Kanamycin – Uses and Precautions

Background

Kanamycin (also known as kanamycin A) is an aminoglycoside bacteriocidal antibiotic, available in oral, intravenous, and intramuscular forms, and used to treat a wide variety of infections. Kanamycin is isolated from the bacterium Streptomyces kanamyceticus and its most commonly used form is kanamycin sulfate.

Properties and Characteristics of Kanamycin

Drug class Aminoglycosides
Brand Names  Kantrex
Synonyms Kanamycin A
Molecular Formula     C18H36N4O11
Molecular Weight        484.5 g/mol
IUPAC Name (2R,3S,4S,5R,6R)-2-(aminomethyl)-6-{[(1R,2R,3S,4R,6S)-4,6-diamino-3-{[(2S,3R,4S,5S,6R)-4-amino-3,5-dihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy}-2-hydroxycyclohexyl]oxy}oxane-3,4,5-triol
Structural formula of main components
Pure active ingredient kanamycin sulfate
Appearance Crystals
Melting point   >175°C (dec.)
Solubility         Miscible with water at 25 °C (1.0X10+6 mg/L) (est)
Excretion Excreted unchanged in the urine
Storage Store it at room temperature (15° to 30°C).
Available Forms          Injection, solution, Capsule, Powder, Suspension
Prescription    Doctor prescription is required

Kanamycin Uses

Kanamycin is used in the treatment of bacterial infections and tuberculosis.

Kanamycin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using kanamycin and call your doctor at once if you have any of these serious side effects:

  • Changes in your hearing;
  • Spinning sensation, problems with balance;
  • Ringing or roaring sound in your ears;
  • Numbness or tingling of your skin;
  • Muscle twitching, seizure (convulsions); or
  • Urinating less than usual or not at all.

Mechanism of action

Aminoglycosides like kanamycin “irreversibly” bind to specific 30S-subunit proteins and 16S rRNA. Specifically, Kanamycin binds to four nucleotides of 16S rRNA and a single amino acid of protein S12. This interferes with decoding site in the vicinity of nucleotide 1400 in 16S rRNA of 30S subunit. This region interacts with the wobble base in the anticodon of tRNA. This leads to interference with the initiation complex, misreading of mRNA so incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides and the breakup of polysomes into nonfunctional monosomes.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Ataluren

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alcuronium
  • Ascorbic Acid
  • Cholera Vaccine, Live
  • Decamethonium
  • Emtricitabine
  • Fazadinium
  • Gallamine
  • Hexafluorenium
  • Lysine
  • Metocurine
  • Pancuronium
  • Rapacuronium
  • Succinylcholine
  • Tacrolimus
  • Vecuronium

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Bumetanide

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma or
  • Sulfite allergy, history of—This medicine contains sodium bisulfite which may cause an allergic reaction in patients with these conditions.
  • Kidney disease, severe or
  • Muscle problems (e.g., infant botulism) or
  • Myasthenia gravis (severe muscle weakness) or
  • Nerve problems or
  • Parkinson’s disease—Use with caution. May make these condition worse.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of this medicine from the body.

Dosage and uses of Kanamycin

Dosage Forms & Strengths

Injectable solution: 75mg/2mL, 500mg/2mL, 1g/3mL

Susceptible Infections

IV Administration: 5-7.5 mg/kg/dose divided q8-12hr; not to exceed 15 mg/kg/day divided q6-12hr; administer slowly.

IM Administration: 5-7.5 mg/kg/dose divided q8-12hr; not to exceed 15 mg/kg/day IM divided q12hr at equally divided intervals; continuously high blood levels are desired; daily dose of 15 mg/kg may be given divided q6-8hr

Aerosol: 250 mg q6-12hr by nebulization

Renal Impairment

CrCl 50-80 mL/min: give 60-90% of usual dose or give q8-12hr

CrCl 10-50 mL/min: give 30-70% of usual dose or give q12hr

CrCl <10 mL/min: give 20-30% of usual dose or give q24-48hr

Monitor

Peak (15-30 mg/L)

Trough (5-10 mg/L)

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include hearing problems, ringing in your ears, dizziness or problems with balance, or seizure (convulsions).

Precautions for Kanamycin

Your doctor will check your progress closely while you or your child are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you or your child should continue to receive it. Blood, urine, hearing, and nerve tests may be needed to check for unwanted effects.

If your or your child’s symptoms do not improve within a few days, or if they become worse, check with your doctor.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have itching; hives; hoarseness; shortness of breath; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you receive this medicine.

Stop using this medicine and check with your doctor right away if you or your child have sudden decrease in hearing or loss of hearing, which may be accompanied by dizziness and ringing in the ears. Tell your doctor if you or your child have dizziness or lightheadedness; feeling of constant movement of self or surroundings; or sensation of spinning. These may be symptoms of a damage to your hearing or sense of balance.

Tell your doctor right away if you have trouble using your muscles or trouble breathing while receiving this medicine.

Check with your doctor right away if you or your child have blood in the urine, change in frequency of urination or amount of urine, difficulty with breathing, drowsiness, increased thirst, loss of appetite, nausea or vomiting, swelling of feet or lower legs, or weakness. These may be symptoms of a serious kidney problem.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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