Garamycin
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Garamicin is a broad-spectrum antibacterial agent from the aminoglycoside group.
Release form and composition
- Solution for injection (1 and 2 ml in ampoules, 10 ampoules in a package);
- Cream (15 g in tubes);
- Ointment (15 g in tubes).
The active substance is gentamicin sulfate:
- 1 ml of solution - 0.04 g;
- 1 g of cream - 0.001 g;
- 1 g of ointment - 0.001 g.
Indications for use
For injection solution:
- Sepsis in newborns;
- Bacteremia;
- Septicemia;
- Respiratory tract infections;
- Gastrointestinal tract infections;
- Urinary tract and kidney infections;
- Central nervous system infections, incl. meningitis;
- Intraperitoneal infections, incl. peritonitis;
- Eye infections;
- Bone, soft tissue and skin infections, incl. infected wounds and burns;
- Gonorrhea;
- Perioperative prevention of infection.
Cream and ointment are used to treat bacterial skin lesions.
Contraindications
Absolute:
- Severe chronic renal failure with uremia and azotemia;
- Acoustic neuritis;
- History of hypersensitivity to the drug or other aminoglycosides.
Relative (due to the risk of complications, care should be taken):
- Botulism;
- Parkinsonism;
- Myasthenia gravis;
- Renal failure;
- Dehydration;
- Prematurity of children;
- Newborn period;
- Elderly age.
During pregnancy and lactation, the use of the drug is possible only if there are vital indications.
Method of administration and dosage
Cream and ointment
Cream and ointment Garamicin is applied externally: a thin layer is applied to the affected skin surfaces 3-4 times a day. If necessary, the product can be used under a bandage.
Injection
Solution for injection Garamycin is intended for intramuscular and intravenous administration.
The drug is injected intravenously over 1.5-2 hours in a 5% dextrose solution or 0.9% sodium chloride solution, the injected volume is from 50 to 300 ml. For children, the volume of injected fluid is reduced (the concentration should not exceed 0.1% = 1 mg / ml).
For diseases of moderate severity, adults with normal renal function are prescribed 3 mg / kg per day with a frequency of administration 2 or 3 times a day, respectively, in two equal portions after 12 hours or in three equal portions after 8 hours.
In a severe course of the disease with a high risk of death, the daily dose is increased to 5 mg / kg with a multiple of 3-4 times, after clinical improvement of the condition, the dose is reduced to 3 mg / kg / day. The course of treatment is no more than 7-10 days.
In case of infectious and inflammatory diseases of the urinary tract in patients with normal renal function, the drug is administered intramuscularly at a dose of 120-160 mg once a day for 7-10 days, for gonorrhea - intramuscularly once at a dose of 240-280 mg. Intramuscularly, it is recommended to inject 1/2 dose into each buttock.
Doses for children:
- Newborns (before the 7th birthday) and premature babies - 2.5-3 mg / kg every 12 hours;
- Infants over 7 days old and children under 1 year old - 2.5 mg / kg every 8 hours;
- Children over 1 year old - 2-2.5 mg / kg every 8 hours.
Elderly people and patients with impaired renal excretory function, as well as with severe burn disease, the dose of Garamicin is determined depending on the concentration of gentamicin in the blood plasma. The interval between average doses is determined by the formula: interval (in hours) = creatinine concentration (mg / 100 ml) x 8.
In severe infectious processes, the introduction of smaller doses with greater frequency is recommended. In this case, a single dose should be selected so that the maximum concentration of gentamicin does not exceed 0.012 mg / ml.
For obesity, ascites and edema, the dose is determined by "dry" and "ideal" body weight.
In case of impaired renal function and hemodialysis after the session, it is recommended to administer the drug in a dose: for adults - 1-1.7 mg / kg, for children - 2-2.5 mg / kg, depending on the severity of the infection.
Side effects
- Digestive system: nausea, vomiting, hyperbilirubinemia, increased activity of hepatic transaminases;
- Hematopoietic organs: granulocytopenia, leukopenia, thrombocytopenia, anemia;
- Nervous system: feeling of numbness, paresthesia, muscle twitching, drowsiness, headache, epileptic seizures; in children - psychosis;
- Urinary system: impaired renal function (microhematuria, proteinuria, oliguria); in some cases - renal tubular necrosis;
- Sense organs: labyrinth and vestibular disorders, hearing loss, tinnitus, irreversible deafness;
- Allergic reactions: fever, skin rash, itching, eosinophilia, angioedema;
- Others: fever, superinfection;
- Laboratory indicators: in children - hypokalemia, hypocalcemia, hypomagnesemia.
special instructions
During treatment, the serum gentamicin concentration and creatinine clearance should be monitored, especially in the elderly.
The risk of developing nephrotoxicity is higher in patients with impaired renal function, as well as when using the drug in high doses or for a long period. For this reason, kidney function should be monitored regularly: 1-2 times a week, and in patients receiving large doses or being treated for more than 10 days - daily.
In order to prevent the development of hearing impairment, it is necessary to periodically (1-2 times a week) examine the vestibular function to determine hearing loss at high frequencies. In case of unsatisfactory audiometric tests, the dose should be reduced or the drug should be discontinued.
Patients with infectious and inflammatory diseases are advised to consume an increased amount of fluid during treatment.
The likelihood of developing resistance of microorganisms should be considered. In this case, it is necessary to cancel Garamycin and prescribe appropriate treatment, based on the antibiogram data.
One should bear in mind the likelihood of neuromuscular blockade and respiratory paralysis.
Drug interactions
- Curariform drugs: their muscle relaxant effect is enhanced;
- Anti-myasthenic drugs: their effectiveness decreases;
- Loop diuretics, cisplatin, other oto- and nephrotoxic drugs: increased nephro- and ototoxicity of gentamicin;
- Penicillin antibiotics (for example, carbenicillin, ampicillin): the antimicrobial effect of gentamicin increases;
- Parenteral indomethacin: the risk of developing the toxic effects of Garamicin increases;
- Methoxyflurane, polymyxins for parenteral administration and other drugs that block neuromuscular transmission (narcotic analgesics, halogenated hydrocarbons as a means for inhalation anesthesia, transfusion of large amounts of blood with citrate preservatives): the risk of developing nephrotoxic effects and respiratory arrest due to increased neuromuscular blockade.
In the form of a solution, Garamicin is pharmaceutically incompatible with any other drugs, so they cannot be mixed in the same syringe.
Analogs
Garamicin analogues are: Gentamicin, Gentamicin K, Gentamicin sulfate, Gentamicin-AKOS, Amgent, Gentamin, Gentamicin Lerken, Gentamicin sterile sulfate, Gentamicin-Darnitsa, Gentamicin-K, Gentamicin-M. J., Gentamicin-Ratiopharm, Gentamicin-Teva, Gentamicin-Ferein, Gentatsikol, Gentina, Gentsin, Septopal.
Terms and conditions of storage
Store at temperatures from 2 to 30 ºС out of reach of children.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
