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Amikacin

Antibiotic, Bactericidal, Aminoglycoside Antibiotic, Ototoxic drug, Nephrotoxic drug

Brand Names

Amifuse E, Amiglyde-V®, Amiject D, Amikacin C Injection, Amikacin E, Amikacin K-9, Amikin®, Amimax™ C, Amimax™ E, Caniglide™, Equi-Phar EquiGlide™

Drug Information

Pharmacology

Aminoglycoside bactericidal antibiotic

Contraindications

General
  • Contraindicated in patients with known sensitivity to this type of drug.
  • Use with extreme caution with pre existing renal disease and with close monitoring and dose interval adjustment.
  • Use with caution in neonates and geriatric patients, fever, sepsis and dehydration.
  • Use with caution in patients with neuromuscular disease due to the neuromuscular blocking activity.
  • Contraindicated in pregnancy.
General
  • Do not use in animals intended for human consumption.
Horse
  • Don’t breed mare for at least 8 hours after intrauterine infusion.
Dog
  • Can cause irreversible ototoxicity – use with caution in working dogs, i.e. seeing eye dogs.
Cat
  • Cats may be more sensitive to toxic effects.
Rabbit
  • Contraindicated in rabbits as they adversely affect GI flora.

Adverse Effects

General
  • Nephrotoxic, ototoxic auditory or vestibular.
  • Can also cause neuromuscular blockade and respiratory paralysis, facial edema, pain and inflammation at injection site, peripheral neuropathy and hypersensitivity reactions.
  • Rarely GI, hematologic and hepatic.

Interactions

Category Interactions
Anesthesia
  • Neuromuscular blockade effects may be potentiated.
Cephalosporin antibiotic
  • May cause additive nephrotoxicity-only documented with cephalothin.
Diuretic
  • May increase toxicity.
Nephrotoxic drug
  • May increase risk of nephrotoxicity.
Neuromuscular blocker
  • May be potentiated.
Ototoxic drug
  • May increase risk of ototoxicity.
Drug Interactions
Cephalothin sodium
  • May cause additive nephrotoxicity.
Furosemide
  • Nephrotoxicity is enhanced with furosemide.

Comments

For information regarding compatibility in solution or combination with other drugs, refer to specialized reference material.
Amikacin serum concentrations an be falsely decreased if used with Beta lactam antibiotics.
If monitoring serum levels draw sample at peak and trough levels are advised.
Therapeutic levels are reported to be 2 – 25 microgram/mL depending on the susceptibility of the organism, Consult reference material for more information.
Monitor efficacy, renal toxicity with baseline urinalysis, serum BUN and creatinine.
Urine casts may be first indication of renal side effect.
Monitor for auditory or vestibular dysfunction.
Injectable solution may become pale yellow with time but does not affect potency.

Available Forms

Human
  • Injection in 50 mg/mL and 250 mg/mL , Amikin® and generic
Veterinary – General
  • Injection 50 mg/mL in 50 mL bottle, Amiglyde V®, Amiject D, Amikacin C Injection, Amikacin K-9 Injection, Amimax™ C, Caniglide™ and generic. Approved for use in dogs. Intrauterine solution 250 mg/mL in 48 mL vials- Amiglyde – V ® Intrauterine, Amifuse E, Amikacin E, Amimax™ E, Equi-Phar EquiGlide™. Approved for intrauterine use in horses.