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Pharmacological effects of the neomycin sulfate
Pharmacokinetics: neomycin is rarely absorbed by oral administration (about 3%), but a considerable amount can still be absorbed when intestinal mucosa is ulcerated or inflammatory, especially when blood concentration can be significantly increased in renal dysfunction. After oral administration, most of it is passed in the stool unchanged.
Indicationsof the neomycin sulfate: Oral can be used for:
1. Intestinal infection
2. It can also be used as an auxiliary treatment for intestinal preparation before colon surgery or hepatic coma. Neomycin is not suitable for the treatment of systemic infection.
Usage and dosageof the neomycin sulfate:
1. Oral administration, adults 0.25 ~ 0.5g (neomycin), 4 times a day. Adjuvant treatment of hepatic encephalopathy, 0.5 ~ 1g, every 6 hours, a course of 5 ~ 6 days. Colon surgery preparation, 0.5g per hour, 4 times, followed by 0.5g every 4 hours, for 24 hours. 
2. Children according to their weight 25 ~ 50mg/kg a day, divided into 4 times.
Neomycin sulfate of the adverse reactions:
1. Can cause loss of appetite, nausea, diarrhea, etc., but long-term application (more than 10 weeks) does not affect the synthesis of vitamin K.
2. Hearing loss, tinnitus or fullness in the ear are rarely found; Dizziness or unsteadiness of step; Significantly reduced urine output or frequency of urination or extreme thirst.
3. Occasionally can cause atrophy of intestinal mucosa and lead to malabsorption syndrome and fat diarrhea, or even pseudomembranous enteritis.
Contraindication: This product is contraindicated in patients allergic to neomycin or other aminoglycoside antibiotics.
Neomycin sulfate precautions:
1. Cross-hypersensitivity to an aminoglycoside antibiotic such as streptomycin, gentamicin, amikacin patients may also be allergic to this product.
2. Routine urine and renal function tests should be carried out regularly in the course of medication to prevent renal toxicity, and audiometry or electroaudiogram should be carried out.
3. This product should be used with caution in the following conditions: water loss, damage to the 8th pair of cerebral nerves, myasthenia gravis, Parkinson’s disease, renal impairment, ulcerative colitis and patients with oral diseases (neomycin may cause oral irritation or pain).
4. Attention should be paid to the possibility of nephrotoxic or ototoxic symptoms in patients with chronic intestinal infection who take this product orally for a long time, especially those with renal dysfunction or who take other ototoxic or nephrotoxic drugs.
Medication for pregnant and lactating women: Pregnant women should use this product with caution. Breastfeeding women should suspend breastfeeding during medication.
Medication for children: there is a lack of data on safe use of this product in premature and newborn infants, so it is not suitable for use.
Elderly patients: elderly patients should be careful with this product.
Neomycin sulfate about the drug interactions:
1. Long-term use with oral contraceptives containing estrogen may lead to contraceptive failure and increase the incidence of bleeding.
2. Oral neomycin can affect the absorption of digitalis glycoside, fluorouracil, methotrexate, penicillin V, vitamin A or vitamin B12, and reduce the curative effect; Therefore, patients should be closely observed to change the efficacy of digitalis drugs. Oral neomycin may increase vitamin B12 requirements when combined with colchicine and vitamin A.
3. This product is not suitable for use with other nephrotoxic drugs and ototoxic drugs.
4. When combined with neuromuscular blockers, it may increase the neuromuscular blocking effect and lead to skeletal muscle weakness.
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