Gentamicin Risks, Warnings, and Complications
| Gentamicin can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatment options if you are at an increased risk of adverse effects from this antibiotic. NEPHROTOXICITY: Treatment with aminoglycosides, including gentamicin, requires close monitoring due to the risk of nephrotoxicity (damage to the kidneys). Aminoglycoside antibiotics undergo renal clearance (they are removed from the body by the kidneys). The risk of toxic effects on the kidneys is higher in people with renal impairment (pre-existing kidney problems) and in those who receive high doses of gentamicin or are on long-term gentamicin therapy. Risk factors for toxic reactions also include the concurrent use of other drugs that are nephrotoxic, advanced age, and dehydration. Your doctor will carefully monitor your kidney function while you are on gentamicin. NEUROTOXICITY AND OTOTOXICITY: Patients receiving gentamicin can develop irreversible ototoxicity (damage to the inner ear). This risk is higher in those with pre- existing kidney problems and those on high doses of gentamicin or a long treatment duration. Gentamicin ototoxicity can cause the following symptoms: vertigo, dizziness, tinnitus (ringing in the ears), roaring in the ears, and hearing loss. Your doctor may recommend a dosage adjustment or discontinuance of gentamicin if this occurs. Your healthcare provider may order serial audiograms (hearing tests) if you are deemed high-risk. Other neurotoxicity manifestations of gentamicin may include numbness, tingling, muscle twitching, and seizures. Your healthcare provider will measure serum concentrations of gentamicin to ensure adequate levels and to avoid potentially toxic levels. High gentamicin peak concentration is avoided for prolonged periods due to the risk of serious adverse effects. In people with an overdose or severe toxic reactions, hemodialysis is sometimes necessary to rapidly remove gentamicin from the blood. There may be a genetic link to the risk of ototoxicity in a small number of people. Individuals with a certain variant of a gene can develop ototoxicity even when serum concentrations of aminoglycosides are in the recommended range. Tell your doctor if you have a family history of ototoxicity with aminoglycoside use. RISKS DURING PREGNANCY: Aminoglycosides, including gentamicin, may cause harm to an unborn baby if used during pregnancy. Gentamicin passes across the placenta, and other medications in this drug class, such as streptomycin, have caused irreversible congenital deafness. While gentamicin sulfate has not been linked to these serious side effects, this and other aminoglycosides should be used with caution in pregnant women. ALLERGIC REACTIONS: Gentamicin contains sodium metabisulfite and can trigger an allergic reaction in people with a sulfite allergy, including an asthmatic attack or a life-threatening anaphylactic reaction. Seek emergency medical care if you develop a skin reaction, swelling or throat closing, trouble swallowing, or difficulty breathing after taking gentamicin.
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Precautions Before Starting Gentamicin
Tell your doctor if you are allergic to gentamicin, any of the active or inactive ingredients in gentamicin injection solution, other aminoglycosides, sulfites, or any other medicines. Examples of other aminoglycoside antibiotics include kanamycin, amikacin, neomycin, streptomycin, paromomycin, and tobramycin.
Give your doctor and pharmacist a complete list of all your medications, including prescription drugs, over-the-counter medications, vitamins, dietary supplements, and herbal products. This can help avoid possible drug-drug interactions.
Give your doctor a complete medical history. Gentamicin may not be safe for people with certain medical conditions such as kidney disease, Parkinson’s disease, cystic fibrosis, and myasthenia gravis.
Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant soon, or are nursing an infant with breast milk.
Precautions During Use of Gentamicin
Keep all your medical and laboratory appointments while on gentamicin. This antibiotic is associated with an increased risk of kidney problems, nerve problems, and hearing loss. Your healthcare provider may want to order certain laboratory tests such as serum creatinine and glomerular filtration rate to monitor kidney function, serum levels (drug concentration), as well as hearing tests.
Tell your doctor if you become pregnant while on gentamicin.
Tell all your doctors you are on gentamicin before any surgery, including dental procedures.
Gentamicin Drug Interactions
Certain drugs can affect gentamicin efficacy. Possible interactions with other drugs can increase the risk of severe adverse effects. Other potentially neurotoxic and/or nephrotoxic drugs that can interact with gentamicin and increase the risk of serious adverse effects, include:
- Cisplatin
- Antibiotics such as cephaloridine, amikacin, kanamycin, neomycin, colistin, paromomycin, polymyxin B, streptomycin, vancomycin, tobramycin, and viomycin
- Diuretics (water pills) such as ethacrynic acid and furosemide
Give your doctor or pharmacist a complete list of your medications, including prescription medications, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.
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