General Dosing

15-22.5 mg/kg/day IV/IM divided q8hr  

Neonates

Aged ≤7 days

• ≤29 weeks gestational age: 18 mg/kg IV/IM q48hr  
• 30-33 weeks gestational age: 18 mg/kg IV/IM q36hr
• ≥34 weeks gestational age: 15 mg/kg IV/IM q24hr

Aged >7 days

• 30-33 weeks gestational age: 15 mg/kg IV/IM q24hr  
• ≥34 weeks gestational age: 15 mg/kg IV/IM q12-18hr

Aged 8-28 days old & <29 weeks gestational age

• 15 mg/kg IV/IM q36hr  
• Also use this dose for the following: significant asphyxia, indomethacin for PDA, poor cardiac output, or renal impairment

Neonates Aged >28 days old & <29 weeks gestational age

• 15 mg/kg IV/IM q24hr  
• Also use this dose for the following: significant asphyxia, indomethacin for PDA, poor cardiac output, or renal impairmen

Contraindications

Documented hypersensitivity

Cautions

Caution in patients with renal impairment

Not intended for long-term therapy; caution in patients with renal failure (not on dialysis), hypocalcemia, myasthenia gravis, and conditions that depress neuromuscular transmission

Serious and potentially life-threatening hypersensitivity reactions, including anaphylaxis, reported; before therapy instituted, evaluate for previous hypersensitivity reactions to aminoglycosides; if anaphylaxis or a hypersensitivity reaction occurs, discontinue therapy and institute appropriate supportive measures

Hypersensitivity pneumonitis reported; if hypersensitivity pneumonitis occurs, discontinue therapy and manage patients as medically appropriate

Higher frequency of hemoptysis and bronchospasm, reported with treatment; if these occur, manage patients as medically appropriate

Aminoglycosides can cause nephrotoxicity; close monitoring of patients with known or suspected renal dysfunction may be needed when prescribing drug

Higher frequency of ototoxicity reported with treatment; closely monitor patients with known or suspected auditory or vestibular dysfunction; if patients develop tinnitus this may be an early symptom of ototoxicity

Aminoglycosides may aggravate muscle weakness because of a potential curare-like effect on neuromuscular function; if neuromuscular blockade occurs, it may be reversed by the administration of calcium salts, but mechanical assistance may be necessary

Higher frequency of exacerbations of underlying pulmonary disease reported with treatment; treat patients as medically appropriate if this occurs

Aminoglycosides can cause total, irreversible, bilateral congenital deafness in pediatric patients exposed in utero

Pregnancy & Lactation