What is neomycin sulfate?

Neomycin Sulfate

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 12/13/2016

Neomycin Sulfate is an antibiotic used to reduce the risk of infection during surgery of the bowel. Neomycin is also used to reduce the symptoms of hepatic coma. Neomycin sulfate is available in generic form. Common side effects of neomycin sulfate include:

  • nausea,
  • vomiting, or
  • diarrhea.

Contact your doctor if you have serious side effects of neomycin including:

  • drowsiness,
  • confusion,
  • mood changes,
  • increased thirst,
  • loss of appetite,
  • weight gain,
  • shortness of breath,
  • shallow breathing,
  • hearing problems,
  • spinning sensation,
  • feeling like you might pass out,
  • loss of balance or coordination,
  • trouble walking,
  • numbness or tingly feeling under your skin,
  • muscle twitching,
  • seizures (convulsions),
  • urinating less than usual or not at all,
  • swelling,
  • severe stomach cramps, or
  • diarrhea that is watery or bloody.

Neomycin Sulfate dose depends on the condition being treated. The lowest possible dose and the shortest possible treatment period to control the condition should be used to reduce toxicity. Neomycin Sulfate may interact with other drugs that affect the kidneys, Do not take any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, without first talking to your doctor. It is not recommended to take Neomycin Sulfate during pregnancy, as it is known to be harmful to a fetus. It is not known whether this medication passes into breast milk. Consult your doctor before breastfeeding.

Our Neomycin Sulfate Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

SIDE EFFECTS: See also Warning section.Nausea, vomiting, and diarrhea may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: difficulty walking, numbness/tingling, muscle twitching or weakness, seizure.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking neomycin tablets, tell your doctor or pharmacist if you are allergic to it; or to other aminoglycoside antibiotics (such as tobramycin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: hearing problems (including deafness, decreased hearing), intestinal problems (including blockage, swelling, ulcers), kidney problems, myasthenia gravis, Parkinson’s disease.High doses or longer use of neomycin may cause your body to not properly absorb some foods, nutrients (such as iron, Vitamins A and B-12), and drugs (such as digoxin, warfarin). Consult your doctor for more details.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Newborn and premature babies may be more sensitive to the side effects of this drug, especially hearing problems.This medication is not recommended for use during pregnancy. Although there have been reports of harm in babies born to women using similar drugs, the risk for harm may not be the same with this drug. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. However, many doctors consider breastfeeding safe while using this medication. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: See also Precautions section.The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor’s approval.Other medications that may affect the kidneys or hearing may increase the risk of kidney damage or hearing loss if taken with neomycin. Some examples include: amikacin, tobramycin, amphotericin B, cidofovir, cisplatin, polymyxin B, cephalosporins such as cephaloridine, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, among others.Although most antibiotics probably do not affect hormonal birth control such as pills, patch, or ring, some antibiotics may decrease their effectiveness. This could cause pregnancy. Examples include rifamycins such as rifampin or rifabutin. Be sure to ask your doctor or pharmacist if you should use additional reliable birth control methods while using this antibiotic.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

SLIDESHOW

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Why has my veterinarian prescribed this medicine?

Neomycin sulfate is an antibiotic. It is used to reduce the number of bacteria in the colon (a part of the intestine) prior to surgery. It may also be used to decrease the numbers of ammonia producing bacteria in the treatment of brain disorders caused by the liver not working properly (a condition called hepatic encephalopathy).

How do I give this medication?

“Give this medication for as long as prescribed by your veterinarian, even if it appears the pet is feeling better.”

  • Give this medication to your pet as directed by your veterinarian. READ THE LABEL CAREFULLY.
  • Give this medication for as long as prescribed by your veterinarian, even if it appears the pet is feeling better.
  • DO NOT give the pet more medicine than directed.
  • DO NOT give the medicine more often than directed.
  • Try not to miss giving any doses.

What if I miss giving a dose?

Give the dose as soon as possible. If it is almost time for the next dose, skip the missed dose, and continue with the regular schedule. Do not give the pet two doses at once.

How do I store this medicine?

  • Keep this medicine out of reach of children.
  • Store the medication in a tight, light resistant container. Store away from heat and direct sunlight.
  • Do not store this medicine in the bathroom, near the kitchen sink or in other damp places. The medicine may break down if exposed to heat or moisture.

What are the potential side effects?

“Neomycin sulfate may cause allergic reactions.”

  • Neomycin sulfate may cause allergic reactions. Contact your veterinarian IMMEDIATELY if you notice any of the following: scratching, a swollen face, tongue or throat, or difficulty breathing.
  • Neomycin-like drugs can cause hearing loss. If you notice that your pet is having trouble hearing, is tilting its head or losing balance, contact your veterinarian immediately.
  • Other side effects may occur. If you notice anything unusual, contact your veterinarian.

