Severe Toxicity Risk
Ensure that patients receiving aminoglycosides, including gentamicin, are closely monitored due to the potential for toxicity associated with their use. Gentamicin has the potential to cause nephrotoxicity, particularly in patients with impaired renal function or those receiving high dosages or prolonged therapy. Neurotoxicity, characterized by ototoxicity affecting both the vestibular and auditory systems, can also occur, especially in patients with preexisting renal damage or in those receiving higher than recommended doses or prolonged treatment. Aminoglycoside-induced ototoxicity is usually irreversible and may present as symptoms such as dizziness, vertigo, tinnitus, and hearing loss. Other signs of neurotoxicity may include numbness, tingling, muscle twitching, and seizures. Close monitoring of renal function and eighth cranial nerve function is essential, particularly in patients with known or suspected renal impairment. Urine analysis should be performed to assess specific gravity, protein excretion, and the presence of cells or casts. Periodic measurement of serum urea nitrogen, serum creatinine, or creatinine clearance is recommended. Audiograms should be obtained in eligible patients, especially those at high risk, to detect early signs of ototoxicity. If evidence of ototoxicity or nephrotoxicity emerges, dosage adjustment or discontinuation of the drug may be necessary. Serum concentrations of aminoglycosides should be monitored whenever possible to ensure appropriate levels and prevent potentially toxic concentrations. Peak concentrations of gentamicin should be adjusted to avoid prolonged levels above 12 mcg/mL, while trough concentrations should be maintained below 2 mcg/mL. Excessive peak or trough levels increase the risk of renal and eighth cranial nerve toxicity. In cases of overdose or toxic reactions, hemodialysis may be beneficial in removing gentamicin from the bloodstream, particularly if renal function is compromised. Peritoneal dialysis is less effective in eliminating gentamicin. Concurrent or sequential use of other neurotoxic or nephrotoxic medications, such as cisplatin, cephaloridine, and various aminoglycosides, should be avoided. Advanced age and dehydration may also increase the patient's risk of toxicity. Concurrent use of potent diuretics, like ethacrynic acid or furosemide, should be avoided as they may enhance the risk of ototoxicity and alter gentamicin concentrations in the blood and tissues when administered intravenously.
Allopathy
Prescription Required
DCGI (Drugs Controller General of India)
Schedule H
Gentamicin belongs to the pharmacological class of Aminoglycoside antibiotics.
Gentamicin has been approved to relieve symptoms and also for the treatment and maintenance of Gentamicin can help to relieve symptoms and also for the treatment and maintenance of Bartonella spp. infection , Bloodstream infection, Brucellosis, CNS infection, health care–associate, Dermatologic infection, Endocarditis, treatment, Meningitis, bacterial, Osteomyelitis, prevention, following open fractures, Ophthalmic infection, Pelvic infections, Peritonitis, treatment, Plague, Sepsis or septic shock, adjunctive empiric gram-negative coverage, Sexually transmitted infections, Surgical prophylaxis, Tularemia and Urinary tract infection, complicated.
Gentamicin, an antibiotic administered parenterally, is rapidly and completely absorbed after injection, reaching peak plasma concentrations within 30 to 90 minutes. With a large volume of distribution, it spreads extensively throughout tissues and body fluids. Metabolism of gentamicin is minimal, as it is primarily excreted unchanged through the kidneys, with an elimination half-life of 2 to 3 hours in patients with normal renal function. Impaired renal function may prolong the elimination half-life. Renal excretion accounts for approximately 80% to 90% of the dose, while a smaller fraction is eliminated through nonrenal routes.
The common side effects involved in using Gentamicin areVisual disturbances, Nausea, Vomiting, Decreased appetite, Weight loss, Feeling light-headed or faint, Itching or a rash, Pain at the site of injection, Headache and changes in mood, and Joint pain.
Gentamicin is available in the form of injection, eyedrops, ointment, cream, and nebulizer solution.
Gentamicin is approved in Germany, Japan, Malaysia, India, the U.K., the U.S, and China.
Gentamicin belongs to the pharmacological class of Bacteriostatic antibiotics.
Gentamicin exhibits bactericidal properties by disrupting protein synthesis in susceptible bacteria, leading to cell death. It displays activity against a broad spectrum of Gram-negative pathogens, including Escherichia coli, Pseudomonas aeruginosa, both indole-positive and indole-negative Proteus species, Klebsiella, Enterobacter, and Serratia species. Additionally, it demonstrates effectiveness against certain Gram-positive bacteria, such as Staphylococcus, including strains resistant to methicillin and penicillin. In vitro studies have shown gentamicin's activity against Salmonella and Shigella as well. However, certain organisms like Streptococcus pneumoniae and anaerobic bacteria like Bacteroides or Clostridium species may exhibit resistance to aminoglycosides, including gentamicin.
