NEUOROTOXICITY (INCLUDING OTOTOXICITY AND NEPHROTOXICITY) FOLLOWING THE ORAL USE OF Neomycin Sulfate HAVE BEEN REPORTED, EVEN WHEN USED IN RECOMMENDED DOSES. NEUROTOXICITY (INCLUDING OTOTOXICITY) AND NEPHROTOXICITY FOLLOWING THE ORAL USE OF NEOMYCIN SULFATE HAVE BEEN REPORTED, EVEN WHEN USED IN RECOMMENDED DOSES. If blockage occurs, calcium salts may reverse these phenomena but mechanical respiratory assistance may be necessary.Concurrent and/or sequential systemic, oral or topical use of other aminoglycosides, including paromomycin and other potentially nephrotoxic and/or neurotoxic drugs such as bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin, should be avoided because the toxicity may be additive.Other factors which increase the risk of toxicity are advanced age and dehydration.The concurrent use of neomycin with potent diuretics such as ethacrynic acid or furosemide should be avoided, since certain diuretics by themselves may cause ototoxicity. Other aminoglycosides have been shown to be excreted in human milk. Neomycin Sulfate Tablets USP, 500 mg (equivalent to 350 mg of neomycin base per tablet) are available as round, off-white, unscored tablets, debossed “93” and “1177”, in bottles of 100 tablets (NDC 0093-1177-01). THE RISK OF NEPHROTOXICITY AND OTOTOXICITY IS GREATER IN PATIENTS WITH IMPAIRED RENAL FUNCTION. The possibility of the occurrence of neuromuscular blockage and respiratory paralysis should be considered if neomycin is administered, especially to patients receiving anesthetics, neuromuscular blocking agents such as tubocurarine, succinylcholine, decamethonium, or in patients receiving massive transfusions of citrate anticoagulated blood. Delayed-onset irreversible deafness, renal failure and death due to neuromuscular blockade (regardless of the status of renal function) have been reported following irrigation of both small and large surgical fields with minute quantities of neomycin.Cross-allergenicity among amino-glycosides has been demonstrated.Aminoglycosides should be used with caution in patients with muscular disorders such as myasthenia gravis or parkinsonism since these drugs may aggravate muscle weakness because of their potential curare-like effect on the neuromuscular junction.Small amounts of orally administered neomycin are absorbed through intact intestinal mucosa.There have been many reports in the literature of nephrotoxicity and/or ototoxicity with oral use of neomycin. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Neomycin Sulfate Tablets USP and other antibacterial drugs, Neomycin Sulfate Tablets USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.SYSTEMIC ABSORPTION OF NEOMYCIN OCCURS FOLLOWING ORAL ADMINISTRATION AND TOXIC REACTIONS MAY OCCUR. These antibiotics include combination drugs: 1. Release of tissue-bound neomycin occurs slowly over a period of several weeks after dosing has been discontinued.Protein binding studies have shown that the degree of aminoglycoside protein binding is low and, depending upon the methods used for testing, this may be between 0% and 30%.If susceptibility testing is needed, using a 30 mcg disc, organisms producing zones of 16 mm or greater are considered susceptible. Preoperative Prophylaxis for Elective Colorectal SurgeryWe comply with the HONcode standard for trustworthy health information - Copy the URL below and paste it into your RSS Reader application.DailyMed will deliver notification of updates and additions to Drug Label information currently shown on this site through its RSS feed.DailyMed will deliver this notification to your desktop, Web browser, or e-mail depending on the RSS Reader you select to use. Although serious side effects to fetus or newborn have not been reported in the treatment of pregnant women with other aminoglycosides, the potential for harm exists. Poorly absorbed from the GI tract; 26 29 about 3% of an oral dose is absorbed. The kidney functions as the primary excretory path as well as the tissue binding site, with the highest concentrations found in the renal cortex.