What Amikacin injection is and what it is used for
Amikacin Injection is one of a group of antibiotic medicines called ‘aminoglycosides’.
Amikacin Injection is used in the treatment of serious infections caused by bacteria sensitive to amikacin.
Before you use Amikacin injection
Do not use Amikacin Injection
- if you have shown signs of hypersensitivity (severe allergy) to amikacin, or any of the other ingredients listed in section 6, in the past
- if you suffer from a disorder called myasthenia gravis (severe weakness of certain muscles of the body)
Tell your doctor if any of the above applies to you before this medicine is used.
Take special care with Amikacin Injection
- if you have kidney problems
- if you have hearing difficulties or tinnitus (ringing or buzzing in the ears)
- if you have shown signs of allergy to any of the antibiotics related to amikacin (aminoglycosides) in the past
Amikacin should be used with caution in premature and neonatal infants.
Tell your doctor if any of the above applies to you before this medicine is used.
Taking/using other medicines
Special care is needed if you are taking/using other medicines as some could interact with amikacin for example:
- diuretics (water tablets) such as furosemide and ethacrynic acid
- other antibiotics that can affect your kidneys or hearing, such as streptomycin, dihydrostreptomycin, gentamicin, tobramycin, kanamycin, neomycin, polymyxin B, colistin, cephaloridine or viomycin
- anaesthetics or muscle-relaxing drugs, such as ether, halothane, d-tubocurarine, succinylcholine and decamethonium
- indomethacin (an anti-inflammatory medicine)
Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Pregnancy and breast-feeding
Tell your doctor if you are pregnant, trying to become pregnant or breast-feeding. Your doctor will only use this medicine if the expected benefits outweigh any potential risk to your baby.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
Do not drive or use machines if you experience any side effect (e.g. dizziness) which may lessen your ability to do so.
Important information about some of the ingredients of Amikacin Injection
This medicine contains sodium metabisulphite, which may rarely cause hypersensitivity (severe allergy) reactions and bronchospasm (breathing difficulties).
This medicinal product contains less than 1 mmol (23 mg) sodium per dose, i.e. essentially ‘sodium free’.
How to use Amikacin injection
This medicine is usually injected into a muscle. It may also be given into a vein, either as an injection or (following dilution) as an infusion (drip).
Amikacin can also be given into the peritoneum (abdominal cavity) during surgery, and can be used to wash out abscess cavities, the lung cavity and brain cavities.
Dose
Your doctor will work out the correct dose of amikacin for you and how often it must be given.
The dose will depend upon your age, the infection you have, how well your kidneys are working, if you have poor hearing and any other medicines you may be taking.
It will usually be given to you two or three times a day, for up to 10 days.
Adults and children over 12 years:
The usual dose is 15 mg per kg which is administered as a single dose or divided into two equal doses of 7.5 mg per kg administered every 12 hours. The total dose should not exceed 1.5 g.
Children up to 12 years:
The usual dose is 15-20 mg per kg of body weight once a day or divided into two equal doses of 7.5 mg per kg which is administered every 12 hours.
Neonates:
The initial dose is 10 mg per kg of body weight followed by 7.5 mg per kg every 12 hours.
Premature infants:
The recommended dosing in premature babies is 7.5 mg per kg every 12 hours.
During treatment you may undergo blood tests, be asked to provide urine samples and possibly have hearing tests to look for signs of side effects. Your doctor may change your dose depending upon the results of these tests.
If you are given too much or too little Amikacin Injection
This medicine will be given to you in a hospital, under the supervision of a doctor. It is unlikely that you will be given too much or too little, however, tell your doctor or nurse if you have any concerns.
Possible side effects
Like all medicines, amikacin can cause side effects, although not everybody gets them.
If any of the following happens, tell your doctor immediately:
- severe allergic reaction – you may experience a sudden itchy rash (hives), swelling of the hands, feet, ankles, face, lips, mouth or throat (which may cause difficulty in swallowing or breathing), and you may feel you are going to faint
- ringing in your ears or loss of hearing
- decrease in the amount of urine you produce
These are serious side effects. You may need urgent medical attention.
If any of the following happens, tell your doctor as soon as possible:
- dizziness or vertigo (spinning sensation)
- problems with your eyesight (such problems have been reported after amikacin has been injected into the eye)
- abnormal tingling sensation
- skin rash
- fever
- headache
- nausea and vomiting
Amikacin may lead to changes in your kidney function. Your doctor may take blood samples to monitor for this. Your doctor may also ask you to undergo hearing tests.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor.
How to store Amikacin injection
Keep out of the reach and sight of children
Expiry
This medicine must not be used after the expiry date which is stated on the vial and carton after ‘EXP’. Where only a month and year is stated, the expiry date refers to the last day of that month.
Storage
The vials should be stored at, or below, 25°C.
Unused portions of opened vials must not be stored for later use.
Prepared injections or infusions should be used immediately, however, if this is not possible they can be stored for up to 24 hours.
Further information
What Amikacin Injection contains
The active substance is amikacin. Each millilitre (ml) of solution contains 250 milligrams (mg) of amikacin (as amikacin sulphate).
The other ingredients are sodium citrate, sodium metabi sulphite and Water for Injections. See section 2 for further information about sodium metabisulphite.
What Amikacin Injection looks like and contents of the pack
Amikacin Injection is a clear, colourless to pale yellow solution for injection which comes in glass containers called vials.
It may be supplied in packs containing 5 x 500 mg/2 ml vials
Incompatibilities
Amikacin is incompatible with some penicillins and cephalosporins, amphotericin chlorothiazide sodium, erythromycin gluceptate, heparin, nitrofurantoin sodium, phenytoin sodium, thiopentone sodium and warfarin sodium, and depending on the composition and strength of the vehicle, tetracyclines, vitamins of the B group with vitamin C, and potassium chloride.
At times, amikacin may be indicated as concurrent therapy with other antibacterial agents in mixed or superinfections. In such instances, amikacin should not be physically mixed with other antibacterial agents in syringes, infusion bottles or any other equipment. Each agent should be administered separately.
Instructions for use and handling
Single use only
Discard any unused contents
The solution may darken from colourless to a pale yellow but this does not indicate a loss of potency.
If required, suitable diluents for intravenous use are normal saline or 5% dextrose in water.
Amikacin in concentrations of 0.25% (2.5 mg/ml) may be used satisfactorily as an irrigating solution in abscess cavities, the pleural space, the peritoneum and the cerebral ventricles.
In use storage precautions
Following dilution in 0.9% sodium chloride and 5% glucose solutions, chemical and physical in-use stability has been demonstrated for 24 hours at a temperature not above 25°C.
From a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 24 hours at 2 to 8°C, unless dilution has taken place in controlled and validated aseptic conditions.