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Why it's used

Amikacin is used for the short-term treatment of serious bacterial infections. It is a prescription medicine. This medicine works by killing the bacteria or preventing their growth. Amikacin is also used to treat life-threatening infections caused by bacteria (pseudomonas). It is also used to treat urinary tract infections. Amikacin is also used to treat inflammation of the heart valve (endocarditis). Amikacin is also used to treat the development of fever in patients with a low number of neutrophils (febrile neutropenic). Amikacin is also used to treat infections of the blood, skin, stomach, lungs, bones, and joints.
When not to use
Amikacin will not work against flu, cold or other viral infections.
Aminoglycoside Antibacterial
Amikacin belongs to a class of medicines called Aminoglycoside Antibacterial. Aminoglycoside antibacterials are a class of antibiotics used to treat serious bacterial infections. These include bloodstream infections, complicated intra-abdominal infections, complicated urinary tract infections, and respiratory tract infections. These medicines work by killing the bacteria by stopping the production of proteins needed for their survival.

How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Amikacin. If you have any questions related to this medicine, ask your doctor or pharmacist. Inject this medicine as recommended by your doctor.
Amikacin is injected with or without food. Before using Amikacin, patient's weight should be calculated for correct dosage.
The typical dose of Amikacin is 15 mg/kg (7lb) per day or 7.5 mg/kg (3.4lb) in a single dose or divided dose in every 12 hours respectively for intravenous (into a vein) or intramuscular (into a muscle) injection. The usual dose for children is 7.5 mg/kg (3.4lb) in a single dose or divided dose in every 12 hours for intravenous (into a vein) or intramuscular (into a muscle) injection. The maximum adult dose of Amikacin is 1500 mg/day in a day. This medicine is typically used for a period of 7-10 days for serious bacterial infection in premature infants, and 10 days for life-threatening infections caused by bacteria (pseudomonas) in adults.
This medicine should be used on an as-needed basis. You should continue to use this medicine as directed by the doctor even if you feel well.
Talk to your doctor if your condition does not improve or worsens. Tell your doctor if pain at the injection site, decreased appetite, fever, dizziness, feeling sick, and nausea and vomiting. If you have any kidney disease, Dosage in patients with abnormal functioning of the kidney is adjusted by either taking normal doses for long-term or by taking the low dose for fixed intervals.
If you are giving Amikacin to a child, be sure to use a product that is meant for children. Before giving this medicine to a child, use the child's weight or age to find the right dose from the product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
Amikacin injection is intended for intramuscular (into a muscle), intravenously (into a vein), and within the abdominal cavity (intraperitoneal).
Your doctor may request that specific lab tests be performed before you start using Amikacin. You may need to have Kidney Function Panel test. Amikacin may cause drug-induced kidney damage. Kidney parameter test is required before taking this medicine. Your doctor may request Antibiotic Susceptibility test. You may need to undergo Audiometry T test. Amikacin may cause drug-induced ear damage. Hearing test (audiometry) is required before taking this medicine. Before starting this medicine, your doctor would require you to undergo medical or laboratory tests (Kidney Function Panel, and Audiometry T) to monitor for side-effects. Once the administration of the medicine starts, your doctor should monitor you for these medical and laboratory tests to make sure that the side-effects of this medicine are not impacting your health.
You should store Amikacin above 25°C, away from moisture, and away from light. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Amikacin for conditions for which it was not prescribed. Do not give Amikacin to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Amikacin

The dose and frequency of using Amikacin will depend on the following factors:
  • age of the patient
  • the weight of the patient
  • patient's health
  • the health of the patient's liver
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements being used
  • response to the medicine