Are there any possible drug interactions?

  • Make sure to tell your veterinarian if you are giving your pet any other medication or supplements.
  • Quite often, your veterinarian may prescribe two different medications, and sometimes a drug interaction may be anticipated. If this occurs, your veterinarian may vary the dose and/or monitor your pet more closely.
  • The following drugs can potentially interact with neomycin sulfate: penicillin VK, digoxin, vitamin K, methotrexate.
  • Contact your veterinarian if your pet experiences any unusual reactions when different medications are given together.

Contributors: Lifelearn Inc. © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license.

Neomycin

Neomycin is an antibiotic that’s used to prevent or treat bacterial infections.

It belongs to a class of antibiotics called aminoglycosides, which work by stopping the production of proteins that bacteria need to survive.

The oral form of neomycin is given to lower the risk of infection after certain intestinal surgeries.

It’s also used to treat hepatic encephalopathy, which is a serious brain complication that sometimes results from liver disease.

The topical form of this drug is used to treat skin infections.

Neomycin is also found in some combination products that treat ear infections.

The U.S. Food and Drug Administration (FDA) first approved neomycin in 1964. It’s sold under different brand names and manufactured by various companies.

Neomycin Warnings

Oral neomycin: The oral form of neomycin contains a black-box warning because it can cause permanent hearing loss, nerve damage, or severe kidney damage.

Tell your doctor immediately if you experience any of the following symptoms:

  • Hearing loss
  • Ringing in the ears
  • Dizziness
  • Unusual tingling or numbness of the skin
  • Muscle twitching
  • Seizures

Oral neomycin also contains a black-box warning because it may cause severe muscle relaxation that can lead to paralysis or breathing problems.

Taking certain other medicines may raise your risk of developing serious side effects from neomycin.

Tell your doctor if you’re taking any of the following before starting on oral neomycin:

  • Anesthetics
  • Neuromuscular-blocking agents, such as Anectine (succinylcholine)
  • Transfusions of citrate-anticoagulated blood
  • Diuretics, such as Edecrin (ethacrynic acid) or Lasix (furosemide)
  • Other aminoglycosides, such as Humatin (paromomycin)
  • Other nephrotoxic or neurotoxic medicines, such as bacitracin

You may also have a higher risk of developing serious side effects if you’re an older adult, or if you’re dehydrated.

Neomycin will only work for bacterial infections. It’s not effective for fungal or viral infections.

Before taking oral neomycin, tell your healthcare provider if you have, or have ever had:

  • An intestinal obstruction
  • Ulcers of the bowel
  • Inflammatory bowel disease or stomach disease
  • A stomach infection
  • Nerve damage
  • Muscle weakness
  • Parkinson’s disease
  • Myasthenia gravis (a chronic neuromuscular disease)
  • Kidney problems
  • Allergies to medications

Also, let your doctor know if you have diarrhea or are dehydrated before taking this medicine.

Tell your healthcare provider right away if you develop severe diarrhea, stomach pain, or bloody stools.

Take neomycin for the full course of treatment. Don’t stop taking the oral form of the medicine without first talking to your doctor.

Long-term use of neomycin could lead to a secondary infection. Tell your doctor if you notice any signs of another infection.

Oral neomycin shouldn’t be taken by babies younger than six months old. Newborn and premature babies may be more sensitive to certain side effects of this drug.

If you’re taking neomycin to treat hepatic encephalopathy, you may need to follow a special diet. Talk to your doctor about which foods to eat, and which ones to avoid, during your treatment.

Your doctor will most likely want to order tests to check your body’s response to neomycin. Keep all appointments with your doctor’s office and laboratory while taking this medicine.

Be sure to tell your healthcare provider that you’re taking this drug before having any type of surgery, including a dental procedure.

Topical neomycin: Don’t apply topical neomycin more frequently than instructed. It can be absorbed into the body through broken skin, and could cause hearing difficulties or kidney problems.

Before using topical neomycin, tell your doctor if you’ve ever had kidney problems or kidney disease.

Let your doctor know if your skin problem doesn’t improve, or worsens, after one week of using topical neomycin.

Pregnancy and Neomycin

Neomycin may cause harm to an unborn baby.

Tell your doctor if you’re pregnant, or might become pregnant, before using this medicine.

It’s not known whether neomycin passes into breast milk. Don’t breastfeed while taking this medicine without first talking to your doctor.

