Brand Names

Category

• Bowel preparation, preoperative, adjunct
• Hepatic encephalopathy therapy adjunct

Description

Oral neomycin (nee-oh-MYE-sin) is used to help lessen the symptoms of hepatic coma, a complication of liver disease. In addition, it may be used with another medicine before any surgery affecting the bowels to help prevent infection during surgery.

Neomycin is available only with your doctor's prescription, in the following dosage forms:

Oral
• Solution (U.S. and Canada)
• Tablets (U.S. and Canada)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For oral neomycin, the following should be considered:

Allergies--Tell your doctor if you have ever had any unusual or allergic reaction to oral neomycin, or to any related antibiotics such as amikacin (e.g., Amikin), gentamicin (e.g., Garamycin), kanamycin (e.g., Kantrex), neomycin by injection (e.g., Mycifradin), netilmicin (e.g., Netromycin), streptomycin, or tobramycin (e.g., Nebcin). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy--Studies have shown that neomycin may damage the infant's kidneys. In addition, some reports have shown that related medicines, especially streptomycin and tobramycin (e.g., Nebcin), may damage the infant's hearing and sense of balance. Be sure you have discussed this with your doctor.

Breast-feeding--It is not known whether neomycin passes into the breast milk. However, neomycin has not been reported to cause problems in nursing babies.

Children--Damage to hearing, sense of balance, and kidneys is more likely to occur in premature infants and neonates, who are more sensitive than adults to the effects of neomycin.

Older adults--Serious side effects, such as damage to hearing, sense of balance, and kidneys may occur in elderly patients, who are usually more sensitive than younger adults to the effects of neomycin.

Other medicines--Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems--The presence of other medical problems may affect the use of oral neomycin. Make sure you tell your doctor if you have any other medical problems, especially:

• Blockage of the bowel

• Eighth-cranial-nerve disease (loss of hearing and/or balance)--Oral neomycin may increase the chance of hearing loss and/or balance problems

• Kidney disease--Patients with kidney disease may have an increased chance of side effects

• Myasthenia gravis or
• Parkinson's disease--Patients with myasthenia gravis or Parkinson's disease may have an increased chance of developing muscular weakness

• Ulcers of the bowel--Patients with ulcers of the bowel may have an increased chance of side effects since more neomycin may be absorbed by the body

Proper Use of This Medicine

This medicine may be taken on a full or empty stomach.

For patients taking the oral liquid form of neomycin:

• Use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

Keep taking this medicine for the full time of treatment. Do not miss any doses .

Dosing--The dose of oral neomycin will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of oral neomycin. If your dose is different, do not change it unless your doctor tells you to do so.

• For oral dosage forms (solution, tablets):
  • For patients in a coma from liver disease:
    • Adults and teenagers--1 to 3 grams every six hours for five or six days.
    • Children--Dose is based on body size (not weight) and must be determined by your doctor. That dose is given every six hours for five or six days.
  • For cleaning the bowel before surgery:
    • Adults and teenagers--1 gram every hour for four hours, then 1 gram every four hours for the rest of a twenty-four hour period; or 1 gram nineteen hours before surgery, 1 gram eighteen hours before surgery, and 1 gram nine hours before surgery.
    • Children--Dose is based on body weight. The usual dose is 14.7 milligrams (mg) per kilogram (kg) (6.7 mg per pound) of body weight every four hours for three days.

Missed dose--If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage--To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the oral liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Any loss of hearing; clumsiness; diarrhea; difficulty in breathing; dizziness; drowsiness; greatly decreased frequency of urination or amount of urine; increased amount of gas; increased thirst; light-colored, frothy, fatty-appearing stools; ringing or buzzing or a feeling of fullness in the ears; skin rash; unsteadiness; weakness

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common

Irritation or soreness of the mouth or rectal area; nausea or vomiting

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 10/20/92
Interim revision: 03/17/94

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