Drug Characteristics
  • Formulation

    Injection: 100 mg/2ml, 500 mg/2ml        

  • Dose

    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.        

  • Side Effects

    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.

  • Interactions

    Other nephrotoxic drugs e.g. foscarnet, cidofovir (absolutely contraindicated), other aminoglycosides, amphotericin, IV pentamidine and high dose loop diuretics

  • Renal

    The specific manufacturers’ advice must be followed in all patients with reduced renal function.

    Renal handbook

    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          

  • Hepatic

    No dosage adjustment currently recommended

  • Pregnancy

    Human Data Suggest Low Risk

  • Other Information

    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.