Neomycin Sulfate(nee o mye’ sin)
Mycifradin, Neo-fradin, Neo-Tabs
PREGNANCY CATEGORY D
Drug class
Aminoglycoside
Therapeutic Actions
Bactericidal: Inhibits protein synthesis in susceptible strains of bacteria; functional integrity of bacterial cell membrane appears to be disrupted, causing cell death. Due to poor PO absorption, oral neomycin is used to suppress GI bacterial flora.
Indications
Preoperative suppression of GI bacterial flora
Adjunct treatment in hepatic coma to reduce ammonia-forming bacteria in the GI tract
Contraindications and Cautions
Contraindicated with allergy to aminoglycosides, intestinal obstruction, pregnancy, lactation.
Use cautiously in the elderly or in patients with diminished hearing, decreased renal function, dehydration, neuromuscular disorders (myasthenia gravis, parkinsonism, infant botulism).
Available Forms
Tablets—500 mg; oral solution—125 mg/5 mL
Dosages
Adults
Preoperative preparation for elective colorectal surgery: See manufacturer’s recommendations for a complex 3-day regimen that includes oral erythromycin, bisacodyl, magnesium sulfate, enemas, and dietary restrictions.
Hepatic coma: 4–12 g/day PO in divided doses for 5–6 days, as adjunct to protein-free diet and supportive therapy, including transfusions, as needed.
Pediatric patients
Hepatic coma: 50–100 mg/kg/day PO in divided doses for 5–6 days, as adjunct to protein-free diet and supportive therapy including transfusions, as needed.
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