Gentamicin has been approved to relieve symptoms and also for the treatment and maintenance of Gentamicin can help to relieve symptoms and also for the treatment and maintenance of Bartonella spp. infection , Bloodstream infection, Brucellosis, CNS infection, health care–associate, Dermatologic infection, Endocarditis, treatment, Meningitis, bacterial, Osteomyelitis, prevention, following open fractures, Ophthalmic infection, Pelvic infections, Peritonitis, treatment, Plague, Sepsis or septic shock, adjunctive empiric gram-negative coverage, Sexually transmitted infections, Surgical prophylaxis, Tularemia and Urinary tract infection, complicated.
For intravenous (IV) administration:
- Cmax: Achieved shortly after completion of the infusion.
- Tmax: Varies depending on the infusion rate and duration.
For intramuscular (IM) injection:
- Cmax: Generally reached within 30 minutes to 2 hours after injection.
- Tmax: Typically occurs within 1 to 3 hours after injection.
Gentamicin is found to be available in the form of injection, eye drops, ointment, cream, and nebulizer solution.
Gentamicin can be used in the following treatment:
- Bartonella spp. infection
- Bloodstream infection
- Brucellosis
- CNS infection, health care–associated
- Dermatologic infection
- Endocarditis, treatment
- Meningitis, bacterial
- Osteomyelitis, prevention, following open fractures
- Ophthalmic infection
- Pelvic infections
- Peritonitis, treatment
- Plague
- Sepsis or septic shock, adjunctive empiric gram-negative coverage
- Sexually transmitted infections
- Surgical prophylaxis
- Tularemia
- Urinary tract infection, complicated
Gentamicin can help to relieve symptoms and also for the treatment and maintenance of Bartonella spp. infection , Bloodstream infection, Brucellosis, CNS infection, health care–associate, Dermatologic infection, Endocarditis, treatment, Meningitis, bacterial, Osteomyelitis, prevention, following open fractures, Ophthalmic infection, Pelvic infections, Peritonitis, treatment, Plague, Sepsis or septic shock, adjunctive empiric gram-negative coverage, Sexually transmitted infections, Surgical prophylaxis, Tularemia and Urinary tract infection, complicated.
Gentamicin is approved for use in the following clinical indications:
- Bartonella spp. infection
- Bloodstream infection
- Brucellosis
- CNS infection, health care–associated
- Dermatologic infection
- Endocarditis, treatment
- Meningitis, bacterial
- Osteomyelitis, prevention, following open fractures
- Ophthalmic infection
- Pelvic infections
- Peritonitis, treatment
- Plague
- Sepsis or septic shock, adjunctive empiric gram-negative coverage
- Sexually transmitted infections
- Surgical prophylaxis
- Tularemia
- Urinary tract infection, complicated
- Bartonella spp. infection: The recommended dosage is typically 3 to 5 mg/kg of body weight administered intravenously every 8 hours.
- Bloodstream infection: The usual dosage range is 3 to 5 mg/kg of body weight administered intravenously every 8 hours. The specific dose may vary depending on the severity of the infection and other individual factors.
- Brucellosis: The recommended dosage is usually 3 to 5 mg/kg of body weight administered intravenously every 8 hours. Treatment duration can vary and is typically guided by the healthcare provider.
- CNS infection, healthcare-associated: The usual dosage range is 3 to 5 mg/kg of body weight administered intravenously every 8 hours. The specific dose may vary depending on the severity of the infection and other individual factors.
- Endocarditis, treatment: The recommended dosage is typically 3 to 5 mg/kg of body weight administered intravenously every 8 hours. The duration of treatment can vary and may involve combination therapy with other antibiotics.
- For dermatologic infections, the recommended treatment is topical application to the affected area, typically 3 to 4 times daily.or ophthalmic infections, the recommended treatment options are as follows:
- Ophthalmic ointment: Apply a ribbon of ointment measuring 1/2 inch (1.25 cm) to the affected eye(s) 2 to 3 times daily.
- Ophthalmic solution: Instill 1 to 2 drops into the affected eye(s) every 4 hours. In severe infections, up to 2 drops can be administered every hour.
