AMISUL

*Serious Gram-negative infections resistant to gentamicin including, Bone & Joint Infections, Lower Respiratory Tract Infections, Septicemia and Meningitis:* BY IM INJ, OR BY SLOW IV INJ, OR BY IV INF: Adult: 15 mg/kg daily in 2 divided doses, increased to22.5 mg/kg daily in 3 divided doses for up to 10 days, higher dose to be used in severe infections; max.1.5 g per day; max. 15 g per course. Children: Neonates: initially10 mg/kg then 15 mg/kg daily in two divided doses; others same as adult. BY IV INF: Adult: Initially 15 mg/kg (max. per dose 1.5 g once daily), dose to be adjusted according to serum-amikacin concentration; max. 15 g per course.

Administer IM injection in large mass. Do not mix with other drugs, administer separately.The quantity of infusion solution in IV infusion should be sufficient to infuse amikacin over 1 to 2 hours in infants, and 30-60 min children and adults; at a final concentration not to exceed 5 mg amikacin/ ml.

Myasthenia gravis.

To avoid excessive dosage in obese patients, use ideal weight for height to calculate dose and monitor serum amikacin concentration closely. Care must be taken with dosage, caution in conditions characterized by muscular weakness (aminoglycosides may impair neuromuscular transmission). Ensure adequate hydration; if possible, dehydration should be corrected before starting an aminoglycoside, if possible, parenteral treatment should not exceed 7 days, renal impairment

Furosemide, ethacrynic acid, anaesthetics. Neuro-muscular blocking drugs.

Auditory damage, impaired neuromuscular transmission, irreversible ototoxicity, nephrotoxicity, transient myasthenic syndrome in patients with normal neuromuscular function with large doses given during surgery, vestibular damage. Rare: Antibiotic-associated colitis, electrolyte disturbances, hypocalcaemia, hypokalaemia, hypomagnesaemia on prolonged therapy, nausea, peripheral neuropathy, stomatitis, vomiting, Blood disorders, CNS effects, convulsions, encephalopathy, rash