Amikacin Dosage

Dosage for serious bacterial infections

Adult (adults and children over 12 years)
  • Recommended: 15 mg/kg (7mg/lb) per day or 7.5 mg/kg (3.4 mg/lb) in a single dose or divided dose in every 12 hours respectively for intravenous (into a vein) or intramuscular (into a muscle) injection
  • Maximum: 1500 mg/day
Children (children 4 weeks to 12 years)
  • Recommended: 15-20 mg/kg (7-9 mg/lb) once a day or 7.5 mg/kg (3.4 mg/lb) in every 12 hours for intravenous (into a vein) and intramuscular (into a muscle) injection
Children (neonates)
  • Initial: 10 mg/kg (4.5 mg/lb) followed by 7.5 mg/kg (3.4 mg/lb) in every 12 hours for intravenous (into a vein) and intramuscular (into a muscle) injection
Children (premature infants)
  • Recommended: 7.5 mg/kg (3.4 lb) in every 12 hours for intravenous (into a vein) and intramuscular (into a muscle) injection
  • Maximum: 15-20 mg/kg (7-9 mg/lb) per day for intravenous (into a vein) and intramuscular (into a muscle) injection

Dosage for inflammation of the heart valve (endocarditis)

Adult (adults and children over 12 years)
  • Recommended: 7.5 mg/kg (3.4 mg/lb) twice daily for intravenous (into a vein) and intramuscular (into a muscle) injection
Children (children 4 weeks to 12 years)
  • Recommended: 7.5 mg/kg (3.4 mg/lb) twice daily for intravenous (into a vein) and intramuscular (into a muscle) injection

Dosage for development of fever in patients with a low number of neutrophils (febrile neutropenic)

Adult (adults and children over 12 years)
  • Recommended: 7.5 mg/kg (3.4lb) twice daily for intravenous (into a vein) and intramuscular (into a muscle) injection
Children (children 4 weeks to 12 years)
  • Recommended: 7.5 mg/kg (3.4 mg/lb) twice daily for intravenous (into a vein) and intramuscular (into a muscle) injection

Dosage for life-threatening infections caused by bacteria (Pseudomonas)

Adult
  • Recommended: 500 mg every eight hours for intravenous (into a vein)
  • Maximum: 15000 mg/day for intravenous (into a vein)

Dosage for urinary tract infections

Adult
  • Recommended: 7.5 mg/kg (3.4mg/lb) per day in two equally divided doses for intravenous (into a vein)

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Parental liquid
Strength: 250 mg/ml
Parental solution
Strength: 250 mg/ml, 50 mg/ml, 500 mg/2ml
Parental suspension
Strength: 590 mg/8.4mL

Special Instructions

Intravenous use (into a vein)
If required, suitable diluents such as 5% dextrose in water and normal saline are used for intravenous injection. This diluted solution should be used as soon as possible and should not be stored. For adults, this medicine should be injected slowly by infusion over a period of 30 to 60 minutes. In the case of infants, slow infusion of 1 to 2 hours is required to inject Amikacin intravenously.
Intraperitoneal use (into the abdominal cavity)
The intraperitoneal use of Amikacin is not recommended in young children.
Intramuscular (into the muscles)
Intramuscular route of Amikacin is preferred for most infections but in life-threatening or condition in which intramuscular route is not viable, the intravenous (IV) route may be used.

Overdose

What to do if you overdose on Amikacin?
Cleaning of the abdomen (peritoneal dialysis) and purification of blood (hemodialysis) is performed to remove Amikacin from the body. Ionic calcium solution like 10-20% gluconat or lactobionat solution is given in case of breathing arrest due to the neuromuscular blockage. Blood exchange method (exchange transfusion) may be considered in the newborn infant.
Symptoms of an overdose of Amikacin
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • harmful effect of drugs to ears
  • harmful effect of drugs to kidney
  • neuromuscular blockage with breathing arrest
If you think you have overdosed on Amikacin, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Amikacin