Generic Name: neomycin (nee oh MY sin)
Brand Name: Neo-Fradin, Neo-Tab, Mycifradin

Medically reviewed by Drugs.com on Feb 5, 2019 – Written by Cerner Multum

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What is neomycin?

Neomycin is an antibiotic that fights bacteria in the body.

Neomycin is used to reduce the risk of infection during surgery of your intestines. Neomycin is also used to reduce the symptoms of hepatic coma.

Neomycin may also be used for purposes not listed in this medication guide.

Important Information

You should not take neomycin if you are allergic to neomycin or similar antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), paromomycin (Humatin, Paromycin), streptomycin, or tobramycin (Nebcin, Tobi).

You should not take neomycin if you have ulcerative colitis, Crohn’s disease, a blockage in your intestines, or other inflammatory bowel disease.

Do not use neomycin if you are pregnant. It could harm the unborn baby.

Before you take neomycin, tell your doctor if you have kidney disease, myasthenia gravis, or Parkinson’s disease.

Never take neomycin in larger amounts than recommended, or for longer than 2 weeks. High doses or long-term use of neomycin can cause serious kidney problems, or hearing loss that may not be reversible. The longer you take neomycin, the more likely you are to develop these serious side effects.

To be sure this medication is not causing harmful effects, your kidney function, and your nerve and muscle function will need to be tested often. You may also need hearing tests. Neomycin can have long lasting effects on your body. Do not miss any follow up visits to your doctor for blood or urine tests.

Neomycin can harm your kidneys, and this effect is increased when you also use certain other medicines harmful to the kidneys. Before using neomycin, tell your doctor about all other medicines you use. Many other drugs (including some over-the-counter medicines) can be harmful to the kidneys.

If you are being treated for hepatic coma, avoid eating foods that are high in protein. Follow your doctor’s instructions about any other restrictions on food, beverages, or activity.

Before taking this medicine

You should not take this medicine if you are allergic to neomycin or similar antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), paromomycin (Humatin, Paromycin), streptomycin, or tobramycin (Nebcin, Tobi).

You should not take neomycin if you have ulcerative colitis, Crohn’s disease, a blockage in your intestines, or other inflammatory bowel disease.

To make sure you can safely take neomycin, tell your doctor if you have any of these other conditions:

  • kidney disease;

  • myasthenia gravis; or

  • Parkinson’s disease.

FDA pregnancy category D. Do not use neomycin if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

It is not known whether neomycin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using neomycin.

How should I take neomycin?

Never take neomycin in larger amounts than recommended, or for longer than 2 weeks. High doses or long-term use of neomycin can cause serious kidney problems, or hearing loss that may not be reversible. The longer you take neomycin, the more likely you are to develop these serious side effects. Follow the directions on your prescription label.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Take neomycin for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Neomycin will not treat a viral infection such as the common cold or flu.

To be sure this medication is not causing harmful effects, your kidney function, and your nerve and muscle function will need to be tested often. You may also need hearing tests. Neomycin can have long lasting effects on your body. Do not miss any follow up visits to your doctor for blood or urine tests.

If you are taking neomycin for hepatic coma, your treatment may also include a special diet. It is very important to follow the diet plan created for you by your doctor. You should become very familiar with the list of foods you should avoid to help control your condition.

If you need surgery, tell the surgeon ahead of time that you are using neomycin. Neomycin can interact with certain medicines that may be given during surgery.

Store at room temperature away from moisture and heat. Do not allow the liquid form of this medicine to freeze.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while taking neomycin?

If you are being treated for hepatic coma, avoid eating foods that are high in protein. Follow your doctor’s instructions about any other restrictions on food, beverages, or activity.

Neomycin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • hearing problems, ringing in your ears, or a feeling of fullness in the ears;

  • spinning sensation, nausea, feeling like you might pass out;

  • loss of balance or coordination, trouble walking;

  • numbness or tingly feeling under your skin;

  • muscle twitching, seizure (convulsions);

  • urinating less than usual or not at all;

  • drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting;

  • swelling, weight gain, feeling short of breath;

  • weak or shallow breathing; or

  • severe stomach cramps, diarrhea that is watery or bloody.

Less serious side effects may include:

  • mild nausea, vomiting; or

  • mild diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect neomycin?

Neomycin can harm your kidneys, and this effect is increased when you also use certain other medicines harmful to the kidneys. Before using neomycin, tell your doctor about all other medicines you use. Many other drugs (including some over-the-counter medicines) can be harmful to the kidneys.

Before you take neomycin, tell your doctor if you are using any other antibiotics, such as

Tell your doctor about all other medicines you use, especially:

This list is not complete and other drugs may interact with neomycin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 2.01.

