Paromomycin

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Paromomycin Brand Name– Humatin

What is Paromomycin

Paromomycin (also known as aminosidine, Gabbromicina) is an aminoglycoside antibiotic that is structurally similar to neomycin and kanamycin. It is derived from cultures of Streptomyces rimosus.

The spectrum of activity includes many of the protozoal species. Paromomycin is also active against nearly all of the important gram negative aerobic bacteria, with the exception of Pseudomonas aeruginosa. Anaerobic bacteria are resistant to paromomycin.

The gram positive bacteria, Staphylococcus aureus and S. epidermidis are generally sensitive to paromomycin, while streptococci and gram positive bacilli are relatively resistant.

Although bioavailability after oral administration is especially poor, paromomycin is administered orally in patients with hepatic coma, intestinal amebiasis, and various intestinal parasites.

Paromomycin has also been used as a topical formulation for the treatment of trichomoniasis. An injectable form of paromomycin (aminosidine) has been available outside the US for many years.

Although reported in some literature to be extremely ototoxic and nephrotoxic when given to animals and humans, treatment with the injection has not resulted in a higher incidence of toxicity than either gentamicin or kanamycin.

Aminosidine injection has been studied extensively in India, Africa and the United Kingdom for visceral leishmaniasis.

Paromomycin has orphan drug designations for the treatment of visceral leishmaniasis, multiple-drug resistant tuberculosis, and Mycobacterium avium complex.

The oral form of paromomycin is the only product that is FDA approved for use in the United States.

Paromomycin was first marketed in 1959.

Indications

  1. amebiasis
  2. cestodiasis
  3. cryptosporidiosis
  4. Cryptosporidium parvum
  5. Dientamoeba fragilis
  6. Diphyllobothrium latum
  7. Dipylidium caninum
  8. Entamoeba histolytica
  9. giardiasis
  10. hepatic encephalopathy
  11. Hymenolepis nana
  12. leishmaniasis
  13. Taenia saginata
  14. Taenia solium
  15. Trichomonas vaginalis

Side Effects

  1. abdominal pain
  2. azotemia
  3. cylindruria
  4. diarrhea
  5. hearing loss
  6. hyposthenuria
  7. myasthenia
  8. nausea
  9. oliguria
  10. proteinuria
  11. pyuria
  12. renal failure (unspecified)
  13. renal tubular acidosis (RTA)
  14. renal tubular necrosis
  15. superinfection
  16. vertigo
  17. vitamin B12 deficiency
  18. vitamin B6 deficiency

Monitoring Parameters

  • audiometry
  • serum creatinine/BUN

Contraindications

  • aminoglycoside hypersensitivity
  • botulism
  • breast-feeding
  • colitis
  • dehydration
  • diarrhea
  • driving or operating machinery
  • GI disease
  • GI obstruction
  • hearing impairment
  • ileus
  • inflammatory bowel disease
  • myasthenia gravis
  • parkinsonism
  • pregnancy
  • pseudomembranous colitis
  • renal failure
  • renal impairment
  • ulcerative colitis

Patients with aminoglycoside hypersensitivity should not receive paromomycin. Allergenic reactions to aminoglycosides are generally uncommon, but hypersensitivity with one agent may demonstrate cross-sensitivity with another aminoglycoside.

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Diphenhydramine
  • Acyclovir
  • Adefovir
  • Aldesleukin, IL-2
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Aprotinin
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atracurium
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Bacitracin
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Beractant
  • Bictegravir; Emtricitabine; Tenofovir Alafenamide
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bleomycin
  • Botulinum Toxins
  • Bumetanide
  • Calfactant
  • Capreomycin
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carboplatin
  • Cefepime
  • Cefotaxime
  • Cefotetan
  • Cefoxitin
  • Cefprozil
  • Ceftazidime
  • Ceftazidime; Avibactam
  • Ceftizoxime
  • Cefuroxime
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Choline Salicylate; Magnesium Salicylate
  • Cidofovir
  • Cisatracurium
  • Cisplatin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colfosceril; Cetyl Alcohol; Tyloxapol
  • Cyclizine
  • Cyclosporine
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Deferasirox
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Promethazine
  • Digoxin
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Doxacurium
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir alafenamide
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Enflurane
  • Entecavir
  • Ethacrynic Acid
  • Fluphenazine
  • Foscarnet
  • Furosemide
  • Gallium
  • Gallium Ga 68 Dotatate
  • Ganciclovir
  • Ginger, Zingiber officinale
  • Gold
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibandronate
  • Ibuprofen lysine
  • Immune Globulin IV, IVIG, IGIV
  • Inotersen
  • Iohexol
  • Iopamidol
  • Iopromide
  • Ioversol
  • Isosulfan Blue
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Magnesium Salicylate
  • Mannitol
  • Meclizine
  • Meperidine; Promethazine
  • Mesoridazine
  • Methotrexate
  • Mivacurium
  • Neuromuscular blockers
  • Non-Ionic Contrast Media
  • Oral Contraceptives
  • Pamidronate
  • Pancuronium
  • Pentamidine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenylephrine; Promethazine
  • Polymyxin B
  • Polymyxins
  • Poractant Alfa
  • Promethazine
  • Pyridostigmine
  • Rapacuronium
  • Rocuronium
  • Salicylates
  • Salsalate
  • Scopolamine
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Streptozocin
  • Succinylcholine
  • Surfactants
  • Tacrolimus
  • Telavancin
  • Tenofovir Alafenamide
  • Tenofovir, PMPA
  • Thioridazine
  • Torsemide
  • Trifluoperazine
  • Trimethobenzamide
  • Tubocurarine
  • Urea
  • Valacyclovir
  • Valganciclovir
  • Vancomycin
  • Vecuronium
  • Warfarin
  • Zalcitabine, ddC
  • Zoledronic Acid

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