- Injection: Gentamicin sulfate injection: Typically available in vials or ampules containing 20 mg/mL, 40 mg/mL, 80 mg/mL, or 100 mg/mL of gentamicin.
- Ointment (Topical): Gentamicin ointment: Commonly available in strengths of 0.1% (1 mg/g) or 0.3% (3 mg/g) of gentamicin.
- Cream (Topical): Gentamicin cream: Typically available in strengths of 0.1% (1 mg/g) or 0.3% (3 mg/g) of gentamicin.
- Eye Drops (Ophthalmic): Gentamicin ophthalmic solution: Usually available in strengths of 0.3% (3 mg/mL) or 0.5% (5 mg/mL) of gentamicin.
- Ear Drops (Otic): Gentamicin otic solution: Typically available in strengths of 0.3% (3 mg/mL) or 0.5% (5 mg/mL) of gentamicin.
Injection: This is the most common form of gentamicin and is typically administered intravenously (IV) or intramuscularly (IM). It comes as a liquid solution in vials or ampules and is used for systemic treatment.
Eye Drops: Gentamicin is formulated as eye drops for the treatment of eye infections. It is usually supplied in small plastic dropper bottles for easy instillation into the eyes.
Ointment: Gentamicin ointment is used topically for the treatment of skin infections, particularly those caused by bacteria susceptible to gentamicin. It is applied directly to the affected area.
Cream: Similar to ointment, gentamicin cream is also used topically for the treatment of skin infections. It is typically formulated with additional ingredients for smoother application and absorption.
Nebulizer Solution: Gentamicin nebulizer solution is used for inhalation to treat respiratory tract infections, particularly those caused by Pseudomonas aeruginosa in patients with cystic fibrosis or bronchiectasis.
Dosage Adjustments in Kidney Patients:
Renal Impairment
Conventional dosing
For conventional dosing, the following adjusted dose recommendations are provided based on doses of 1.7 mg/kg/dose every 8 hours or 5-7 mg/kg/dose once daily:
- Creatinine Clearance (CrCl) >50 mL/min: No dosage adjustment necessary.
- CrCl 10-50 mL/min: Administer every 12 to 48 hours.
- CrCl <10 mL/min: Administer every 48 to 72 hours.
Once daily (interval adjustment of extended interval dosing)
For once-daily dosing, adjust doses based on serum concentrations and organism MIC:
- CrCl ≥60 mL/min: No dosage adjustment necessary.
- CrCl 40-59 mL/min: Administer 5-7 mg/kg intravenous (IV) every 36 hours.
- CrCl 20-39 mL/min: Administer 5-7 mg/kg IV every 48 hours.
- CrCl <20 mL/min: Administer 5-7 mg/kg IV once; monitor serum levels and redose when gentamicin level is <1 mcg/mL.
Intermittent hemodialysis
Administer after hemodialysis on dialysis days:
- The extent of dialyzability is approximately 30-50% and depends on factors such as patient's size, injection site, filter, and duration and type of intermittent hemodialysis.
- After the initial hemodialysis session, administer 1-1.7 mg/kg IV or intramuscular (IM); subsequent dosing should be guided by serum gentamicin concentrations.
Peritoneal dialysis
For intermittent dosing in anuric patients, administer 0.6 mg/kg per exchange once daily. For non-anuric patients during long dwell periods, administer 0.75 mg/kg/dose intraperitoneally (IP) daily. Treatment duration may vary based on infecting organism and patient's clinical status and may range from 2 to 3 weeks.
For continuous dosing, administer an 8 mg/L loading dose followed by a 4 mg/L maintenance dose.
Continuous renal replacement therapy
Dosage adjustment for continuous renal replacement therapy should be based on the method of renal replacement, filter type, and flow rate. Close monitoring of pharmacologic response, adverse reactions due to accumulation, and target drug concentration is necessary for appropriate dosing.
Administer 3 mg/kg/day IV or IM divided every 8 hours; in life-threatening infections, the dose may be increased to up to 5 mg/kg/day IV or IM divided every 6-8 hours. Adjust the dose based on serum concentration monitoring, and avoid peak concentrations exceeding 12 mcg/mL.
Dosage Adjustments in Pediatric Patients:
- For dermatologic infections in infants, children, and adolescents, topical treatment options are available. These include cream and ointment formulations. The recommended dosage is to apply the cream or ointment to the affected area 3 to 4 times per day.