Before you use Amikacin, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic any of the following substances: gentamicin, kanamycin, streptomycin, sulfites, tobramycin, or neomycin.
Before you use Amikacin, tell your doctor of your medical and health history including the following: kidney disease, hearing disorders or tinnitus (ringing or buzzing in the ears, hearing loss), allergy to sulphites, condition damaging lung or digestive system (cystic fibrosis), muscle weakness, movement disorder (Parkinson's disease), seizures, dizziness, vertigo, or burning or numbness in hands, arms, feet, or legs. Before having surgery during the use of Amikacin, discuss with your doctor and dentist about the medicinal products you use including prescription/non-prescription/herbal medicines.
The use of this medicine may change excretion of proteins. The use of Amikacin may increase the excretion of protein in the urine.
The use of this medicine may change creatinine-clearance. The use of Amikacin may decrease the creatinine clearance.
The use of Amikacin may change blood-urea-nitrogen. The use of Amikacin may alter the functioning of the kidney.
The use of this medicine may change blood-creatinine. The use of Amikacin may alter the functioning of the kidney.
The use of Amikacin may change urine specific gravity. The use of Amikacin may decrease the excretion of urine components which lead to decrease specific gravity.
Amikacin can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Amikacin can worsen the sleepiness. Amikacin may cause rarely seizures in some people. If you perform any activities where a loss of consciousness may cause harm to you (or others), you should discuss with your doctor.
Consult with your doctor on the use of Amikacin during pregnancy, or if you are planning to become pregnant. Amikacin should be used in pregnant women if potential benefits justify the potential risk of medicine to the fetus. Amikacin may affect your developing baby if Amikacin is given it during pregnancy. Consult with your doctor on the use of Amikacin during breastfeeding. It is not known whether Amikacin may pass into breast milk. A decision should be made whether to discontinue breastfeeding or to discontinue Amikacin therapy. Consult with your doctor on the use of Amikacin, if you are trying to conceive. Amikacin should be used, only if potential benefits justify the potential risk of medicine.
Amikacin may cause increased incidence of side-effects in older patients. Elderly patients may see an increased risk of drug inducing harmful effect on the kidney, drug inducing harmful effect on ears, and neuromuscular blockade.
drug inducing harmful effect on kidney | drug inducing harmful effect on ears | neuromuscular blockade

Amikacin Side-effects

Rarely, the use of Amikacin may cause the following side-effects:
  • abnormally high levels of nitrogen-containing compounds in the blood (azotemia)
  • balance disorder
  • blindness
  • cells in urine
  • decreased appetite
  • dizziness
  • drug inducing kidney damage
  • feeling sick
  • headache
  • hearing loss (hypoacusis)
  • hives
  • increase in the number of eosinophils in the blood (eosinophilia)
  • joint pain
  • muscle twitching
  • nausea
  • numbness
  • pain at the injection site
  • presence of albumin in the urine (albuminuria)
  • rash
  • resistant growth of the bacteria or yeast
  • retinal arteries blockages
  • ringing in the ears (tinnitus)
  • severe skin itching
  • skin tingling
  • superinfections
  • tremor
  • vertigo
  • vomiting
  • wheezing
The following severe side-effects may also occur when using Amikacin:
  • immune system disorders
    Symptoms: life-threatening allergic reaction (anaphylactic reaction/anaphylactic shock/anaphylactoid reaction), allergic reaction, swelling of the face, lips tongue or other parts of the body
    Urgent medical attention should be required if these side effects occur.
  • If this happens, contact your doctor as soon as possible.
  • kidney and urinary disorders
    Symptoms: decreased urine production, increased blood creatinine acute kidney failure
    Urgent medical attention should be required if these side effects occur.
  • nervous disorder
    Symptoms: paralysis
    Urgent medical attention should be required if these side effects occur.
  • Symptoms: deficiency of red cells or hemoglobin in the blood (anaemia)
    If this happens, contact your doctor as soon as possible.
  • metabolism and nutrition disorder
    Symptoms: low magnesium level
    If this happens, consult with your doctor.
  • Symptoms: breathing difficulty during sleep (apnea), breathing difficulty (bronchospasm) shortness of breath
    Urgent medical attention should be required if these side effects occur.
  • Symptoms: deafness
    Hospitalization or urgent medical attention should be required if these side effects occur.
Your doctor has prescribed Amikacin because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Amikacin.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Use of Amikacin in neonatal and premature infants

Neonatal and premature infants are at an increased risk when using this medicine. The use of Amikacin may decrease the functioning of the kidney which may results in an increased time of staying (half-life) of medicine in the blood. Precaution should be taken in such patients when using Amikacin.