Related questions

  • Can I use expired neomycin and polymyxin b sulfates, dexamethasone ophthalmic?
  • How long does it take for neomycin, polymyxin b and hydrocortisone ear drops to work?

Medical Disclaimer

More about neomycin

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  • Drug class: aminoglycosides

Consumer resources

  • Neomycin Tablets
  • Neomycin Oral Solution
  • Neomycin (Advanced Reading)

Other brands: Neo-Fradin, Neo-Tab

Professional resources

  • Neomycin Sulfate (AHFS Monograph)
  • … +2 more

Related treatment guides

  • Bowel Preparation
  • Diarrhea
  • Hepatic Coma
  • Hepatic Encephalopathy

Identification

Are you a new drug developer? Contact us to learn more about our customized products and solutions. Stay in the know! As part of our commitment to providing the most up-to-date drug information, we will be releasing #DrugBankUpdates with our newly added curated drug pages. #DrugBankUpdates Name Neomycin Accession Number DB00994 (APRD00013) Type Small Molecule Groups Approved, Vet approved Description

A component of neomycin that is produced by Streptomyces fradiae. On hydrolysis it yields neamine and neobiosamine B. (From Merck Index, 11th ed). Neomycin is a bactericidal aminoglycoside antibiotic that binds to the 30S ribosome of susceptible organisms. Binding interferes with mRNA binding and acceptor tRNA sites and results in the production of non-functional or toxic peptides.

Synonyms

  • Fradiomycin
  • Kaomycine
  • Neomicina
  • Neomycin
  • Vonamycin

External IDs Caswell No. 595 / USAF CB-19 Product Ingredients

Ingredient UNII CAS InChI Key
Neomycin palmitate 3I9J454G9F 55298-68-5 Not applicable
Neomycin sulfate 057Y626693 1405-10-3 Not applicable

Product Images

    Prescription Products

    Name Dosage Strength Route Labeller Marketing Start Marketing End
    Unlock Additional Data
    Mycifradin Sulfate Oral Solution Solution Oral Pharmacia & Upjohn Inc 1957-12-31 2000-08-02 Canada
    Mycifradin Sulfate Tablets 0.5 Gm Tablet Oral Pharmacia & Upjohn Inc 1953-12-31 2000-08-02 Canada
    Myciguent Ointment Ointment Topical Upjohn 1951-12-31 1998-08-12 Canada

    Additional Data Available

  • Application Number Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Generic Prescription Products

Name Dosage Strength Route Labeller Marketing Start Marketing End
Unlock Additional Data
Neo-Fradin Solution 87.5 mg/5mL Oral X Gen Pharmaceuticals, Inc. 2002-05-23 2012-12-31 US
Neomycin Sulfate Tablet 500 mg/1 Oral Teva Pharmaceuticals USA, Inc. 1990-09-30 Not applicable US
Neomycin Sulfate Tablet 500 mg/1 Oral Golden State Medical Supply 2011-01-03 2018-10-11 US
Neomycin Sulfate Tablet 500 mg/1 Oral Lannett Company, Inc. 2016-06-10 Not applicable US
Neomycin Sulfate Tablet 500 mg/1 Oral Major 2009-09-14 2012-10-01 US
Neomycin Sulfate Tablet 500 mg/1 Oral X-GEN Pharmaceuticals, Inc. 2010-03-12 Not applicable US
Neomycin Sulfate Tablet 500 mg/1 Oral Eci Pharmaceuticals Llc 2016-01-16 2016-07-10 US
Neomycin Sulfate Tablet 500 mg/1 Oral HI TECH PHARMACAL CO INC 2010-03-12 Not applicable US
Neomycin Sulfate Tablet 350 mg/1 Oral Breckenridge Pharmaceutical, Inc. 2011-01-03 2020-04-30 US

Additional Data Available

  • Application Number Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Over the Counter Products

Name Dosage Strength Route Labeller Marketing Start Marketing End
Unlock Additional Data
Antibiotic Ointment 3.5 mg/1g Topical Kareway Product, Inc. 2011-08-11 Not applicable US
Antibiotic Ointment 3.5 mg/1g Topical Pro Mex Llc 2013-12-05 Not applicable US
Antibiotic Ointment 3.5 mg/1g Topical Total Resources International 2019-10-07 Not applicable US
Antibiotic Ointment 3.5 mg/1g Topical Morales Distributors, Inc. 2012-09-25 Not applicable US
Antibiotic Ointment Ointment 3.5 mg/1g Topical Neopharm Co., Ltd 2010-08-26 Not applicable US
Baclezene Cream 5 mg/0.9g Topical Curazene, Llc 2014-06-19 Not applicable US
Family Care Antibiotic Ointment 3.5 mg/1g Topical United Exchange Corporation 2017-12-29 Not applicable US
Family Care Antibiotic Ointment 3.5 mg/1g Topical United Exchange Corporation 2012-11-30 2017-12-26 US
Family Care Triple Antibiotic Pain Relief Ointment 3.5 mg/1g Topical United Exchange Corporation 2012-02-07 Not applicable US
First Aid Only Antibiotic Neomycin Sulfate Ointment 3.5 mg/1g Topical Acme United Corporation 2017-12-18 Not applicable US

