Neomycin

What it is used for

• Hepatic encephalopathy
• Hepatic encephalopathy
• Hepatic encephalopathy (stable animals)
• Campylobacteriosis
• Systemic therapy
• Susceptible enteral infections (Young pigs)
• Susceptible enteral infections
• Susceptible enteric infections
• Susceptible enteral infections (Lambs)
• Susceptible enteral infections
• Susceptible enteral infections (Adults)
• Susceptible enteral infections (Foals)
• Susceptible enteral infections

How it is given

Possible side effects

• Nephrotoxicity (severe if given parenterally)
• Ototoxicity (irreversible, parenteral or rarely oral)
• Severe diarrhea
• Intestinal malabsorption
• GI superinfections (with chronic oral use)
• Ototoxicity (deafness)
• Vestibular toxicity (ataxia, head tilt, nystagmus)
• Local irritation or erythema at the application site
• Ototoxicity (vestibular and auditory)
• Nephrotoxicity
• Severe diarrhoea or malabsorption syndrome (oral use)
• Bacterial or fungal superinfections
• Local irritation (topical ophthalmic use)

Cautions & contraindications

• Hypersensitivity to aminoglycosides
• Intestinal obstruction (for oral use)
• Rabbits and hares (disrupts GI flora)
• Neonates (avoid oral use due to higher systemic absorption)
• Animals with a perforated tympanic membrane (eardrum)
• Concurrent use with other known ototoxic products
• Known hypersensitivity to aminoglycosides
• Pre-existing renal disease (for systemic use)
• Ruptured tympanic membrane (for otic preparations)
• Use with extreme caution in patients with **renal dysfunction**, even when given orally, as a small percentage is absorbed. Avoid parenteral use in **working dogs** due to the risk of irreversible ototoxicity. Use cautiously in patients with **neuromuscular disorders** (e.g., myasthenia gravis) due to the neuromuscular blocking activity of aminoglycosides. **Geriatric and neonatal** animals require careful monitoring and dosage adjustments if systemic absorption is expected.

Drug interactions

• Digoxin: Oral neomycin may decrease digoxin absorption. In a small subset of patients who metabolize digoxin in the GI tract, neomycin may increase serum digoxin levels.
• Methotrexate: Absorption may be reduced by oral neomycin.
• Ototoxic or Nephrotoxic Drugs: Concurrent use increases the risk of additive toxicity, even with oral neomycin, and should be done with caution.
• Penicillin VK (oral): Concurrent use may cause malabsorption of the penicillin.
• Warfarin: Oral neomycin may decrease vitamin K absorption from the gut, potentially increasing anticoagulant effects.
• Other ototoxic drugs (e.g., loop diuretics, other aminoglycosides): Increased risk of cumulative ototoxicity (deafness and vestibular dysfunction)
• Potassium: Decreased absorption of potassium
• Vitamin K: Decreased absorption of vitamin K
• Furosemide: Synergistic ototoxicity and nephrotoxicity

Frequently asked questions