Netilmicin

475.58

475.58

260-146-8

DTXSID1048542

200

-3

1.32g/cm3

684.3ºC at 760mmHg

367.7ºC

1.597

Commercially available netilmicin sulfate injection should be stored at 2 - 30 deg C. /Netilmicin sulfate/

LD50 in mice (mg/kg): 40 i.v.; 125 i.p.; 175 s.c. (Miller)

D26 +164° (c = 3 in water)

P201, P202, P261, P271, P280, P281, P302+P352, P304+P312, P304+P340, P308+P313, P312, P322, P363, P405, P501

H312

SRP: At the time of review, criteria for land treatment or burial (sanitary landfill) disposal practices are subject to significant revision. Prior to implementing land disposal of waste residue (including waste sludge), consult with environmental regulatory agencies for guidance on acceptable disposal practices.

Manufacturers, packers, and distributors of drug and drug products for human use are responsible for complying with the labeling, certification, and usage requirements as prescribed by the Federal Food, Drug, and Cosmetic Act, as amended (secs 201-902, 52 Stat. 1040 et seq., as amended; 21 U.S.C. 321-392).

Concurrent and/or sequential use of 2 or more aminoglycosides by any route or concurrent use of capreomycin with aminoglycosides should be avoided since the potential for ototoxicity, nephrotoxicity, and neuromuscular blockade may be increased; hearing loss may occur and may progress to deafness even after discontinuation of the drug; loss of hearing may be reversible, but usually is permanent; neuromuscular blockade may result in skeletal muscle weakness and respiratory depression or paralysis (apnea). Also, concurrent use of 2 or more aminoglycosides may result in reduced bacterial uptake of each one since the medications compete for the same uptake mechanism. /Aminoglycosides/|Concurrent use of medications with neuromuscular blocking activity, including halogenated hydrocarbon inhalation anesthetics, opioid analgesics, and massive transfusions with citrate anticoagulated blood, with aminoglycosides should be carefully monitored since neuromuscular blockade may be enhanced, resulting in skeletal muscle weakness and respiratory depression or paralysis (apnea); caution is recommended when these medications and aminoglycosides are used concurrently during surgery or in the postoperative period, especially if there is a possibility of incomplete reversal of neuromuscular blockade postoperatively; treatment with anticholinesterase agents or calcium salts may help reverse the blockade. /Aminoglycosides/|Vancomycin and aminoglycosides must often be administered concurrently in the prophylaxis of bacterial endocarditis, in the treatment of endocarditis caused by streptococci and Corynebacteria species, in the treatment of resistant staphylococcal infections, or in penicillin-allergic patients; appropriate monitoring will help to reduce the risk of nephrotoxicity or ototoxicity; renal function determinations, serum aminoglycoside and vancomycin concentrations, dosage reductions, and/or dosage interval adjustments, or alternate antibacterials, may be required. /Aminoglycosides/|Concurrent or sequential use of these medications /nephrotoxic or ototoxic medications/ with aminoglycosides may increase the potential for ototoxicity or nephrotoxicity; hearing loss may occur and may progress to deafness even after discontinuation of the drug and may be reversible, but usually is permanent; serial audiometric function determinations may be required with concurrent or sequential use of other ototoxic antibacterials; renal function determinations may be required. /Aminoglycosides/|For more Interactions (Complete) data for NETILMICIN (9 total), please visit the HSDB record page.

Gentamycins|Netilmicin is indicated in the treatment of biliary tract infections caused by susceptible organisms. /Included in US product labeling/|Netilmicin is indicated in the treatment of bone and joint infections caused by susceptible organisms. /Included in US product labeling/|Netilmicin is indicated in the treatment of central nervous system infections caused by susceptible organisms. /Included in US product labeling/|For more Therapeutic Uses (Complete) data for NETILMICIN (13 total), please visit the HSDB record page.

CNS depression, characterized by stupor, flaccidity, coma, or deep respiratory depression, has been reported in very young infants receiving streptomycin at doses that exceeded the maximum recommended amount. However, all aminoglycosides have this potential to cause neuromuscular blockade. /Aminoglycosides/|These aminoglycosides /including netilmicin/ should be used with caution in premature infants and neonates because of these patients' immature renal capability, which may result in prolonged elimination half-life and aminoglycoside-induced toxicity. Dosage adjustments may be required in pediatric patients.|Because of their toxicity, aminoglycosides should be used with caution in elderly patients, only after less toxic alternatives have been considered and/or found ineffective. Elderly patients are more likely to have an age-related decrease in renal function. Recommended doses should not be exceeded, and the patient's renal function should be carefully monitored during therapy. Geriatric patients may require smaller daily doses of aminoglycosides in accordance with their increased age, decreased renal function, and, possibly, decreased weight. In addition, loss of hearing may result even in patients with normal renal function. /Aminoglycosides/|Neuromuscular blockade, respiratory paralysis, ototoxicity, and nephrotoxicity may occur following local irrigation and following topical application of aminoglycosides during surgery. /Aminoglycosides/|For more Drug Warnings (Complete) data for NETILMICIN (17 total), please visit the HSDB record page.

Netilmicin is poorly absorbed from the intact GI tract following oral administration. The drug is rapidly and completely absorbed following IM administration.|Following absorption, netilmicin rapidly distributes into tissues, sputum, and pericardial, synovial, and peritoneal fluids. ...distributed principally in the extracellular fluid volume... The volume of distribution ...is approximately 20% of body weight. The drug is reportedly 0-30% protein bound.|Netilmicin crosses the placenta and has been detected in cord blood. Small amounts of the drug are distributed into milk.|...is not metabolized and is excreted unchanged in urine mainly by glomerular filtration. In adults with normal renal function, 74% of a 2 mg/kg dose of netilmicin is excreted unchanged within 24 horus: in adults with creatinine clearances of 30-80 or 10-30 mL/min or in anephric adults, 55, 25, or 15% of the dose is excreted in urine within 24 hours, respectively.|Netilmicin is removed by hemodialysis. The drug is also removed by peritoneal dialysis but less readily than by hemodialysis.

The plasma elimination half-life on netilmicin is about 2-2.5 hr following IV or IM administration of a single dose in adults with normal renal function. The serum half-life is reported to be 18 hr in adults with creatinine clearances of 10-30 mL/min and more than 30 hr in anephric adults. The plasma elimination half-life of netilmicin in neonates is inversely related to birthweight and gestational and postnatal age and has been reported to be about 8 or 4.5 hr in neonates less than 7 days of age weighing 1.5-2 or 3-4 kg, respectively. The plasma elimination half-life for children 6 weeks of age and older is 1.5-2 hr.

Aminoglycosides are usually bacterial in action. Although the exact mechanism of action has not been fully elucidated, the drugs appear to inhibit protein synthesis in susceptible bacteria by irreversibly binding to 30S ribosomal subunits. /Aminoglycosides/|/AMINOGLYCOSIDES/ INHIBIT PROTEIN BIOSYNTHESIS & DECR FIDELITY OF TRANSLATION OF GENETIC CODE. /AMINOGLYCOSIDES/

Poison by intravenous, intramuscular, and subcutaneous routes. Human systemic effects by intravenous route: changes to kidney, ureter, and bladder.