- For ophthalmic infections in infants, children, and adolescents, there are ophthalmic treatment options available. These include ointment and solution formulations. The recommended dosages are as follows:
- Ophthalmic Ointment: Apply 1/2 inch (1.25 cm) of ointment to the affected eye(s) 2 to 3 times daily.
- Ophthalmic Solution: Instill 1 to 2 drops into the affected eye(s) every 4 hours. In cases of severe infections, up to 2 drops may be instilled every hour.
- Brucellosis:The recommended dosage of gentamicin for brucellosis in pediatric patients is typically 2.5 mg/kg to 3.5 mg/kg per day, divided into two or three equally spaced doses. The total daily dosage should not exceed 5 mg/kg.
- CNS infection:For central nervous system (CNS) infections, the usual dosage of gentamicin in pediatric patients is 2.5 mg/kg to 3.5 mg/kg per day, divided into two or three equally spaced doses. The total daily dosage should not exceed 5 mg/kg.
- Cystic fibrosis, pulmonary infection:In cystic fibrosis patients with pulmonary infections, the recommended dosage of gentamicin is typically 2.5 mg/kg to 5 mg/kg per day, divided into two or three equally spaced doses. The total daily dosage should not exceed 5 mg/kg.
- Endocarditis, treatment:The recommended dosage of gentamicin for the treatment of endocarditis in pediatric patients is generally 3 mg/kg to 5 mg/kg per day, divided into two or three equally spaced doses. The total daily dosage should not exceed 7 mg/kg.
- Gonococcal infection, uncomplicated infection of the cervix, urethra, or rectum:For uncomplicated gonococcal infections, the usual dosage of gentamicin in pediatric patients is 2 mg/kg to 2.5 mg/kg as a single dose.
- Intra-abdominal infection, complicated; Peritonitis:The recommended dosage of gentamicin for complicated intra-abdominal infections or peritonitis in pediatric patients is typically 2.5 mg/kg to 3.5 mg/kg per day, divided into two or three equally spaced doses. The total daily dosage should not exceed 5 mg/kg.
- Surgical prophylaxis:For surgical prophylaxis, the usual dosage of gentamicin in pediatric patients is 2 mg/kg to 2.5 mg/kg given as a single dose, administered shortly before the surgical procedure.
- Tularemia:The recommended dosage of gentamicin for tularemia in pediatric patients is generally 2.5 mg/kg to 3.5 mg/kg per day, divided into two or three equally spaced doses. The total daily dosage should not exceed 5 mg/kg.
- Urinary tract infection:For urinary tract infections, the typical dosage of gentamicin in pediatric patients is 2.5 mg/kg to 3.5 mg/kg per day, divided into two or three equally spaced doses. The total daily dosage should not exceed 5 mg/kg.
There are no specific dietary restrictions associated with the use of Gentamicin. However, it is always recommended to follow a balanced and healthy diet while undergoing any treatment.
Gentamicin may be contraindicated under the following conditions:
- Patients who have a known hypersensitivity to any component of Gentamicin or to other drugs in the same class.
The physician should closely monitor the patients and keep pharmacovigilance as follows:
- Nephrotoxicity: Patients receiving gentamicin should be closely monitored due to the potential toxicity associated with its use. Gentamicin, like other aminoglycosides, has the potential to cause kidney damage (nephrotoxicity). Patients with impaired renal function are at a higher risk. Therefore, caution should be exercised when using gentamicin in such patients. The frequency of administration should be reduced, renal function should be monitored, and prolonged concentrations above 10 micrograms/mL should be avoided. In neonates, infants, and children, dosage adjustments may be necessary to prevent toxicity.
- Ototoxicity: Gentamicin, along with other aminoglycosides, has the potential to cause both vestibular and auditory ototoxicity. Auditory changes may be irreversible, often affecting both ears partially or completely. Other signs of neurotoxicity may include numbness, tingling, muscle twitching, and convulsions. The risk of ototoxicity is higher with high doses, prolonged treatment, or impaired renal function. Close monitoring of renal and eighth cranial nerve function is important, especially in patients with known or suspected reduced renal function. Serial audiograms should be obtained in high-risk patients. If signs of ototoxicity or nephrotoxicity occur, dosage adjustment or discontinuation of the drug is necessary. Treatment duration should generally not exceed 10-14 days.
- Interaction with Other Medications: Concurrent or sequential use of other potentially neurotoxic and/or nephrotoxic drugs should be avoided. This includes potent diuretics, cephalosporins, and other aminoglycosides. Dehydration and advancing age can increase the risk of toxicity, so patients should remain well hydrated during therapy.
