Indications
Neomycin is an antibiotic. It is mostly used on the skin, often combined with other antibiotics such as Bacitracin or Polymyxin B, to treat or prevent minor bacterial skin infections in cuts, scrapes, burns and wounds. It is also found in some eye and ear drops. Tablets are used by doctors, as prescribed, to reduce gut bacteria before bowel surgery and in some people with severe liver disease (hepatic encephalopathy).
How It Works
It stops bacteria from making the proteins they need to survive, so the bacteria die. Very little is absorbed from the gut or from small areas of intact skin, which is why it works mainly where it is applied.
Dosage and Administration
Skin products: clean the area and apply a thin layer 1 to 3 times a day, usually for no longer than 7 to 10 days unless the doctor advises otherwise. Eye and ear products: as directed on the pack or by the doctor. Tablets: as prescribed only; dose and length of treatment depend on the condition. Wash your hands before and after use.
Interactions
- When significant amounts are absorbed (tablets, large or broken skin areas), the risk of kidney and hearing damage rises with other medicines that affect the kidneys or ears, such as Gentamicin and other aminoglycosides, Furosemide, Vancomycin, Ciclosporin and Amphotericin B.
- Tablets can reduce absorption of Digoxin and Penicillin V and may increase the effect of Warfarin.
- Absorbed neomycin can increase the effect of muscle relaxants used during surgery.
Contraindications
- Allergy to neomycin or any other aminoglycoside antibiotic.
- Ear drops: a perforated eardrum.
- Tablets: bowel blockage, or myasthenia gravis (a muscle weakness disease).
Side Effects
Skin products: itching, redness, burning or a rash. Neomycin is a fairly common cause of contact allergy, which can make the skin look worse instead of better. Tablets: nausea, vomiting and diarrhoea. If too much is absorbed: hearing loss, ringing in the ears and kidney damage.
Get urgent medical help for:
- Any hearing loss, ringing in the ears, or dizziness and loss of balance.
- Passing much less urine than usual, or swelling of the legs.
- Swelling of the face or throat, difficulty breathing, or a spreading severe rash.
- Severe or bloody diarrhoea.
Pregnancy and Lactation
Tablets should be avoided in pregnancy, as absorbed neomycin can harm the baby’s hearing. Short-term use on small areas of skin is unlikely to cause harm, but ask the doctor first. While breastfeeding, short-term use on small areas is generally acceptable; do not apply it to the breast. Ask the doctor before taking tablets.
Precautions and Warnings
- Do not use on large areas, deep wounds or badly broken skin, or for long periods, unless the doctor advises it.
- Stop and see a doctor if the skin becomes more red, itchy or swollen.
- Extra care in kidney disease, in older people and in young children.
- Long use can allow resistant germs or fungus to grow.
Overdose
Swallowing a small amount of ointment is unlikely to be harmful. An overdose of tablets can damage the kidneys and hearing and cause muscle weakness affecting breathing; get emergency medical help.
Therapeutic Class
Aminoglycoside antibiotic.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Do not use eye or ear drops for more than 4 weeks after opening unless the pack says otherwise.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.