A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Neomycin Sulfate Indications, Dosage, Storage, Stability - Neomycin Sulfate
Neomycin Sulfate Indications, Dosage, Storage, Stability - Neomycin Sulfate
INDICATIONS
Suppression of Intestinal Bacteria: Neomycin sulfate tablets are
indicated as adjunctive therapy as party of a regimen for the suppression
of the normal bacterial flora of the bowel, eg, preoperative preparation
of the bowel. It is given concomitantly with erythromycin enteric-coated
base (see DOSAGE AND ADMINISTRATION
section).
Hepatic Coma (portal-systemic encephalopathy): Neomycin sulfate
has been shown to be effective adjunctive therapy in hepatic coma by reduction
of the ammonia-forming bacteria in the intestinal tract. The subsequent
reduction in blood ammonia has resulted in neurologic improvement.
DOSAGE AND ADMINISTRATION
To minimize the risk of toxicity, use the lowest possible dose and the
shortest possible treatment period to control the condition. Treatment
for periods longer than two weeks is not recommended.
Hepatic Coma
For use as an adjunct in the management of hepatic coma, the recommended
dose is 4-12 grams per day given in the following regimen:
1. Withdraw protein from diet. Avoid use of diuretic agents.
2. Give supportive therapy, including blood products, as indicated.
3. Give Neomycin Sulfate Tablets in doses of 4-12 grams of neomycin sulfate
per day (eight to 24 tablets) in divided doses. Treatment should be continued
over a period of five to six days, during which time protein should be
returned incrementally to the diet.
4. If less potentially toxic drugs cannot be used for chronic hepatic
insufficiency, neomycin in doses of up to four grams daily (eight tablets
per day) may be necessary. The risk for the development of neomycin-induced
toxicity progressively increases when treatment must be extended to preserve
the life of a patient with hepatic encephalopathy who has failed to fully
respond. Frequent periodic monitoring of these patients to ascertain the
presence of drug toxicity is mandatory (see PRECAUTIONS).
Also, neomycin serum concentrations should be monitored to avoid potentially
toxic levels. The benefits to the patient should be weighed against the
risks of nephrotoxicity, permanent ototoxicity and neuromuscular blockade
following the accumulation of neomycin in the tissues.
Preoperative Prophylaxis for Elective Colorectal Surgery
Listed below is an example of a recommended bowel preparation regimen.
A proposed surgery time of 8:00 am. has been used.
Pre-op Day 3: Minimum residue or clear liquid diet. Bisacodyl,
1 tablet orally at 6:00 p. m.
Pre-op Day 2: Minimum residue or clear liquid diet. Magnesium
sulfate, 30 mL, 50% solution (15 g) orally at 10:00 a.m., 2:00 p.m., and
6:00 p.m. Enema at 7:00 p.m. and 8:00 p.m.
Pre-op Day 1: Clear liquid diet. Supplemental (IV) fluids as needed.
Magnesium sulfate, 30 mL, 50% solution (15 g) orally at 10:00 a. m., and
2:00 p.m. Neomycin sulfate (1 g) and erythromycin base (1 g) orally at
1:00 p. m., 2:00 p.m. and 11:00 p.m. No enema.
Day of Operation: Patient evacuates rectum at 6:30 a.m. for scheduled
operation at 8:00 a.m.
HOW SUPPLIED
Neomycin Sulfate Tablets, USP, 500 mg (equivalent to 350 mg of neomycin
base per tablet) are available as round, off-white, unscored tablets,
imprinted “BL” and “18”, in bottles of 100 tablets.
Store at controlled room temperature 15°-30° C( 59°-86°
F). Dispense in tight containers as defined in the USP/NF.
CAUTION: Federal law prohibits dispensing without prescription.
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