Patients using intravitreous (injection into the eye) of Amikacin

Patients using intravitreous (injection into the eye) of Amikacin are at an increased risk. Amikacin may cause visually disabling condition (macular infarction) which may lead to permanent loss of vision.

Patients having surgery

Patients having surgery are at an increased risk when using this medicine. The use of Amikacin during surgery may cause irreversible deafness, kidney failure, excessive growth of non-susceptible organisms and fatal. The large dose of Amikacin may cause defects of the neuromuscular junction (transient myasthenic syndrome) in patients during surgery. In case of excessive growth of non-susceptible organisms in patients, suitable therapy should be started.

Drug-induced harmful effect to ear

Patients with abnormal functioning of the kidney, patients using Amikacin high doses or for more 5-7 days are at an increased risk when using this medicine. These patients may experience skin tingling, high-frequency deafness, vertigo, numbness, convulsions and muscle twitching. Amikacin should not be used or dose adjustment should be considered when symptoms of drug-induced harmful effects to ear appear.

Drug-induced harmful effects to the neuromuscular system

Patients taking Amikacin, anaesthetics, neuromuscular blocking agents such as decamethonium, tubocurarine, succinylcholine, atracurium, vecuronium or rocuronium and patients receiving massive transfusions of citrate-anticoagulated blood are at an increased risk. These patients are at an increased risk of neuromuscular blockade and complete or severe weakness of the muscles of respiration (respiratory paralysis). Calcium salts along with artificial respiration through ventilator are used in such patients.

Patients with muscle weakness

Patients with muscle weakness are at an increased risk when using this medicine. The use of Amikacin may induce harmful effects to the neuromuscular system which may reduce the activity of neuromuscular transmission. Such patients should not use this medicine.

Patients with a movement disorder (Parkinson's disease)

Patients with parkinsonism disease are at an increased risk when using this medicine. The use of Amikacin may potentiate the risk of muscle weakness in these patients. Precaution is required in such patients.

Allergic to Amikacin, aminoglycosides or have kidney damage or eighth nerve damage caused by using nephrotoxic or ototoxic drugs

Patients allergic to aminoglycosides or have kidney disease or eighth nerve damage caused by using nephrotoxic or ototoxic drugs such as dihydrostreptomycin, streptomycin, polymyxin B, gentamicin, cephaloridine, tobramycin, kanamycin, neomycin, colistin, or viomycin are at an increased risk when using this medicine. These patients are at an increased risk of harmful effects to the kidney. Precaution should be taken in these patients. If needed, this medicine should be used after the opinion of a doctor when therapeutic benefits outweigh the possible risks.

History of inner ear or hearing damage and reduced urine production

Patients with a history of inner ear or hearing damage and reduced urine production are at an increased risk when using this medicine. The use of Amikacin in such patients may increase the risk of drug inducing harmful effects of ear and kidney. Patients should be well hydrated and kept under close clinical observation. A hearing ability test should be performed in these patients when Amikacin therapy is expected to last 7 days or more.

Amikacin at higher doses or for long-term

Patients taking Amikacin at higher doses or for long-term are at an increased risk. These patients are at an increased risk of kidney damage. Special precautions should be considered in such patients. Patients should be hydrated and should be monitored for the functioning of the kidney in starting of therapy and during the therapy. A dose reduction should be considered on the occurrence of symptoms of kidney failure such as the presence of albuminuria, red cells, white cells, or urinary casts, decreased urine specific gravity or creatinine clearance, and increased blood urea nitrogen, blood creatinine, or reduced urination. Amikacin should not be used if there is an increase in nitrogen-containing compounds (azotemia) or continuous decrease in urinary output.

