Kanamycin information from DrugsUpdate  

Pharmacodynamics

Pharmacokinetics

Kanamycin irreversibly binds to 30S, and to some extent 50S, ribosomal subunits of susceptible bacteria disrupting protein synthesis, thus rendering the bacterial cell membrane defective.

Absorption <1% is absorbed from the GI tract but may be markedly increased if GI mucosa is inflamed or ulcerated (oral); peak plasma concentrations after 1 hr (IM).

Distribution Present in cord blood and breast milk.

Excretion Via urine by glomerular filtration (as unchanged drug); 3 hr (elimination half-life).

Kanamycin Indications / Kanamycin Uses

Information Not Available

Kanamycin Adverse Reactions / Kanamycin Side Effects

Pain, inflammation, bruising, haematoma at inj site; GI disturbances; malabsorption of fat. Potentially Fatal: Neuromuscular blockade; nephrotoxicity; ototoxicity.

Precautions

Neurotoxicity Manifests as both auditory and vestibular ototoxicity, and primarily occurs in patients with preexisting renal damage with prolonged therapy. Partial or total irreversible deafness may continue to develop after drug is stopped. Other features of neurotoxicity include paresthesia, twitching, and seizures. Nephrotoxicity Usually reversible.

Special Precautions

Renal impairment, dehydration, previous exposure to ototoxic drugs; preexisting tinnitus, vertigo or subclinical hearing loss. Parkinsonism, myasthenia gravis. Infants, neonates, elderly. Pregnancy, lactation.

Other Drug Interactions

Synergistic effects with ampicillin, benzylpenicillin and other β-lactam antibiotics. May reduce renal excretion of zalcitabine. Potentially Fatal: Increased risk of ototoxicity with ethacrynic acid and furosemide. Increased risk of nephrotoxicity with cephalosporins, ciclosporin, cisplatin, vancomycin, hydrocortisone and indomethacin. Potentiates effects of neuromuscular blocking agents.

Other Interactions

Information Not Available

Dosage

Oral Suppression of intestinal flora Adult: Pre-operative use: 1 g every hr for 4 hr, then 1 g every 6 hr for 36-72 hr. Renal impairment: Adjustments in dose and/or dosing frequency may be required. Oral Hepatic encephalopathy Adult: 8-12 g daily in divided doses. Renal impairment: Adjustments in dose and/or dosing frequency may be required. Intramuscular Penicillin-resistant gonorrhoea Adult: 2 g as a single dose. Renal impairment: Adjustments in dose and/or dosing frequency may be required. Intramuscular Treatment and prophylaxis of neonatal gonococcal infections Child: Infants born to mothers with gonorrhoea: 25 mg/kg as a single dose. Max: 75 mg. Renal impairment: Adjustments in dose and/or dosing frequency may be required. Parenteral Susceptible Gram-negative and staphylococcal infections Adult: 15 mg/kg daily IM or as IV infusion of a 0.25-0.5% solution over 30-60 minutes. Max: 1.5 g daily in 2-4 divided doses. Recommended treatment duration: Not more than 7-10 days for acute infections. Not to exceed a cumulative dose of 10 g. For chronic bacterial infections: 3-4 g wkly, given as 1 g on alternate days or 1 g bid on 2 days each wk. Max cumulative dose: 50 g. Prolonged use is not recommended due to risk of nephrotoxicity. Child: 15 mg/kg daily IM or as IV infusion of a 0.25-0.5% solution over 30-60 min. Max daily dose: 1.5 g in 2-4 divided doses. Treatment duration: 7-10 days. Max cumulative dose: 10 g. Renal impairment: Adjustments in dose and/or dosing frequency may be required. Inhalation Susceptible Gram-negative and staphylococcal infections Adult: 250 mg 2-4 times daily, given via nebulisation. Dilute 250 mg in 3 mL 0.9% sodium chloride. Renal impairment: Adjustments in dose and/or dosing frequency may be required. Intraperitoneal Peritonitis or peritoneal contamination during surgery Adult: Dilute 500 mg in 20 mL sterile distilled water and instill into the peritoneal cavity. Renal impairment: Adjustments in dose and/or dosing frequency may be required. Irrigation Irrigation of body cavities Adult: Instil 0.25% solution into abscess cavities, pleural space, or peritoneal or ventricular cavities. Renal impairment: Adjustments in dose and/or dosing frequency may be required.

Food(before/after)

Information Not Available

Kanamycin and Pregnancy

Caution when used during pregnancy. Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Kanamycin and Lactation

Caution when used during lactation

Kanamycin and Children

Use cautiously in premature infants and newborns because of renal immaturity.

Kanamycin and Geriatic

Information Not Available

Kanamycin and Other Contraindications

Hypersensitivity. GI ulceration (oral).

Storage

Intramuscular Store at 20-25 ℃ Parenteral Store at 20-25 ℃

Lab interference

Intramuscular Store at 20-25 ℃ Parenteral Store at 20-25 ℃