescribed internally:

for infections and inflammation in the gastrointestinal tract ( enteritis );
as part of preparatory measures before operations on the gastrointestinal tract, for partial “sterilization” of the intestines.

Contraindications

Neomycin preparations are not used:

when on others aminoglycosides or active component of a medicine;
if local application causes damage to the skin surface;
in patients with large areas of damage, trophic ulcers (for external use);
in combination with nephro- or ototoxic drugs ;
in children under 6 years of age;
for obstructive conditions or intestinal diseases (tablets);
in persons suffering from renal failure (oral intake).

elderly patients;
with damage to the 8th pair of cranial nerves;
patients with,;
at botulism ;
pregnant women;
at ;
during breastfeeding.

Side effects

During topical use of this product, the following may occur: allergic reactions, skin irritation, itching, skin rashes, hyperemia , contact dermatitis .

When taken orally, the following are observed:

nausea, hyperbilirubinemia , vomiting, increased activity of liver enzymes, hypersalivation ;
anemia , granulocytopenia , thrombocytopenia ;
involuntary muscle twitching, numbness of some parts of the body;
leukopenia , increase or decrease in blood pressure;
reticulocytopenia , paresthesia , ;
weight loss, hypocalcemia , hypomagnesemia ;
rarely – weakness, breathing problems, and headaches;
complications in the ears, tinnitus, sensation of blocked ears;
decreased hearing acuity, dizziness;
unsteadiness of gait, deafness (rare);
development of secondary infections, hyponatremia ;
skin allergic reactions, eosinophilia , itching;
, hypokalemia , hyperthermia .

Neomycin, instructions for use (Method and dosage)

The dosage regimen of the drug is individual. Depends on the disease, dosage form, age and condition of the patient.

Instructions for Neomycin Sulfate for oral administration

For children aged 12 years or more and adult patients, the single dosage is 1 gram. In pediatric practice, no more than 0.25-0.5 g of the product is used at a time. The daily dosage is determined by the attending physician on an individual basis.

The maximum duration of treatment is 10 days.

The substance is used locally 1 to 3 times a day. The drug is applied in a thin layer. Avoid treating large areas of skin.

Overdose

In case of an overdose, respiratory arrest occurs, a decrease in neuromuscular conduction, and an increase in other adverse reactions. As a treatment for adults, it is administered intravenously anticholinesterase medications (For example, proserpine 2 minutes after the heart rate increases), calcium supplements, (0.5-07, mg). Atropine injections can be performed.

In case of overdose in children, calcium supplements and artificial ventilation if necessary are indicated. The medicine can be removed by hemolytic dialysis And peritoneal dialysis .

Interaction

Neomycin enhances the effect of taking it indirect anticoagulants , as it reduces metabolic rate vitamin K in the intestinal flora.

When this substance is combined with , ,vitamins A And B12 , cardiac glycosides , chenodeoxycholic acid or oral contraceptives, the effectiveness of the drugs may be reduced.

The medicine should not be taken simultaneously with kanamycin , , and others nephro- And ototoxic antibacterial agents .

Taking medication with drugs that block neuromuscular transmission, capreomycin , aminoglycosides , inhalational anesthetics , citrate preservatives in artificial blood its toxic effect on the ears, kidneys and central nervous system is enhanced.

Terms of sale

You must have your prescription with you.

Special instructions

You should avoid applying ointment or gel to a large or damaged area of skin, as this can lead to hearing loss and the development of other undesirable side reactions.

At perforation of the eardrum Taking this antibiotic orally is highly not recommended.

If during therapy the patient begins to have noise in the ears, protein is detected in the urine, or allergic reactions develop, then the drug must be stopped.

Treatment with the drug should not be carried out for more than 10 days, as the risk of developing skin sensitization or cross-sensitivity to other antibiotics of this group increases.

For children

Elderly

Antibiotic treatment should be used with extreme caution in persons over 65 years of age.

During pregnancy and lactation

During pregnancy, the medicine is not prescribed, as it can cause disturbances in the development of the 8th pair of cranial nerves in the fetus.

It should also be remembered that the active substance is excreted in small quantities in breast milk. The question of stopping breastfeeding should be raised.

Drugs containing (Analogues)

Level 4 ATX code matches:

This substance is included in: tablets Neomycin , Neomycin sulfate .

Also in combination with other active ingredients, Neomycin is found in the following preparations: Flukort N , , Nefluan , , Polygynax Virgo , , (neomycin and), , Dexon , Triasept , , With phenylephrine , Trofodermin , , Betnovate , Elzhina .