Additional Data Available

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  • Product Code Product Code

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Mixture Products Unapproved/Other Products International/Other Brands Myacyne / Mycifradin / Myciguent / Neo-Rx / Neobiotic / Nivemycin Categories UNII I16QD7X297 CAS number 1404-04-2

Pharmacology

Indication

Topical uses include treatment for superficial eye infections caused by susceptible bacteria (used in combination with other antiinfectives), treatment of otitis externa caused by susceptible bacteria, treatment or prevention of bacterial infections in skin lesions, and use as a continuous short-term irrigant or rinse to prevent bacteriuria and gram negative rod bacteremia in abacteriuric patients with indwelling catheters. 2,3,4,5 May be used orally to treat hepatic encephalopathy, as a perioperative prophylactic agent, and as an adjunct to fluid and electrolyte replacement in the treatment of diarrhea caused to enteropathogenic E. coli (EPEC). 5

Associated Conditions

  • Anterior Uveitis (AU)
  • Bacterial Infections
  • Blepharoconjunctivitis
  • Conjunctivitis
  • Corneal Inflammation
  • Dermatosis
  • Eye Infections
  • Hepatic Encephalopathy
  • Keratoconjunctivitis
  • Otitis Externa
  • Bacterial blepharitis
  • Infection due to indwelling catheter
  • Superficial skin infections

Associated Therapies

  • Antibiotic pre-surgical prophylaxis therapy

Pharmacodynamics

Neomycin is an aminoglycoside antibiotic. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit, causing misreading of t-RNA, leaving the bacterium unable to synthesize proteins vital to its growth. Aminoglycosides are useful primarily in infections involving aerobic, Gram-negative bacteria, such as Pseudomonas, Acinetobacter, and Enterobacter. In addition, some mycobacteria, including the bacteria that cause tuberculosis, are susceptible to aminoglycosides. Infections caused by Gram-positive bacteria can also be treated with aminoglycosides, but other types of antibiotics are more potent and less damaging to the host. In the past the aminoglycosides have been used in conjunction with penicillin-related antibiotics in streptococcal infections for their synergistic effects, particularly in endocarditis. Aminoglycosides are mostly ineffective against anaerobic bacteria, fungi and viruses.

Mechanism of action

Aminoglycosides like neomycin “irreversibly” bind to specific 30S-subunit proteins and 16S rRNA. Specifically neomycin binds to four nucleotides of 16S rRNA and a single amino acid of protein S12. This interferes with decoding site in the vicinity of nucleotide 1400 in 16S rRNA of 30S subunit. This region interacts with the wobble base in the anticodon of tRNA. This leads to interference with the initiation complex, misreading of mRNA so incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides and the breakup of polysomes into nonfunctional monosomes.

Target Actions Organism
A30S ribosomal protein S12 inhibitor Escherichia coli (strain K12)
A16S ribosomal RNA inhibitor Enteric bacteria and other eubacteria
UExtracellular calcium-sensing receptor Not Available Humans

Unlock Additional Data Additional Data Available Adverse Effects

Comprehensive structured data on known drug adverse effects with statistical prevalence. MedDRA and ICD10 ids are provided for adverse effect conditions and symptoms.

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Structured data covering drug contraindications. Each contraindication describes a scenario in which the drug is not to be used. Includes restrictions on co-administration, contraindicated populations, and more.

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Structured data representing warnings from the black box section of drug labels. These warnings cover important and dangerous risks, contraindications, or adverse effects.

Learn more Absorption

Poorly absorbed from the normal gastrointestinal tract. Although only approximately 3% of neomycin is absorbed through intact intestinal mucosa, significant amounts may be absorbed through ulcerated or denuded mucosa or if inflammation is present.

Volume of distribution Not Available Protein binding

Protein binding studies have shown that the degree of aminoglycoside protein binding is low and, depending upon the methods used for testing, may be between 0% and 30%.

Metabolism

Neomycin undergoes negligible biotransformation after parenteral administration.

Route of elimination

The small absorbed fraction is rapidly distributed in the tissues and is excreted by the kidney in keeping with the degree of kidney function.