- Absorption from Body Surfaces: Recent evidence suggests that neurotoxic and nephrotoxic antibiotics can be absorbed in significant amounts from body surfaces after local irrigation or application. Therefore, the potential toxic effects should be considered, and any inadvertent contact with the skin should be washed off with water.
- Use in Neuromuscular Disorders: Caution should be exercised when using aminoglycosides in patients with neuromuscular disorders like myasthenia gravis or parkinsonism, as gentamicin may worsen muscle weakness due to its curare-like effect on neuromuscular function.
- Use during Anesthesia: When administering gentamicin to patients under anesthesia who are concurrently receiving neuromuscular blocking agents or undergoing massive transfusions of citrated blood, the possibility of prolonged or secondary apnea should be considered. If neuromuscular blockade occurs, it may be reversed by administering calcium salts.
- Superinfection: Treatment with gentamicin may lead to the overgrowth of non-susceptible organisms. In such cases, appropriate therapy should be initiated.
- Allergic Reactions: Allergic reactions can occur after the administration of gentamicin. Cross allergenicity among aminoglycosides has also been observed.
Alcohol Warning
There are no specific alcohol warnings related to the use of gentamicin. However, it is generally advisable to avoid consuming alcohol while taking any medication, including gentamicin. Alcohol can interact with medications and potentially interfere with their effectiveness or increase the risk of side effects. Additionally, alcohol consumption can put additional strain on the liver and kidneys, which may already be affected by the medication.
Breast Feeding Warning
Trace amounts of gentamicin have been identified in breast milk. To minimize the potential risk to the newborn, it is advised to discontinue breastfeeding while undergoing gentamicin therapy unless the anticipated benefits outweigh the potential risks involved.
Pregnancy Warning
Pregnancy Category D:
Selective uptake of aminoglycosides by the fetal kidney has been observed, potentially leading to damage to developing nephrons. This damage is likely reversible. In addition, cases of eighth cranial nerve damage have been reported when certain aminoglycosides are administered during pregnancy. Considering their chemical similarity, all aminoglycosides should be regarded as potentially nephrotoxic and ototoxic to the fetus.
Furthermore, it is important to note that therapeutic blood concentrations of aminoglycosides in the mother do not necessarily guarantee safety for the fetus.
Food Warning
There are no specific food warnings related to the use of gentamicin. However, it is generally recommended to follow a balanced and healthy diet while taking any medication, including gentamicin. It is important to maintain good nutrition and stay hydrated to support overall health and aid in the healing process.
The adverse reactions related to Gentamicin can be categorized as follows:
Common
- Nausea and vomiting
- Loss of appetite
- Headache
- Dizziness
- Diarrhea
- Injection site pain or irritation
- Rash or itching
- Increased sensitivity to sunlight
- Muscle weakness or fatigue
Less Common
- Confusion or disorientation
- Difficulty hearing or tinnitus (ringing in the ears)
- Balance problems or unsteadiness
- Joint or muscle pain
- Fever or chills
- Changes in urine output or color
Rare
- Allergic reactions such as hives, swelling, or difficulty breathing
- Severe skin reactions, including blistering or peeling
- Blood disorders, such as low platelet or white blood cell count
- Liver or kidney problems
- Neurological effects, such as seizures or hallucinations
The clinically relevant drug interactions of Gentamicin are briefly summarized here:
- Neuromuscular Blocking Agents:
If a patient receiving gentamicin is also given a neuromuscular blocking agent such as suxamethonium (succinylcholine), tubocurarine, decamethonium, halogenated hydrocarbon inhalation anesthetics, opioid analgesics, or receives massive transfusions with citrated anticoagulated blood, there is a risk of respiratory paralysis and prolonged neuromuscular blockade.
- Other Neurotoxic and/or Nephrotoxic Agents:
To avoid potential additive ototoxic or nephrotoxic effects, it is advisable to refrain from simultaneous or sequential use of other neurotoxic and/or nephrotoxic antibiotics, including other aminoglycosides, polymyxin B, colistin, cisplatin, vancomycin, amphotericin, clindamycin, and cephalosporins.
- Penicillins:
The inactivation of gentamicin by solutions containing beta-lactam antibiotics (penicillins and cephalosporins) should be noted. Therefore, simultaneous administration or combining these drugs in the same intravenous fluid should be avoided. In patients with renal failure, who have a higher level of penicillin for a longer duration, the inactivation of gentamicin by penicillins may occur in vivo. Thus, when gentamicin and penicillins are used together in patients with renal failure, it is recommended to stagger the time of administration of each drug to allow several hours between infusions.
