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amikacin

Generic Amikacin
Used for Bacterial Infection

Amikacin is an aminoglycoside antibiotic that's used to treat several types of bacterial infections in adults and children. It's given as an injection into the veins (IV) or into the muscle (IM) by a healthcare professional. The dosage depends on your age, your weight, and the severity of your infection. Side effects aren't common as long as the level of amikacin in your blood is in a certain range. But they can include diarrhea, nausea, and rash. High amikacin blood levels can lead to more severe risks, such as hearing loss or kidney damage.

Reviewed by:Last reviewed on July 23, 2024
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What is Amikacin?

What is Amikacin used for?

How Amikacin works

Amikacin is an aminoglycoside antibiotic. It works by preventing bacteria from making certain proteins for growth and survival. This stops the bacteria from growing and spreading.

Drug facts

Common BrandsNo brand name available
Drug ClassAminoglycoside antibiotic
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Side effects of Amikacin

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Side effects aren't common. See Other Side Effects.

Less Common Side Effects

  • Rash
  • Fever
  • Headache
  • Tingling or "pins-and-needles" feeling
  • Tremor
  • Nausea
  • Vomiting
  • Joint pain
  • Low blood pressure
  • Low magnesium levels

Amikacin serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Side effects related to the nervous system: hearing problems, ringing in the ears, dizziness, numbness, tingling, muscle twitching, difficulty breathing, seizure
  • Serious kidney problems: tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, muscle cramps
  • C. difficile-related diarrhea: fever, stomach pain or cramps, foul-smelling diarrhea, frequent bowel movements (up to 15 times per day)
  • Serious allergic reaction: hives, rash, swelling of the lips or tongue, difficulty breathing

Source: DailyMed

The following Amikacin side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

Agitation

black, tarry stools

bloody or cloudy urine

bluish lips or skin

blurred vision

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

chest pain

chills

coma

confusion

cough

decrease in the amount of urine

decreased urine output

depression

difficulty with breathing

difficulty with moving

dizziness

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

drowsiness

dry mouth

feeling of fullness in the ears

fever

headache

hearing loss

irritability

lethargy

loss of balance

loss or change in hearing

muscle pain or stiffness

muscle twitching

nausea

not breathing

pain in the joints

pain in the lower back or side

painful or difficult urination

pale skin

rapid weight gain

ringing or buzzing in the ears

seizures

shakiness in the legs, arms, hands, or feet

shortness of breath

sore throat

sores, ulcers, or white spots on the lips or in the mouth

stupor

sweating

swelling of the face, ankles, or hands

swollen glands

thirst

trembling or shaking of the hands or feet

trouble with hearing

troubled breathing with exertion

unusual bleeding or bruising

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Skin rash

vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Pros and cons of Amikacin

Pros

Cons

  • Requires your care team to draw your blood often to check your amikacin levels and make sure it's working and is safe for you
  • Given as an injection
  • Possible risk for hearing problems and kidney damage
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Pharmacist tips for Amikacin

pharmacist
  • Tell your care team about all of the medications you take, especially if you're taking diuretics (water pills) or other antibiotics. These medications can interact with amikacin and raise your risk for kidney damage and hearing problems.
  • If your care team says that you don't need to stay in the hospital for treatment, be sure to mark your appointments on your calendar for your doses, any follow-up visits with them, and any lab tests. This will help make sure your amikacin treatment is going well and that the antibiotic is as safe as possible for you. Carefully follow your care team's instructions to help safely fight your infection.
  • Your care team might order different tests to keep track of your amikacin treatment. These tests help check your amikacin blood levels, kidney health, and hearing. They're important for your infectious disease specialist to decide whether you need dose adjustments to keep the antibiotic working well for you and to keep you safe from side effects.
  • It's possible for amikacin to cause diarrhea. Most times, diarrhea from treatment goes away when you stop taking the antibiotic. But tell your care team right away if you start having watery or bloody diarrhea, fever, fatigue, or stomach cramps anytime during treatment or after stopping amikacin. These can be signs of infectious diarrhea that can be serious and it needs to be treated right away.
  • Get medical help right away if you experience any confusion, ringing in the ears, hearing loss, muscle twitching, tingling, or seizure. These could be signs of side effects of the antibiotic that affect your nervous system.
  • Contact your care team if you develop other symptoms of an illness or if your symptoms become worse. Amikacin can only treat infections caused by bacteria, so it won't help if you have an infection caused by a virus or fungus.
  • It's important to get all of your amikacin doses as instructed and finish your treatment course, even if you feel better. Otherwise, your infection might get worse or become harder to treat.
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Common questions about Amikacin

