Antimicrobials
Neomycin (oral)

Neomycin (oral)

N/A
Low

Spectrum of Activity

Dosing

General Information

  • Perioperative prophylaxis: Oral antibiotic bowel preparation (OAP)
  • Hepatic Encephalopathy
  • Small intestinal bacterial overgrowth (SIBO): Intestinal methanogen overgrowth (IMO)
  • Gastrointestinal: Anorectal pain, diarrhea, mouth irritation, nausea, rectal irritation, vomiting
  • Neomycin is more nephrotoxic compared to other aminoglycosides; however, absorption is very limited with oral administration

Digoxin: may increase serum digoxin level due to the alteration of microbial gut flora by oral neomycin. Monitor for digoxin toxicity and serum concentrations. Dose of digoxin may need to be decreased.

Nephrotoxic agents: may increase risk of nephrotoxicity, but likely only significant for patients with significant renal impairment due to limited absorption.

Serum creatinine/BUN at baseline.

Minimal absorption across GI mucosa or skin surfaces; however, with ulceration, open, or burned surfaces (especially large surfaces), absorption is possible; monitor for ototoxicity, nephrotoxicity, and neurotoxicity.

In ~2000 Oral Neomycin (Mycifradin®) was removed from the Canadian market. Currently oral neomycin for humans can only be compounded by specialty pharmacies specializing in non-sterile compounding.

Antimicrobial class: Aminoglycoside

Pregnancy category: D

Average serum half life: 2 hours

97% of an orally administered dose remains in the GI tract; the remainder concentrates mainly in the renal cortex. With repeat doses, accumulation may occur in the inner ear.

Neomycin can be obtained from Bracebridge Compounding Pharmacy or Laclie Pharmacy (Orillia).