• Bacterial infections:
    • Adults:
      • Conventional interval dosing: IM/IV 7.5mg/kg/dose BD OR 5mg/kg/dose TDS
      • Extended interval dosing: IM/IV 15-20mg/kg/dose OD
        • Not indicated in pregnancy, burns, ascites, obesity, neutropenia or endocarditis
    • Child ≥ 1 month:
      • IV 5-7.5mg/kg/dose TDS
    • <30 week gestation:
      • 0-7 days: IV 18mg/kg/dose every 48h
      • 8-28 days: IV 15mg/kg/dose every 36h
      • ≥ 29 days: IV 15mg/kg/dose OD
    • 30-34 week gestation:
      • 0-7 days: IV 18mg/kg/dose every 36h
      • ≥8 days: IV 15mg/kg/dose OD
    • ≥35 week gestation
      • 0-28 days: IV 15mg/kg/dose OD
  • Hospital-acquired or ventilator-associated pneumonia:
    • IV 15-20mg/kg/dose OD *1/52
    • May administer with antipseudomonal beta-lactam or carbapenem  
  • Urinary tract infections (other than those caused by Pseudomonas):
    • IV/IM 250mg BD
      • A urinary alkalinising agent may be administered concurrently to increase pH and consequently enhance amikacin activity.
    • Active TB (Off-label):
      • IV/IM 10-15mg/kg/dose
        • Not 1st-line agent
        • Part of multi-drug regimen
  • Bacterial endophthalmitis (Off-label):
    • 4mg in 0.1mL sterile water or saline intravitreally *1
  • Injection:
    • 500mg/2mL
    • 125mg/2mL
  • Dilute 500mg to 100 or 200mL sterile diluent (0.9% NaCl or D5W)
  • IM: Administer undiluted to upper outer quadrant of buttocks
  • IV: Infuse over 30-60 min in adults and children; infuse over 1-2h in infants
  • Do NOT mix with other medicines in a syringe or IV bag

Aminoglycoside

It irreversibly binds to 30S subunit of bacterial ribosomes inhibiting protein synthesis

  • Elevated BUN or Cr
  • Hearing loss
  • Tinnitus
  • Dizziness
  • Vertigo
  • Injection site reaction
  • Neurotoxicity
  • Nephrotoxicity
  • Hypersensitivity to class/components

WARNING

  • Increased risk of neurotoxicity, nephrotoxicity and ototoxicity
  • Avoid concurrent or sequential use of neurotoxic and/or nephrotoxic drugs including other aminoglycosides (eg, amikacin, streptomycin, neomycin, kanamycin, gentamicin, paromomycin)
  • Avoid potent diuretics (eg, ethacrynic acid, furosemide) because they increase risk of ototoxicity.
  • Use with caution in premature infants and neonates because of renal immaturity and the resulting prolongation of serum half-life of the drug.
  • Neuromuscular blockade including respiratory paralysis possible
  • Amphotericin B
  • Cidofovir
  • Neomycin

                                   Drug Status

Availability Prescription only
Pregnancy Category D
Breastfeeding Not recommended
Schedule Not scheduled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Amika 500 500mg/2mL Injection 1’s Synermed Pharma Synermed Pharma
Amikanex 500mg/2mL Injection 1’s Umedica Labs Unisel Ltd
Amilab 500mg/2mL Injection 1’s Laborate India Harley’s Ltd
Mica 500mg/2mL Injection 1’s Brawn Labs Sai Pharma
Amikacin 500mg/2mL Injection 1’s Dawa Ltd Dawa Ltd
Lanomycin 500mg/2mL Injection 1’s Pharmathen Pharma Goodman Agencies
Lanomycin 125mg/2mL Injection 1’s Pharmathen Pharma Goodman Agencies