Aminoglycosides – Warnings, Precautions, Side Effects & Interactions

These antibiotics are used mainly to treat serious infections in a clinical setting.

Aminoglycosides are a class of antibiotics used to treat serious infections caused by bacteria that either multiply very quickly or are difficult to treat.

Aminoglycosides are called bactericidal antibiotics because they kill bacteria directly. They accomplish this by stopping bacteria from producing proteins needed for their survival.

Because aminoglycosides are normally used to treat serious infections, they are typically administered into the veins of the body (intravenously, or IV).

However, some aminoglycosides can be taken orally, or as ear or eye drops.

Examples of aminoglycosides include:

  • Gentamicin (generic version is IV only)
  • Amikacin (IV only)
  • Tobramycin
  • Gentak and Genoptic (eye drops)
  • Kanamycin
  • Streptomycin
  • Neo-Fradin (oral)
  • Neomycin (generic version is IV only)

Warnings and Precautions

Avoid aminoglycosides if you're allergic to them or any inactive ingredients these drugs may contain.

Also, you might want to ask your doctor about aminoglycosides if you:

  • Are allergic to sulfites (often found in certain wines and dried fruits)
  • Have kidney or hearing problems, including problems with balance and uncontrollable eye movements
  • Have a disorder affecting the nerves and muscles, like multiple sclerosis or myasthenia gravis.
  • Are 65 years of age or older
  • You have a newborn or very young baby who might be treated for a serious infection using aminoglycosides

Common Side Effects

Aminoglycosides are very powerful antibiotics, and their side effects can be severe — especially when taken by mouth or IV.

The Food and Drug Administration (FDA) has issued black-box warnings for aminoglycosides taken orally or intravenously, noting the following possible side effects:

  • Damage to the hearing structures in the ear, resulting in hearing loss
  • Damage to the inner ear, resulting in trouble maintaining balance
  • Kidney damage (noted by protein in the urine, dehydration, and low levels of magnesium)
  • Paralysis of skeletal muscles

Although side effects and their severity may vary from person to person, the higher the dose of an aminoglycoside you receive, or the longer the duration of use, the greater your risk of side effects.

Drug Interactions

Don't take aminoglycosides by mouth or intravenously if you're already taking:

  • Theracrys (BCG live intravesical)
  • Vistide (cidofovir)
  • Zanosar (streptozocin)

Ask your doctor about aminoglycosides if you're already taking "water pills" known as loop diuretics, such as Lasix (furosemide) or Demadex (torsemide).

Talk to your doctor about aminoglycosides if you're about to undergo surgery.

Certain drugs called neuromuscular blocking agents, often used to prevent patients from moving during surgery, enhance some of the side effects of aminoglycosides.

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