neomycin
Neomycin is an oral antibiotic. It's used to kill certain toxin-producing bacteria in the gut to ease the symptoms of hepatic encephalopathy (also called hepatic coma), a condition where there's brain damage caused by serious liver problems. It's also used to lower the risk of a bacterial infection before bowel surgery. You shouldn't take neomycin longer than what your provider has directed because it can cause serious kidney, nerve, and hearing problems when used long-term.
What is Neomycin?
What is Neomycin used for?
- Prevent bacterial infections during bowel surgery (taken with erythromycin)
- Remove certain toxin-producing bacteria in the gut (hepatic encephalopathy)
How Neomycin works
Neomycin is an aminoglycoside antibiotic. It kills bacteria by preventing them from making proteins that they need to survive.
In people with hepatic coma, neomycin helps remove the bacteria in the intestines (gut) that form toxins that are harmful to the brain; getting rid of these toxins help relieve some of the symptoms of this medical condition.
In people preparing for bowel surgery, neomycin helps remove the bacteria in the gut to help prevent a bacterial infection.
Drug facts
Side effects of Neomycin
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
- Nausea
- Vomiting
- Diarrhea
Less Common Side Effects
- Hearing loss
- Trouble maintaining balance
- Muscle weakness
Neomycin serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious kidney problems: swelling in your feet or ankles, difficulty making urine, feeling tired, feeling confused, nausea, and difficulty breathing
- Serious nerve problems: skin tingling, numbness, muscle weakness or twitching, difficulty breathing, slurred speech, drowsiness, headache
The following Neomycin 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 immediately if any of the following side effects occur:
More common
Itching, rash, redness, swelling, or other sign of irritation not present before use of this medicine
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:
Less common
Burning or stinging
After application, eye ointments may be expected to cause your vision to blur for a few minutes.
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 Neomycin
Pros
- Available as a lower-cost generic medication
- Taken by mouth, so good for people who don't like injections
- Works well for hepatic coma and bowel surgery preparations
- Might work well for people who didn’t see benefits with other medications for hepatic coma
Cons
- Likely to cause severe kidney problems
- Requires regular blood work and lab tests to monitor for serious side effects
- Not the first-line treatment for people with hepatic coma
- Might neeed to take multiple tablets at a time, depending on your condition
Pharmacist tips for Neomycin
- If you're taking neomycin for a bowel surgery, make sure to follow your provider's instructions on how to lower your risk of a bacterial infection before surgery. Your provider will ask you to be on a clear liquid diet for 3 days before the procedure. Clear liquid diet includes water, fruit juices with no pulp, sports drinks, low salt chicken broth, or Jell-O. Additionally, your provider will also prescribe several laxatives to use before your appointment.
- Don't take neomycin more often than what your provider directed. Taking this medication long-term can raise your risk of kidney damage, hearing loss, and getting a yeast infection.
- Make sure to get your routine blood and urine tests done on time while you’re taking neomycin so your provider can make sure this medication is safe for you. Your dose might change depending on these test results, so always follow your provider's most updated instructions on how much neomycin to take.
- Talk to a provider if you experience hearing loss or difficulty hearing while taking neomycin. This is because the medication can cause hearing problems.
- Since medications similar to neomycin can cause nerve problems that might lead to muscle weakness, people with a history of muscle problems, such as myasthenia gravis, should be careful about taking neomycin.
- Neomycin can interact with many medications. Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements, before you start neomycin. Talk with your provider or pharmacist if you have any questions about interactions with this medication.
Common questions about Neomycin
Maybe. If you're allergic to penicillin or sulfa antibiotics, neomycin might be safe for you to take since this medication doesn't contain either type of antibiotic. But if you're allergic to medications such as gentamicin (Gentak), tobramycin, and paromomycin, talk to your provider or pharmacist first before taking neomycin, since this medication is a similar antibiotic. Stop taking this medication and talk to your provider if you experience itching, skin rash, redness, or swelling.
No. It's very important to keep taking neomycin for as long as your provider instructs, even if you start to feel better. If you stop taking this medication too early or miss doses, your infection can become even harder to treat and might not respond to other antibiotics in the future.
Currently, oral neomycin is only FDA-approved to ease symptoms of hepatic coma or to prepare for a bowel surgery. Some studies suggest that neomycin might work well along with rifaximin (Xifaxan) in treating a medical condition called small intestinal bacterial overgrowth (SIMO). SIMO is caused by too much bacteria in the bowel, causing symptoms such as nausea, bloating, too much gas, belly pain, or diarrhea. There are many treatments available to treat SIMO, each with its own safety risks. If you have SIMO or other gut-bacteria related conditions, talk with your provider to see what the best option is for you.
