Netilmicin

Indications
 Parenteral
Susceptible infections
Adult: 4-6 mg/kg once daily or in equally divided doses given every 8 or 12 hr. Life-threatening infections: Increase to up to 7.5 mg/kg daily every 8 hr. All doses may be given as IM, slow IV (over 3-5 min) or as 50-200 ml infusion over 0.5-2 hr. Treatment is usually given for 7-14 days.
Child: Premature infants and neonates <1 wk: 6 mg/kg daily in divided doses every 12 hr. Infants and neonates >1 wk: 7.5-9 mg/kg daily in divided doses every 8 hr. Older children: 6-7.5 mg/kg daily in divided doses every 8 hr. Alternative regimen: Neonates <6 wk: 4-6.5 mg/kg daily in divided doses every 12 hr. Older infants and children: 5.5-8 mg/kg daily in divided doses every 8 or 12 hr.
Renal impairment: Dose reduction or lengthening of interval between doses may be necessary. Haemodialysis: 50% of initial loading dose is required after dialysis.
Parenteral
Urinary tract infections
Adult: 150 mg as a single daily dose for 5 days. Complicated UTI: 3-4 mg/kg daily in divided doses every 12 hr. All doses may be given as IM, slow IV (over 3-5 min) or as a 50-200 ml infusion over 0.5-2 hr. Treatment is usually given for 7-14 days.
Renal impairment: Dose reduction or lengthening of interval between doses may be necessary. Haemodialysis: 50% of initial loading dose is required after dialysis.

Incompatibility: Do not mix in the same syringe with penicillins or cephalosporins.
Contraindications
 Hypersensitivity to the drug or other aminoglycosides.
Warnings / Precautions
 Renal impairment; monitor renal, vestibular and auditory function. Monitor peak serum levels. Myasthenia gravis, parkinsonism, infant botulism; conditions predisposing to ototoxicity and nephrotoxicity. Premature and neonatal infants, dehydration, elderly. Pregnancy and lactation.
Adverse Reactions
 Headache, malaise, visual disturbances, disorientation, tachycardia, hypotension, palpitations, thrombocytosis, paraesthesia, rash, chills, fever, fluid retention, vomiting, diarrhoea. Increased blood sugar; increased alkaline phosphatase; increased liver enzymes, bilirubin; increased potassium; other abnormal LFTs; decreased haemoglobin, WBCs and platelets; eosinophilia, anaemia and increase in prothrombin time.
Potentially Fatal: Nephrotoxicity; ototoxicity; anaphylaxis.
Overdose Reactions
 Haemodialysis will be beneficial. Institute appropriate supportive therapy.
Drug Interactions
 Potentially Fatal: Increased incidence of ototoxicity with ethacrynic acid and furosemide. Increased risk of nephrotoxicity/ototoxicity with cisplatin, bacitracin, polymyxin B, colistin, cefaloridine, amphotericin B, kanamycin, aciclovir, gentamicin, amikacin, sisomicin, tobramycin, neomycin, streptomycin, paromomycin, viomycin and vancomycin. Increased risk of prolonged neuromuscular blockade and respiratory arrest with neuromuscular blocking gents, anaesthetics.
See Below for More netilmicin Drug Interactions
Mechanism of Actions
 Netilmicin, an aminoglycoside antibiotic, binds to 30S and to some extent to 50S ribosomal subunit of susceptible bacteria disrupting photosynthesis, thus rendering the bacterial cell membrane defective.
Absorption: Rapidly and completely absorbed (IM). Peak plasma concentrations after 0.5-1 hr (IM), 1 hr (IV infusion).
Excretion: Via urine within 24 hr (80% of a dose); 2-2.5 hr (elimination half-life).
Storage Conditions
 Parenteral: Store at 2-30°C. Do not freeze.
ATC Classification
 J01GB07 - netilmicin ; Belongs to the class of other aminoglycosides. Used in the systemic treatment of infections.
S01AA23 - netilmicin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
Storage
 Parenteral: Store at 2-30°C. Do not freeze.
Available As
  • Netilmicin 10 mg
  • Netilmicin Sulphate 10 mg
  • Netilmicin 100 mg
  • Netilmicin Sulphate 100 mg
  • Netilmicin 150 mg
  • Netilmicin Sulphate 25 mg
  • Netilmicin 25 mg
  • Netilmicin Sulphate 50 mg
  • Netilmicin 50 mg

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