Injection: 100 mg/2ml, 500 mg/2ml
Mycobacterium avium complex and multi-drug resistant tuberculosis: 15 mg/kg IV daily given in two equally divided doses or as a single dose.
The adult dose should not exceed 1.5 g/day nor be administered for a period longer than 10 days without review and checks for specific toxicity such as nephrotoxicty or hearing damage.
Renal toxicity, ototoxicity (tinnitus, vertigo, partial reversible or irreversible deafness), skin rash, pyrexia, headache, paraesthesia, nausea and vomiting. If therapy is expected to last 7 days or more in patients with renal impairment, or 10 days in other patients, a pre-treatment audiogram should be obtained and repeated during therapy. Amikacin therapy should be stopped if tinnitus or subjective hearing loss develops.
Other nephrotoxic drugs e.g. foscarnet, cidofovir (absolutely contraindicated), other aminoglycosides, amphotericin, IV pentamidine and high dose loop diuretics
The specific manufacturers’ advice must be followed in all patients with reduced renal function.
GFR 20–50: 5–6 mg/kg every 12 hours
GFR 10–20: 3–4 mg/kg every 24 hours
GFR <10: 2 mg/kg every 24–48 hours
No dosage adjustment currently recommended
Human Data Suggest Low Risk
For twice-daily dosing, a trough level should be taken prior to administering the 3rd or 4th dose. The dose or dosage interval should be modified if the trough level is >10mg/ml. Further serum level monitoring should be performed twice weekly.
The adult dose should not exceed 1.5 g/day. Treatment courses longer than 10 days requires careful monitoring and review. The stopping date should be stated clearly on the patient’s drug chart.