Amikacin

Indications
Parenteral
Uncomplicated urinary tract infections
Adult: 250 mg bid, given via IM, IV inj over 2-3 minutes or as IV infusion.
Max Dosage:
Renal impairment: Dosage adjustments may be made by (a) normal doses at increased dosing intervals or (b) reduced doses at the usual intervals. For (a), dosing interval (in hr) can be calculated by multiplying the patient's serum creatinine (mg/100ml) by 9. For (b), initiate at normal dose. Maintenance doses can be calculated by dividing the normal dose by the patient's serum creatinine.
Parenteral
Severe Gram-negative infections resistant to gentamicin and tobramycin
Adult: 15 mg/kg daily in equally divided doses injected every 8 or 12 hr for 7-10 days. Max: Up to 500 mg every 8 hr in life-threatening infections. Max cumulative dose: 15 g. Doses may be given via IM, slow IV inj over 2-3 minutes or IV infusion.
Child: 15 mg/kg daily in equally divided doses injected every 8 or 12 hr for 7-10 days. Neonates: 10 mg/kg daily in 2 divided doses.
Renal impairment: Dosage adjustments may be made by (a) normal doses at increased dosing intervals or (b) reduced doses at the usual intervals. For (a), dosing interval (in hr) can be calculated by multiplying the patient's serum creatinine (mg/100ml) by 9. For (b), initiate at normal dose. Maintenance doses can be calculated by dividing the normal dose by the patient's serum creatinine.

Special Populations: Dosage in renal impairment: A rough guide for calculating the dose in stable patients is to divide the normal dose by the patient's serum creatinine. This dose is given every 12 hrs. More accurate methods for dose calculation are also available.
Contraindications
Pregnancy, perforated ear drum, myasthenia gravis, hypersensitivity.
Warnings / Precautions
Renal impairment; vertigo, tinnitus. Discontinue if signs of ototoxicity, neurotoxicity or hypersensitivity occurs; lactation. Safety has not been established for treatment period >14 days. Monitor renal function before and during treatment.
Adverse Reactions
Tinnitus, vertigo; ataxia and overt deafness.
Potentially Fatal: Ototoxicity, nephrotoxicity, neuromuscular blockade.
Overdose Reactions
Peritoneal dialysis or haemodialysis may be used in case of overdosage.
Drug Interactions
Amphotericin B may lead to increased nephrotoxicity and reduced clearance of amikacin when used together.
Potentially Fatal: Increased ototoxic or nephrotoxic effects with other nephrotoxic or ototoxic drugs. Enhanced neuromuscular blockade with neuromuscular blocking drugs. Increased risk of ototoxicity with potent diuretics.
See Below for More amikacin Drug Interactions
Mechanism of Actions
Amikacin binds to 30S ribosomal subunits of susceptible bacteria, thus inhibiting its protein synthesis.
Distribution: Detected in body tissues and fluids after inj; crosses the placenta but does not readily penetrate the CSF. Significant amounts penetrate the blood-brain barrier in children with meningitis.
Excretion: Via the urine by glomerular filtration (within 24 hr); 2-3 hr (elimination half-life).
Storage Conditions
Parenteral: Store at 15-30°C.
ATC Classification
D06AX12 - amikacin ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases.
J01GB06 - amikacin ; Belongs to the class of other aminoglycosides. Used in the systemic treatment of infections.
S01AA21 - amikacin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
Storage
Parenteral: Store at 15-30°C.
Available As
  • Amikacin Sulphate 0.3%
  • Amikacin 0.3%
  • Amikacin Sulphate 0.5% w/v
  • Amikacin 100 mg
  • Amikacin Sulphate 100 mg
  • Amikacin 125 mg
  • Amikacin 200 mg
  • Amikacin 25 mg
  • Amikacin Sulphate 25 mg
  • Amikacin 250 mg
  • Amikacin Sulphate 250 mg
  • Amikacin 50 mg
  • Amikacin Sulphate 50 mg
  • Amikacin 500 mg
  • Amikacin Sulphate 500 mg
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