Monitor creatinine at baseline and every 2 to 3 days.
Monitor for vestibulotoxicity/ototoxicity, discontinue if any signs.
Extended interval dosing: Target trough within 30 minutes before dose of <1 mg/L
Conventional dosing: Peak monitoring poorly supported by literature, but target peak 6-10 mg/L for most infections; trough < 2 mg/L only if using >4 days
NB: Trough level is 0-30min before a dose (usually pre-3rd or 4th dose), and peak is 30-60min after dose infused (usually post-3rd or 4th dose).
In critically ill patients, check peak level after the 1st dose as volume of distribution and renal function may change rapidly.
Nephrotoxicity (non-oliguric)
Vestibulocochlear toxicity
Can exacerbate neuromuscular blockade
Increased nephrotoxicity
Increased ototoxicity
Non-depolarizing muscle relaxants may be potentiated
Antimicrobial class: Aminoglycoside
Pregnancy category: D
Average serum half life: 2 hours
Urine penetration: Therapeutic
Lung penetration: Therapeutic; do not use as monotherapy for lung infections
CSF penetration: Poor
Biliary penetration: Moderate