Half life

2 to 3 hours

Clearance Not Available Toxicity

LD50 = 200 mg/kg (rat). Because of low absorption, it is unlikely that acute overdosage would occur with oral neomycin. However, prolonged administration could result in sufficient systemic drug levels to produce neurotoxicity, ototoxicity and/or nephrotoxicity. Nephrotoxicity occurs via drug accumulation in renal proximal tubular cells resulting in cellular damage. Tubular cells may regenerate despite continued exposure and nephrotoxicity is usually mild reversible. Neomycin is the most toxic aminoglycoside agent, which is thought to be due to its large number of cationic amino groups. Otoxocity occurs via drug accumulation in the endolymph and perilymph of the inner ear causing irreversible damage to hair cells in the cochlea or summit of ampullar cristae in the vestibular complex. High frequency hearing loss is followed by low frequency hearing loss. Further toxicity may cause retrograde degeneration of the auditory nerve. Vestibular toxicity may result in vertigo, nausea and vomiting, dizziness and loss of balance.

Affected organisms

  • Enteric bacteria and other eubacteria
  • Escherichia coli
  • Klebsiella
  • Enterobacter

Pathways Not Available Pharmacogenomic Effects/ADRs Not Available

Interactions

Drug Interactions This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

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Drug Interaction
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(R)-warfarin The risk or severity of bleeding can be increased when Neomycin is combined with (R)-warfarin.
(S)-Warfarin The risk or severity of bleeding can be increased when Neomycin is combined with (S)-Warfarin.
4-hydroxycoumarin The risk or severity of bleeding can be increased when Neomycin is combined with 4-hydroxycoumarin.
Abacavir Neomycin may decrease the excretion rate of Abacavir which could result in a higher serum level.
Acarbose The metabolism of Acarbose can be decreased when combined with Neomycin.
Aceclofenac The risk or severity of nephrotoxicity can be increased when Aceclofenac is combined with Neomycin.
Acemetacin The risk or severity of nephrotoxicity can be increased when Acemetacin is combined with Neomycin.
Acenocoumarol The risk or severity of bleeding can be increased when Neomycin is combined with Acenocoumarol.
Acetaminophen Neomycin may decrease the excretion rate of Acetaminophen which could result in a higher serum level.
Acetylcholine The therapeutic efficacy of Acetylcholine can be decreased when used in combination with Neomycin.

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Food Interactions Not Available Synthesis Reference

Jaehoon Yu, Jongkook Lee, Miyun Kwon, Ae Pae, Hun Koh, “Heterodimeric conjugates of neomycin-oxazolidinone, their preparation and their use.” U.S. Patent US20050222055, issued October 06, 2005.

US20050222055 General References External Links KEGG Drug D08260 KEGG Compound C00384 PubChem Substance 46505525 ChEBI 7507 Therapeutic Targets Database DAP000036 PharmGKB PA450608 HET CNY RxList RxList Drug Page Drugs.com Drugs.com Drug Page Wikipedia Neomycin ATC Codes A07AA51 — Neomycin, combinations

  • A07AA — Antibiotics
  • A07A — INTESTINAL ANTIINFECTIVES
  • A07 — ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS
  • A — ALIMENTARY TRACT AND METABOLISM

R02AB01 — Neomycin

  • R02AB — Antibiotics
  • R02A — THROAT PREPARATIONS
  • R02 — THROAT PREPARATIONS
  • R — RESPIRATORY SYSTEM

J01GB05 — Neomycin

  • J01GB — Other aminoglycosides
  • J01G — AMINOGLYCOSIDE ANTIBACTERIALS
  • J01 — ANTIBACTERIALS FOR SYSTEMIC USE
  • J — ANTIINFECTIVES FOR SYSTEMIC USE

D06AX04 — Neomycin

  • D06AX — Other antibiotics for topical use
  • D06A — ANTIBIOTICS FOR TOPICAL USE
  • D06 — ANTIBIOTICS AND CHEMOTHERAPEUTICS FOR DERMATOLOGICAL USE
  • D — DERMATOLOGICALS

S03AA01 — Neomycin

  • S03AA — Antiinfectives
  • S03A — ANTIINFECTIVES
  • S03 — OPHTHALMOLOGICAL AND OTOLOGICAL PREPARATIONS
  • S — SENSORY ORGANS

A01AB08 — Neomycin

  • A01AB — Antiinfectives and antiseptics for local oral treatment
  • A01A — STOMATOLOGICAL PREPARATIONS
  • A01 — STOMATOLOGICAL PREPARATIONS
  • A — ALIMENTARY TRACT AND METABOLISM