Amikacin is given by a healthcare professional (HCP) as an infusion into the veins (IV) or as an injection into the muscle (IM). The IV infusion typically takes about 30 minutes to an hour. Keep in mind that your HCP might slow down the infusion depending on how well you tolerate the infusion.

It depends on the type of infection and the severity of your infection. For more serious infections, you'll typically be admitted into the hospital to get treated with amikacin so that a care team can closely monitor your treatment. In some situations, your infectious disease specialist might arrange for you to get treated with amikacin without having to stay at the hospital (e.g., home infusion, clinic). This typically depends on how long you need amikacin and your insurance coverage.

You can probably take amikacin safely if you're allergic to penicillin. This is because amikacin and penicillins are two different types of antibiotics. Amikacin is an aminoglycoside antibiotic, whereas penicillin is a beta-lactam antibiotic. They work differently in your body to treat similar infections. If you're allergic to one, it doesn't mean you'll be allergic to the other.

It can take up to 10 hours for most of amikacin to leave the body after a single dose for people with healthy kidneys. This time frame is based on an estimate of the amikacin's half-life, which is a measure of how long it takes the body to get rid of half of the medication from its system. Keep in mind that the kidneys help the body get rid of amikacin. So when the kidneys aren't working as well as they should (like in people with kidney problems), it might take longer for the body to remove the antibiotic.

Amikacin primarily covers (or fights against) a group of bacteria called Gram-negative bacteria, which can include Escherichia coli (E. coli). More specifically, amikacin is typically used to treat people who have suspected or confirmed infections caused by resistant bacteria, such as Pseudomonas and Acinetobacter baumanii.

Yes, amikacin covers (fights against) the bacteria called Pseudomonas aeruginosa. This is the most common type of the Pseudomonas species that causes infections in people. Pseudomonas aeruginosa is known to cause potentially severe and life-threatening infections if they aren't properly treated. This is why amikacin is often used when it's confirmed or suspected that an infection is caused by Pseudomonas aeruginosa.

Yes. Aminoglycoside antibiotics like amikacin are well-known to potentially cause hearing loss. Your care team will test your hearing regularly throughout treatment, especially if you need to take amikacin for a long time. Let your care team know right away if you notice any changes to your hearing.

Amikacin isn't typically recommended if you're pregnant. Studies found that some children born to mothers who took an aminoglycoside antibiotic similar to amikacin during pregnancy had hearing problems, including deafness. Because of this possible risk, the infectious disease specialist will decide to treat you with amikacin only if it's clearly needed during pregnancy. Make sure your care team knows whether you're pregnant before they start to discuss your treatment options.

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Risks and warnings for Amikacin

Amikacin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Risk of side effects related to the nervous system, including hearing loss

  • Risk factors: History of brain, nervous system, or hearing problems | Taking other medications that cause nervous system or hearing problems | Taking too much amikacin | Taking amikacin for too long | Premature and newborn babies | Older age | Dehydration (low fluids in the body)

Warning Icon Amikacin can potentially cause nervous system problems, including dizziness, numbness, tingling, muscle twitching, difficulty breathing, and even seizures. It's also possible for amikacin to cause ringing in the ears or permanent partial or total hearing loss, typically in both ears. Your risk for hearing problems is higher if you're also taking other medications that can cause hearing loss, such as diuretics (e.g., furosemide (Lasix)).

blank warning iconDepending on how long you need amikacin treatment, your care team might test your hearing regularly during treatment. Get medical help right away or contact your care team if you notice changes in your hearing, dizziness, numbness, tingling, or muscle twitching. They can help you manage these effects.

