Amikin
Generic Name
amikin-100-mg-injection
Manufacturer
Bristol-Myers Squibb
Country
USA
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| amikin 100 mg injection | ৳ 16.00 | N/A |
Description
Overview of the medicine
Amikacin is an aminoglycoside antibiotic used to treat a variety of severe bacterial infections, including those resistant to other antibiotics. It is particularly effective against gram-negative bacteria.
Uses & Indications
Dosage
Adults
Typically 15 mg/kg/day, administered as a single daily dose or divided into 7.5 mg/kg every 12 hours. Max dose: 1.5 g/day for up to 10 days.
Elderly
Careful monitoring of renal function and dose adjustment based on creatinine clearance is crucial due to age-related decline in kidney function.
Renal_impairment
Significant dose reduction and/or extended dosing intervals are required based on the patient's creatinine clearance to prevent accumulation and toxicity.
How to Take
Administer by slow intravenous infusion over 30-60 minutes or by deep intramuscular injection. For IV infusion, dilute the 100 mg vial in 50-200 mL of a compatible IV fluid (e.g., 0.9% NaCl, D5W).
Mechanism of Action
Amikacin irreversibly binds to the 30S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis and leading to bacterial cell death. It exhibits concentration-dependent bactericidal activity.
Pharmacokinetics
Onset
Rapid (intravenous infusion), 30-60 minutes (intramuscular injection).
Excretion
Primarily excreted unchanged by glomerular filtration in the urine. Approximately 94-98% of the dose is recovered in the urine within 24 hours in individuals with normal renal function.
Half life
2-3 hours (in patients with normal renal function). Prolonged significantly in renal impairment.
Absorption
Poorly absorbed from the gastrointestinal tract; rapidly and completely absorbed after intramuscular (IM) injection. Peak plasma concentrations are reached within 1 hour after IM administration.
Metabolism
Amikacin is not significantly metabolized in the body.
Side Effects
Contraindications
- Hypersensitivity to amikacin or any other aminoglycoside.
- History of severe toxic reactions to aminoglycosides.
Drug Interactions
Cephalosporins
Some cephalosporins may increase amikacin levels or alter its effects.
Loop diuretics (e.g., Furosemide)
Increased risk of ototoxicity (hearing and balance problems).
Neuromuscular blocking agents (e.g., Succinylcholine)
Enhanced neuromuscular blockade, potentially leading to respiratory depression or paralysis.
Other nephrotoxic drugs (e.g., Vancomycin, Amphotericin B, Cisplatin, NSAIDs)
Increased risk of nephrotoxicity (kidney damage).
Storage
Store at controlled room temperature (20-25°C, excursions permitted to 15-30°C). Protect from light and freezing. Do not refrigerate.
Overdose
Symptoms of overdose include nephrotoxicity, ototoxicity (hearing loss, vertigo), and neuromuscular blockade (respiratory paralysis). Management involves supportive care, maintaining hydration, and possibly hemodialysis to remove amikacin from the blood. Calcium salts may be used to counteract neuromuscular blockade.
Pregnancy & Lactation
Pregnancy: Category D. Amikacin can cause fetal harm, including congenital deafness. Use only if potential benefits outweigh the potential risks to the fetus. Lactation: Amikacin is excreted in breast milk in small amounts. Use with caution during breastfeeding; monitor the infant for gastrointestinal disturbances (e.g., diarrhea, candidiasis).
Side Effects
Contraindications
- Hypersensitivity to amikacin or any other aminoglycoside.
- History of severe toxic reactions to aminoglycosides.
Drug Interactions
Cephalosporins
Some cephalosporins may increase amikacin levels or alter its effects.
Loop diuretics (e.g., Furosemide)
Increased risk of ototoxicity (hearing and balance problems).
Neuromuscular blocking agents (e.g., Succinylcholine)
Enhanced neuromuscular blockade, potentially leading to respiratory depression or paralysis.
Other nephrotoxic drugs (e.g., Vancomycin, Amphotericin B, Cisplatin, NSAIDs)
Increased risk of nephrotoxicity (kidney damage).
Storage
Store at controlled room temperature (20-25°C, excursions permitted to 15-30°C). Protect from light and freezing. Do not refrigerate.
Overdose
Symptoms of overdose include nephrotoxicity, ototoxicity (hearing loss, vertigo), and neuromuscular blockade (respiratory paralysis). Management involves supportive care, maintaining hydration, and possibly hemodialysis to remove amikacin from the blood. Calcium salts may be used to counteract neuromuscular blockade.
Pregnancy & Lactation
Pregnancy: Category D. Amikacin can cause fetal harm, including congenital deafness. Use only if potential benefits outweigh the potential risks to the fetus. Lactation: Amikacin is excreted in breast milk in small amounts. Use with caution during breastfeeding; monitor the infant for gastrointestinal disturbances (e.g., diarrhea, candidiasis).
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 2-3 years when stored as recommended; consult the specific product's label for exact shelf life.
Availability
Hospitals, Pharmacies
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Amikacin has undergone extensive clinical trials since its development in the 1970s, establishing its efficacy and safety profile. Ongoing research includes studies on optimal dosing strategies, monitoring techniques, and resistance patterns in various bacterial infections.
Lab Monitoring
- Renal function (serum creatinine, blood urea nitrogen - BUN) must be monitored regularly (e.g., every 1-3 days).
- Amikacin peak and trough serum levels should be measured to optimize dosing and minimize toxicity.
- Audiometric testing (pure tone and speech audiograms) is recommended before and periodically during therapy, especially in high-risk patients or for prolonged treatment.
Doctor Notes
- Strictly monitor renal function (creatinine, BUN) and obtain baseline and serial audiograms, especially in elderly patients, those with renal impairment, or when co-administered with other nephrotoxic/ototoxic drugs.
- Therapeutic drug monitoring (TDM) of peak and trough serum levels is highly recommended to ensure efficacy and minimize toxicity. Adjust doses based on TDM results and clinical response.
- Be vigilant for signs of neuromuscular blockade, particularly in patients with pre-existing neuromuscular disorders or those receiving neuromuscular blocking agents.
Patient Guidelines
- Report any changes in hearing, balance, or vision immediately to your doctor.
- Notify your doctor if you experience decreased urination, swelling, or unusual tiredness.
- Complete the full prescribed course of treatment, even if you feel better.
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered. If it is close to the time for the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Amikacin may cause dizziness, vertigo, or balance problems. Patients should exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain adequate hydration throughout the treatment period.
- Avoid concurrent use of other ototoxic or nephrotoxic medications unless specifically advised by your doctor.
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