A07AA01 — Neomycin

  • A07AA — Antibiotics
  • A07A — INTESTINAL ANTIINFECTIVES
  • A07 — ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS
  • A — ALIMENTARY TRACT AND METABOLISM

S02AA07 — Neomycin

  • S02AA — Antiinfectives
  • S02A — ANTIINFECTIVES
  • S02 — OTOLOGICALS
  • S — SENSORY ORGANS

B05CA09 — Neomycin

  • B05CA — Antiinfectives
  • B05C — IRRIGATING SOLUTIONS
  • B05 — BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS
  • B — BLOOD AND BLOOD FORMING ORGANS

S01AA03 — Neomycin

  • S01AA — Antibiotics
  • S01A — ANTIINFECTIVES
  • S01 — OPHTHALMOLOGICALS
  • S — SENSORY ORGANS

AHFS Codes

  • 08:12.02 — Aminoglycosides
  • 84:04.04 — Antibiotics

FDA label (169 KB) MSDS (72.9 KB)

Clinical Trials

Clinical Trials

Phase Status Purpose Conditions Count
0 Completed Treatment BMI >30 kg/m2 / Diabetes 1
0 Enrolling by Invitation Basic Science Dietary Modifications / Nutrition 1
0 Recruiting Supportive Care Diverticulitis / Inflammatory Bowel Diseases (IBD) / Neoplasms, Colorectal / 1
0 Recruiting Treatment Osteomyelitis 1
1 Completed Not Available Neoplasms 1
1 Recruiting Treatment Retinoblastoma 1
2 Active Not Recruiting Treatment Intestinal Colonization With Multidrug-resistant Bacteria 1
2 Completed Treatment Crohn’s Disease (CD) 1
2 Completed Treatment Pre-Diabetic 1
2 Not Yet Recruiting Prevention Leak, Anastomotic / Rectal Carcinoma 1
2 Recruiting Treatment Crohn’s Disease (CD) 1
2, 3 Unknown Status Prevention Bacteremia / Bacteremia Associated With Intravascular Line / Ventilator-associated Bacterial Pneumonia 1
3 Unknown Status Treatment Acute / Conjunctivitis, Bacterial 1
3 Unknown Status Treatment Hordeolum 1
4 Completed Treatment Allergies 1
4 Completed Treatment Vaginal Inflammation 1
4 Recruiting Basic Science Rabies Human 1
4 Recruiting Prevention Surgery, Colorectal 1
4 Recruiting Prevention Urinary Tract Infection 1
4 Recruiting Treatment Elective Colon Surgery 1
Not Available Completed Not Available Patients Colonized by Klebsiella Pneumoniae 1
Not Available Completed Other Flu caused by Influenza 1
Not Available Completed Prevention Biliary Atresia 1
Not Available Completed Treatment Constipation-predominant Irritable Bowel Syndrome (IBS-C) 1
Not Available Completed Treatment Corneal Diseases 1
Not Available Completed Treatment Nasal Carriers of Staphylococcus Aureus 1
Not Available Completed Treatment Stings 1
Not Available Completed Treatment Ulcerative Colitis 1
Not Available Completed Treatment Wound Chronic Draining 1
Not Available Recruiting Prevention Bowel preparation therapy / Colorectal Cancers / Oral Antibiotics / Postoperative Complications / 1
Not Available Unknown Status Treatment Hepatic Encephalopathy / Liver Cirrhosis / Portal Hypertension 1

Pharmacoeconomics

Manufacturers

  • X gen pharmaceuticals inc
  • Pharmacia and upjohn co
  • Pfizer laboratories div pfizer inc
  • Bristol myers squibb co
  • Lannett co inc
  • Eli lilly and co
  • Oman pharmaceutical products co llc
  • Roxane laboratories inc
  • Sandoz inc
  • Teva pharmaceuticals usa inc

Packagers

  • Akorn Inc.
  • Amend
  • Bausch & Lomb Inc.
  • Dispensing Solutions
  • Draxis Specialty Pharmaceuticals Inc.
  • Hi Tech Pharmacal Co. Inc.
  • Major Pharmaceuticals
  • Murfreesboro Pharmaceutical Nursing Supply
  • Nucare Pharmaceuticals Inc.
  • Pharmedix
  • Physicians Total Care Inc.
  • Southwood Pharmaceuticals
  • Teva Pharmaceutical Industries Ltd.
  • UDL Laboratories
  • X-Gen Pharmaceuticals