- Diuretics:
The ototoxic effects of gentamicin can be potentiated by potent diuretics such as ethacrynic acid or furosemide.
- Vitamin K:
Gentamicin may inhibit the action of intravenous vitamin K on the synthesis of clotting factors.
- Potential Interactions:
In vitro studies have shown both synergism and antagonism between various antineoplastic agents and aminoglycosides.
The following are the side effects involving Gentamicin:
● Visual disturbances
● Nausea
● Vomiting
● Decreased appetite
● Weight loss
● Feeling light-headed or faint
● Itching or a rash
● Pain at the site of injection
● Headache and changes in mood
● Joint pain
Pregnancy:
Pregnancy Category D:
Selective uptake of aminoglycosides by the fetal kidney has been observed, potentially leading to damage to developing nephrons. This damage is likely reversible. In addition, cases of eighth cranial nerve damage have been reported when certain aminoglycosides are administered during pregnancy. Considering their chemical similarity, all aminoglycosides should be regarded as potentially nephrotoxic and ototoxic to the fetus.
Furthermore, it is important to note that therapeutic blood concentrations of aminoglycosides in the mother do not necessarily guarantee safety for the fetus.
Nursing Mothers
Trace amounts of gentamicin have been identified in breast milk. To minimize the potential risk to the newborn, it is advised to discontinue breastfeeding while undergoing gentamicin therapy unless the anticipated benefits outweigh the potential risks involved.
Pediatric Use
Caution must be exercised when administering gentamicin to premature and neonatal infants due to their immature renal function. This immaturity can lead to an extended serum half-life of the drug, increasing the risk of gentamicin-induced toxicity.
Geriatric Use
Caution should be exercised when prescribing gentamicin to elderly patients, especially after considering and exhausting less toxic alternatives. Elderly individuals are more susceptible to age-related decline in renal function, which may not be detectable through routine screening tests such as serum urea or serum creatinine levels. Assessing creatinine clearance can provide more valuable information in such cases. It is important to avoid exceeding the recommended doses of gentamicin and closely monitor renal function throughout the course of therapy.
Due to advanced age, reduced renal function, and potentially decreased weight, elderly patients may require smaller daily doses of gentamicin. Additionally, it should be noted that hearing loss may occur even in patients with normal renal function.
Physicians should be knowledgeable as well as vigilant about the treatment and identification of over dosage of Gentamicin.
Since gentamicin is primarily excreted by the kidneys, the administration of fluids can accelerate its elimination in cases of overdose. Additionally, the use of peritoneal dialysis or hemodialysis can also facilitate the removal of the drug from the body.
Pharmacodynamics
Gentamicin is an antibiotic medication belonging to the aminoglycoside class. It is commonly used to treat various bacterial infections.
Pharmacokinetics
Absorption and Distribution:
● After being injected intramuscularly (IM), gentamicin is quickly absorbed and typically reaches its highest levels in the bloodstream within 30 to 90 minutes. These levels remain detectable for 6 to 8 hours. Gentamicin can be found in various tissues and body fluids following its administration. It is distributed widely in body fluids such as ascitic, pericardial, pleural, synovial, and abscess fluids. However, the concentration of gentamicin in bile is low.
Biotransformation and Elimination:
● There is no significant evidence of gentamicin undergoing metabolism, and it is eliminated mostly unchanged in the body. Renal glomerular filtration is the primary route of excretion for gentamicin, making adjustments in the dosing frequency necessary in cases of renal failure (refer to section 4.2). In adults with normal kidney function, the serum half-life of gentamicin is approximately 2 to 3 hours. However, this half-life is prolonged in patients with impaired renal function and in premature or newborn infants.
- https://www.sandoz.ca/sites/www.sandoz.ca/files/Gentamicin Inj Product Monograph.pdf
- https://reference.medscape.com/drug/gentak-garamycin-gentamicin-342517
- drg-20074471
- https://www.drugs.com/mtm/gentamicin.html
- https://www.sandoz.ca/sites/www.sandoz.ca/files/Gentamicin Inj Product Monograph.pdf
- https://www.accessdata.fda.gov/drugsatfda_docs/psg/Gentamicin sulfate_topical cream_ANDA 062307_RC05-17.pdf
