Applies to neomycin: oral solution, oral tablet.
Warning
Oral route (Tablet; Solution)
Systemic absorption of neomycin occurs following oral administration and toxic reactions may occur. Patients treated with neomycin should be under close clinical observation because of the potential toxicity associated with their use.Neurotoxicity (including ototoxicity) and nephrotoxicity following the oral use of neomycin sulfate have been reported, even when used in recommended doses. The potential for nephrotoxicity, permanent bilateral auditory ototoxicity and sometimes vestibular toxicity is present in patients with normal renal function when treated with higher doses of neomycin and/or for longer periods that recommended. Serial, vestibular, and audiometric tests, as well as tests of renal function, should be performed (especially in high risk patients).The risk of nephrotoxicity and ototoxicity is greater in patients with impaired renal function. Ototoxicity is often delayed in onset and patients developing cochlear damage will not have symptoms during therapy to warn them of developing eighth nerve destruction and total or partial deafness may occur long after neomycin has been discontinued.Neuromuscular blockage and respiratory paralysis have been reported following the oral use of neomycin. The possibility of the occurrence of neuromuscular blockage and respiratory paralysis should be considered if neomycin is administered, especially to patients receiving anesthetics, neuromuscular blocking agents such as tubocurarine, succinylcholine, decamethonium, or in patients receiving massive transfusions of citrate anticoagulated blood. If blockage occurs, calcium salts may reverse these phenomena but mechanical respiratory assistance may be necessary.Concurrent and/or sequential systemic, oral, or topical use of other aminoglycosides, including paromomycin and other potentially nephrotoxic and/or neurotoxic drugs such as bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin, and viomycin should be avoided because the toxicity may be additive.Other factors which increase the risk of toxicity are advanced age and dehydration.The concurrent use of neomycin with potent diuretics such as ethacrynic acid or furosemide should be avoided since certain diuretics by themselves may cause ototoxicity. In addition, when administered intravenously, diuretics may enhance neomycin toxicity by altering the antibiotic concentration in serum and tissue.
Serious side effects of Neomycin
Along with its needed effects, neomycin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking neomycin:
Rare
- Any loss of hearing
- clumsiness
- diarrhea
- difficulty in breathing
- dizziness
- drowsiness
- greatly decreased frequency of urination or amount of urine
- increased amount of gas
- increased thirst
- light-colored, frothy, fatty-appearing stools
- ringing or buzzing or a feeling of fullness in the ears
- skin rash
- unsteadiness
- weakness
Other side effects of Neomycin
Some side effects of neomycin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Irritation or soreness of the mouth or rectal area
- nausea or vomiting
For Healthcare Professionals
Applies to neomycin: compounding powder, oral solution, oral tablet.
General
The most commonly reported side effects included diarrhea, nausea, and vomiting.[Ref]
Gastrointestinal
Common (1% to 10%): Diarrhea, nausea, vomiting
Frequency not reported: Increased fecal fat, increased salivation, steatorrhea, stomatitis[Ref]
Metabolic
Metabolic syndrome occurred with prolonged therapy, and included increased fecal fat, steatorrhea, decreased serum carotene, and a fall in xylose absorption. Steatorrhea and diarrhea occurring during metabolic syndrome can be very severe.[Ref]
Frequency not reported: Decreased serum carotene, electrolyte disturbances, fall in xylose absorption, hypocalcemia, hypokalemia, hypomagnesemia, malabsorption syndrome[Ref]
Nervous system
Frequency not reported: Neuromuscular blockade/blockage, neurotoxicity, nystagmus, paresthesia, vestibular toxicity[Ref]
Other
Frequency not reported: Drug fever, ototoxicity, permanent bilateral ototoxicity[Ref]
Hypersensitivity
Frequency not reported: Anaphylaxis, cross-sensitivity, hypersensitivity reactions[Ref]
Hepatic
Frequency not reported: Increased bilirubin levels, increased hepatic enzyme levels[Ref]
Hematologic
Frequency not reported: Blood dyscrasias, hemolytic anemia[Ref]
Psychiatric
Frequency not reported: Confusion, disorientation[Ref]
Dermatologic
Frequency not reported: Dermatitis, pruritus[Ref]
Renal
Frequency not reported: Nephrotoxicity[Ref]
Immunologic
Frequency not reported: Superinfection[Ref]
Superinfection occurred with prolonged therapy.[Ref]
Respiratory
Frequency not reported: Respiratory paralysis[Ref]
