paromomycin

Indication & Dosage	Oral Tapeworm infections Adult: 1 g every 15 minutes for 4 doses. For cestodiasis caused by Hymenolepis nana: 45 mg/kg daily, given as a single dose for 5-7 days. Child: For infections caused by D. latum, D. caninum, T. saginata or T. solium: 11 mg/kg every 15 min for 4 doses. For infections caused by H. nana: 45 mg/kg/day, given as a single dose for 5-7 days. Oral Cryptosporidiosis Adult: In AIDS patients: 1.5-2.25 g/day in 3-6 divided doses for 10-14 days (courses up to 4-8 wk may be needed). Oral Giardiasis Adult: 25-35 mg/kg/day in 3 divided doses for 7 days. Child: 25-35 mg/kg/day tid for 7 days. Oral Dientamoeba fragilis infections Adult: 25-35 mg/kg/day in 3 divided doses for 7 days. Child: 25-35 mg/kg/day tid for 7 days. Oral Hepatic encephalopathy Adult: Adjunct in the management of hepatic coma: 4 g daily in divided doses for 5-6 days. Oral Amoebiasis Adult: Caused by Entamoeba histolytica: 25-35 mg/kg/day in 3 divided doses for 5-10 days. Child: 25-35 mg/kg/day tid for 5-10 days. Intramuscular Visceral leishmaniasis Adult: 11-20 mg/kg/day for 10-21 days. Topical/Cutaneous Cutaneous leishmaniasis Adult: Paromomycin sulfate 15% and methylbenzethonium chloride 12% in white petrolatum: Apply bid for 10-20 days.
Administration	Should be taken with food. (Take during meals.)
Overdosage	Nausea, vomiting, diarrhoea. Care is supportive and symptomatic.
Contraindications	Intestinal obstruction.
Special Precautions	Renal impairment; ulcerative lesions of the bowel to avoid renal toxicity through inadvertent absorption. Prolonged use may result in fungal or bacterial superinfection. Pregnancy. Do not use alone in the treatment of extraintestinal amoebiasis.
Adverse Drug Reactions	Diarrhoea, abdominal cramps, nausea, vomiting, heartburn. Rarely: Headache, vertigo, exanthema, rash, pruritus, steatorrhoea, secondary enterocolitis, eosinophilia, ototoxicity.
Drug Interactions	Decreased effect of digoxin, vitamin A, and methotrexate; increased effect of oral anticoagulants, neuromuscular blockers, and polypeptide antibiotics.
Food Interaction	Malabsorption of xylose, sucrose, and fats.
Pregnancy Category (US FDA)	Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Storage	Intramuscular: Store at 15-30°C. Protect from moisture. Oral: Store at 15-30°C. Protect from moisture. Topical/Cutaneous: Store at 15-30°C. Protect from moisture.
Mechanism of Action	Paromomycin is an aminoglycoside antibiotic with antibacterial and antiprotozoal activity. It is a luminal or contact amoebicide since it acts primarily in the intestinal lumen. It is direct-acting, and is effective either in the presence or absence of bacteria. Paromomycin is bactericidal and inhibits protein synthesis in susceptible bacteria at the 30S ribosomal unit. Absorption: Poorly from the GI tract. Rapidly following IM inj; peak plasma concentrations achieved within 1 hr. Excretion: Via faeces (100% as unchanged drug); any absorbed drug via urine.http://www.mims.com/Philippines/drug/info/paromomycin/?type=full&mtype=generic#Dosage