Abnormal functioning of kidneys

Patients having abnormal functioning of the kidney are at an increased risk when using this medicine. These patients are at an increased risk of drug inducing harmful effects to the kidney. Precautions should be taken in such patients. Patients should be hydrated and monitored for the eighth-cranial nerve function, Amikacin levels in the blood and for the functioning of the kidneys in starting or during the therapy. A dose reduction should be considered on the occurrence of symptoms of kidney failure such as the presence of albuminuria, red cells, white cells, or urinary casts, decreased urine specific gravity or creatinine clearance, and increased blood urea nitrogen, blood creatinine, or reduced urination. Patients should stop using Amikacin on the occurrence of an increase in nitrogen-containing compounds (azotemia), continuous decrease in urinary output, symptoms of drug-induced kidney damage or harmful effects to ear such as vertigo, dizziness ringing or roaring in ear and loss of hearing, and dose adjustment should also be considered. The hearing test should be performed in patients at high risk.

Taking other neurotoxic or nephrotoxic drugs

Patients using Amikacin with cisplatin, kanamycin, vancomycin, polymyxin B, paromomycin, viomycin, colistin, bacitracin, amphotericin B, cephaloridine or other aminoglycosides are at an increased risk when using this medicine. These patients may increase the risk of drug-induced kidney damage. The patients should not use both medicines together.

Interactions with Amikacin

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Amikacin interacts with potent diuretics (ethacrynic acid or furosemide), which are used to increase the production of urine. Using Amikacin sulphate injection with diuretics may cause harmful effect to the ear. In addition, when diuretics are taken intravenously (into a vein), it may enhance the harmful effect of aminoglycoside by altering the level of antibiotic in the blood and tissue. The use of Amikacin sulphate injection with diuretics should be avoided.
There may be an interaction of Amikacin with beta-lactam antibotics such as penicillin, cephalosporins, which are used to treat bacterial infections. Using Amikacin parenterally with cephalosporins may increase the risk of drug-induced harmful effects on the kidney and increases the creatinine levels in the blood. In addition, when aminoglycosides or penicillins are given by a separate route, it may decrease the activity of the medicine in the blood.
Amikacin may interact with cisplatin, ciclosporin, tacrolimus, which are used to treat cancer. Using Amikacin with cisplatin, ciclosporin or tacrolimus may increase the risk of additive effects. The use of Amikacin with these agents should be avoided. If required, patients should be monitored carefully.
Your doctor's guidelines may need to be followed while taking this medicine along with bisphosphonates, which are used to treat the loss of bone density. When Amikacin is used with bisphosphonates, it may decrease the calcium level in the blood.
Special instructions need to be followed while taking this medicine along with amphotericin B, vancomycin, clindamycine, paromomycin, cephaloridine bacitracin, viomycin, colistin, polymyxin B, or other aminoglycosides which are used to treat bacterial infection. The use of Amikacin with these medicines increases the risk of additive effects. The use of Amikacin with these agents should be avoided.
Your doctor's guidelines may need to be followed while taking this medicine along with opioid painkillers such as codeine, morphine, pethidine, fentanyl which are used to treat mild, moderate and severe pain. Inform or talk to your doctor if you are taking these medicines.
Special instructions need to be followed while taking this medicine along with indomethacin, which is used to treat pain and swelling. Indomethacin may increase the levels of Amikacin in neonates.
Amikacin interacts with anesthetics or muscle-relaxing drugs (including ether, halothane, d-tubocurarine, succinylcholine, suxamethonium and decamethonium) which are used to induce paralysis and anesthesia. Using Amikacin intraperitoneally (inserted into the stomach) with anesthetics or muscle-relaxing drugs may cause neuromuscular blockade which may lead to slow and ineffective breathing. The intraperitoneal (inserted into the abdominal cavity) use of Amikacin with these medicines is not recommended.
There may be an interaction of Amikacin with thiamine (vitamin B1) which plays an important role in glucose metabolism, nerve, muscle, and heart functioning in the body. Thiamine (vitamin B1) may be destroyed by the reactive chemical part (sodium bisulfite) of Amikacin.
Amikacin may interact with platinum compounds, which are used to treat cancer. Using Amikacin with platinum compounds may increase the risk of a drug-induced harmful effect on the kidney and ears.
This page does not contain all the possible interactions of Amikacin. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Amikacin is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Amikacin .
Bacterial Infections
Urinary Tract Infections
Endocarditis
Pneumonia

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