Dosage forms

Form Route Strength
Kit Oral
Kit Ophthalmic; Oral; Topical
Kit Respiratory (inhalation)
Kit Irrigation
Kit Topical
Powder Topical
Ointment Topical 3.5 mg/1g
Cream Topical 5 mg/0.9g
Cream Topical
Solution Auricular (otic)
Suspension Topical
Ointment Ophthalmic; Topical
Kit Ophthalmic
Stick Topical
Solution Oral
Tablet Oral
Ointment Topical
Suspension Auricular (otic); Ophthalmic
Solution Oral 87.5 mg/5mL
Lotion Topical
Liquid Auricular (otic); Ophthalmic
Solution Irrigation
Ointment Ophthalmic
Suspension Ophthalmic
Solution / drops Ophthalmic
Solution / drops Auricular (otic)
Suspension / drops Auricular (otic)
Suspension / drops Ophthalmic
Powder Not applicable 1 g/1g
Tablet Oral 350 mg/1
Tablet Oral 500 mg/1
Solution Auricular (otic); Ophthalmic
Irrigant Irrigation
Solution Urethral
Liquid Ophthalmic
Gel Topical
Suspension Auricular (otic)
Ointment Topical 3.5 mg/57g
Ointment Rectal
Suppository Rectal
Ointment Topical
Solution Ophthalmic
Kit Cutaneous

Prices

Unit description Cost Unit
Neomycin Sulfate 500 mg tablet 1.39USD tablet
Neomycin 500 mg tablet 1.25USD tablet
Neomycin sulfate powder 0.84USD g
Neo-fradin 125 mg/5 ml soln 0.12USD ml

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only. Patents Not Available

Properties

State Solid Experimental Properties

Property Value Source
melting point (°C) 6 mg/mL (as sulfate form) Not Available
logP -7.8 Not Available

Predicted Properties Not Available Predicted ADMET features

Property Value Probability
Human Intestinal Absorption 0.8617
Blood Brain Barrier 0.9659
Caco-2 permeable 0.7502
P-glycoprotein substrate Non-substrate 0.5164
P-glycoprotein inhibitor I Non-inhibitor 0.8023
P-glycoprotein inhibitor II Non-inhibitor 0.8764
Renal organic cation transporter Non-inhibitor 0.7886
CYP450 2C9 substrate Non-substrate 0.8231
CYP450 2D6 substrate Non-substrate 0.8041
CYP450 3A4 substrate Non-substrate 0.6473
CYP450 1A2 substrate Non-inhibitor 0.9157
CYP450 2C9 inhibitor Non-inhibitor 0.9147
CYP450 2D6 inhibitor Non-inhibitor 0.9231
CYP450 2C19 inhibitor Non-inhibitor 0.9034
CYP450 3A4 inhibitor Non-inhibitor 0.9471
CYP450 inhibitory promiscuity Low CYP Inhibitory Promiscuity 0.8446
Ames test Non AMES toxic 0.6934
Carcinogenicity Non-carcinogens 0.9505
Biodegradation Not ready biodegradable 0.8587
Rat acute toxicity 1.4850 LD50, mol/kg Not applicable
hERG inhibition (predictor I) Weak inhibitor 0.9728
hERG inhibition (predictor II) Non-inhibitor 0.81

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST) Not Available Spectra Not Available

Taxonomy

Classification Not classified

Targets

Kind Protein Organism Escherichia coli (strain K12) Pharmacological action Yes Actions Inhibitor General Function Trna binding Specific Function With S4 and S5 plays an important role in translational accuracy.Interacts with and stabilizes bases of the 16S rRNA that are involved in tRNA selection in the A site and with the mRNA backbone. Lo… Gene Name rpsL Uniprot ID P0A7S3 Uniprot Name 30S ribosomal protein S12 Molecular Weight 13736.995 Da Kind Nucleotide Organism Enteric bacteria and other eubacteria Pharmacological action Yes Actions InhibitorIn prokaryotes, the 16S rRNA is essential for recognizing the 5′ end of mRNA and hence positioning it correctly on the ribosome. The 16S rRNA has a characteristic secondary structure in which half of the nucleotides are base-paired. The 16S rRNA sequence has been highly conserved and is often used for evolutionary and species comparative analysis. Kind Protein Organism Humans Pharmacological action Unknown General Function Phosphatidylinositol phospholipase c activity Specific Function Senses changes in the extracellular concentration of calcium ions. The activity of this receptor is mediated by a G-protein that activates a phosphatidylinositol-calcium second messenger system. Gene Name CASR Uniprot ID P41180 Uniprot Name Extracellular calcium-sensing receptor Molecular Weight 120672.385 Da ×Unlock Data

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Drug created on June 13, 2005 07:24 / Updated on February 02, 2020 04:21

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