Concurrent use of neuromuscular blocking agents; myasthenia gravis, parkinsonism; conditions predisposing to ototoxicity and nephrotoxicity; lactation. Monitor plasma concentrations of gentamicin in patients receiving high doses or prolonged courses, in infants, elderly, patients with renal impairment, cystic fibrosis or significant obesity. Monitor auditory and renal functions.
Lactation: safety in nursing infants unknown
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Gentamicin is an aminoglycoside that binds to 30s and 50s ribosomal subunits of susceptible bacteria disrupting protein synthesis, thus rendering the bacterial cell membrane defective.
Interaction
Additive effect w/ other neurotoxic and/or nephrotoxic drugs including cephalosporins, methicillin, amphotericin B, ciclosporin, cisplatin, potent diuretics (e.g. ethacrynic acid, furosemide) and neuromuscular blocking agents (e.g. succinylcholine, tubocurarine). May potentiate the effect of anticoagulants (e.g. warfarin, phenindione). May antagonise the effect of neostigmine and pyridostigmine. Increased risk of hypocalcaemia w/ bisphosphonates. Increased risk of neuromuscular blockade w/ botulinum toxin. Indometacin may increase the plasma concentration of gentamicin in neonates.
Pregnancy Category Note
Pregnancy Category: C
Lactation: safety in nursing infants unknown
Adult Dose
Ophthalmic
Superficial ophthalmic infections
Adult: As eye drops: Instill 1-2 drops into affected eye up to 6 times daily.
For severe infections, initially, 1-2 drops every 15 min, reducing the frequency gradually as the infection is controlled.
As eye oint: Place a small amount into the conjunctival sac 2-3 times daily.
Otic/Aural
Otitis externa
Adult: As ear drops: Instill 2-3 drops in the affected ear 3-4 times a day and at night.
Child Dose
Ophthalmic
Superficial ophthalmic infections
Child: As eye drops: Instill 1-2 drops into affected eye up to 6 times daily.
For severe infections, initially, 1-2 drops every 15 min, reducing the frequency gradually as the infection is controlled.
As eye oint: Place a small amount into the conjunctival sac 2-3 times daily.
Otic/Aural
Otitis externa
Child: As ear drops: Instill 2-3 drops in the affected ear 3-4 times a day and at night.
Renal Dose
N/A
Administration
N/A
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