No, you shouldn't take neomycin if you're pregnant. Although neomycin hasn’t been studied in human pregnancy, research of other antibiotics similar to neomycin suggest it can cause permanent hearing loss in unborn babies. If you're pregnant, talk to your provider to discuss the benefits and risks of taking neomycin or other possible options.
It's not clear whether neomycin is safe to use while breastfeeding. It hasn't been studied in nursing mothers, but medications similar to neomycin have been found in human milk. Generally, it's recommended that you don't breastfeed your baby while receiving this medication due to the risk of serious side effects to babies. Speak to your provider before using neomycin if you're breastfeeding. They can help you come up with the safest option for you and your baby.
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Risks and warnings for Neomycin
Neomycin 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.
Serious kidney problems
- Risk factors: Kidney problems | Taking other medications that can cause kidney problems | Taking higher doses of neomycin | Using neomycin for a long period of time | Older people | Not having enough fluids in your body
For certain people with one of the risk factors listed above, this medication can cause serious kidney problems. These problems can be life-threatening, sometimes leading to kidney failure. If you have any of the risk factors listed above, please talk with your provider so they can decide how you can take neomycin safely.
You’ll need to get blood and urine tests done before you start treatment and while you take neomycin so your provider can check your kidney health. If you experience vomiting, diarrhea, fever, or aren’t drinking fluids as often as usual during treatment, talk with your provider right away since dehydration can raise the risk for kidney problems. Please also talk with your provider if you're urinating less than usual while taking neomycin. You might need to take a lower dose of neomycin or stop this medication since these are signs of kidney problems.
Hearing and balance problems
- Risk factors: Hearing problems | Kidney problems | Taking other medications that can cause hearing problems, such as water pills | Taking higher doses of neomycin | Using neomycin for a long period of time | Young children
Neomycin can put you at risk for damage to your ears. Ear damage can sometimes result in hearing problems that aren't reversible. It can also lead make it difficult for you to maintain your balance. You’ll need to take a hearing test and balance test before starting neomycin and every so often during treatment so your provider can make sure this medication is safe for you. Keep in the mind that you can be at risk for this side effect up to several weeks after you've stopped taking neomycin. If you experience hearing loss or trouble maintaining your balance while taking or after you've received treatment with neomycin, please talk with your provider right away.
Serious nerve and breathing problems
- Risk factors: Blood transfusions | Receiving medications to ease pain (anesthetics) during surgery | Muscle problems
Neomycin can lead to muscle weakness. In some rare cases, this medication can also paralyze your lung muscles, which can make it difficult for you to breathe on your own. The risk is higher if you're receiving a lot of blood transfusions or if you're being put under for a surgery. Get medical attention right away if you experience symptoms of skin tingling, numbness, muscle weakness or twitching, difficulty breathing, slurred speech, drowsiness, or severe headache.
Interaction with other medications
Neomycin can cause serious kidney, hearing, or nerve problems. You should be careful not to take it with other medications that can also cause kidney or nerve problems, such as aminoglycoside antibiotics, cisplatin
(Platinol), or vancomycin (Vancocin). You should also avoid taking neomycin with other medications that can cause hearing problems, such as furosemide (Lasix).
Neomycin also interferes with how your body absorbs or gets rid of other medications. For example, it shouldn’t be taken with penicillin v potassium (Penicillin VK), vitamin B12 (cyanocobalamin) tablets, methotrexate, fluorouracil (Adrucil), or digoxin (Lanoxin). Doing so causes your body to absorb less of these medications. Additionally, you might need to get blood tests done while using digoxin (Lanoxin) with neomycin so your provider can monitor your levels of digoxin.
Let your provider or pharmacist know what other medications you’re taking before and while taking neomycin.
Digestive problems
- Risk factor: Taking a higher dose of neomycin
Sometimes, if you take a high dose of neomycin, it can damage the normal bacterial lining of your gut. This can cause your body to absorb less of certain important nutrients. Talk with your provider if you experience symptoms of diarrhea, weight loss, or a lot of gas.
Neomycin dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 500mg | 6 tablets | $5.78 | $0.96 |
Interactions between Neomycin and other drugs
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. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Neomycin cost?
$5.78
Neomycin 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 Neomycin will not be safe for you to take.
- Current bowel obstruction (a medical condition in which something is blocking your intestines)
- History of allergy to neomycin or other aminoglycosides (e.g., tobramycin (Tobi))
- Inflamed gastrointestinal (GI; stomach and intestines) problems
- Stomach ulcers
What are alternatives to Neomycin?
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