Kidney problems

  • Risk factors: History of kidney problems | Taking other medications that cause kidney damage | Taking too much amikacin | Taking amikacin for too long | Premature and newborn babies | Older age | Dehydration (low fluids in the body)

Warning IconAmikacin can potentially damage the kidneys. Sometimes, kidney damage can cause your body to not make urine as well. Your risk is higher if you're also taking other medications that can harm your kidneys.

blank warning iconYour care team will check your kidney health through urine and blood tests while you're getting treated with amikacin. The infectious disease specialist will adjust your dose or stop treatment if it appears that the antibiotic has affected the kidneys.

blank warning iconTo protect your kidneys, your care team will be sure to give you IV fluids when you're getting your amikacin injection. They might also recommend that you stay well hydrated during treatment. Contact your care team if you notice signs or symptoms of kidney problems, such as tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, or muscle cramps.

Risk of harm to unborn baby

Warning Icon It's possible for aminoglycoside antibiotics like amikacin to cause harm to an unborn baby when it's given during pregnancy. This can include hearing loss. Because of the risk of harm, your care team should be aware of whether you're pregnant before your amikacin treatment starts, if possible. Depending on your infection and your risk factors, the infectious disease specialist might consider a different antibiotic for you.

Serious allergic reaction

  • Risk factors: Allergy to sulfites

Serious allergic reactions to amikacin are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (e.g., closing of the throat). Call for help right away if you notice hives, difficulty breathing, a choking sensation, swelling around your eyes, or swelling of the lips or tongue while you're getting treated with amikacin.

The amikacin injection contains an ingredient called sulfite. Certain people might be sensitive to sulfite and have an allergic reaction to it. Depending on your reaction, the infectious disease specialist might switch you to another antibiotic.

Diarrhea from Clostridioides difficile infection

Antibiotics, including amikacin, raise your risk of getting infected with a bacteria called Clostridioides difficile (C. diff). Antibiotics change the amount of normal bacteria in your stomach and intestines. This can cause C. diff to overgrow in your gut and lead to an infection that causes diarrhea. This diarrhea can sometimes be life-threatening.

C. diff-related diarrhea is a medical emergency. Fet medical attention right away if you experience rapid heart rate, fever, nausea, foul-smelling diarrhea, bloody stools, or frequent bowel movements (even up to 15 times per day). You'll need to get tested for C. diff infection and get treated, if needed.

Development of drug-resistant bacteria

The infectious disease specialist will closely watch your amikacin treatment to make sure you're taking the antibiotic for the appropriate infection and amount of time. Taking amikacin for any shorter or longer periods of time or taking the antibiotic for other illnesses can raise your risk for developing infections caused by drug-resistant bacteria. This puts you at risk of having a severe and life-threatening infection that might be difficult to treat.

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Amikacin dosage

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Interactions between Amikacin and other drugs

Amikacin may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Amikacin. Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Ataluren

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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Amikacin contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Amikacin will not be safe for you to take.

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What are alternatives to Amikacin?

There are a number of medications that your doctor can prescribe in place of Amikacin. Compare a few possible alternatives below.
Amikacin
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References

Best studies we found

American Academy of Allergy, Asthma, and Immunology. (2024). Sulfite and sulfa drugs.

Bush, L. M. (2024). Overview of gram-negative bacteria. Merck Manual Consumer Version.

Bush, L. M. (2024). Pseudomonas infections. Merck Manual Consumer Version.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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