Paromomycin

Administration

• Class:Aminoglycoside
• Type: Amebicide
• Dosage Forms: 250
• Routes of Administration: Oral
• Common Trade Names: Humatin

Adult Dosing

Intestinal amebiasis

• 25-35mg/kg/day PO divided tid x5-10 days
  • Give with food

Hepatic encephalopathy

• adjunct treatment: 1000mg PO QID x5-6 days
  • Give with food

Indications by Disease

Disease	Dose	Context
Acute diarrhea	500mg q8hrs for 7 days	Entamoeba, Luminal
Acute diarrhea	500mg PO q8hrs x 14-28days	Cryptosporidium

Pediatric Dosing

Intestinal amebiasis

• 25-35mg/kg/day PO divided tid x5-10 days

Special Populations

• Poorly absorbed when given orally
• Use during pregnancy has limited data

Renal Dosing

• No change in dosing

Hepatic Dosing

• No change in dosing

Contraindications

• Allergy to class/drug
• GI obstruction
• caution if ulcerative colitis
• caution if inflammatory bowel disease
• caution if renal impairment

Adverse Reactions

Serious

• nephrotoxicity
• ototoxicity, auditory
• ototoxicity, vestibular
• neurotoxicity
• neuromuscular blockade
• malabsorption syndrome (prolonged use)
• superinfection (prolonged use)
• enterocolitis

Common

• nausea
• abdominal cramps
• diarrhea

Pharmacology

• Half-life: Unknown
• Metabolism: CYP450
• Excretion: Feces

Mechanism of Action

Bactericidal and amebicidal. Paromomycin binds to bacterial 30S ribosomal subunit, inhibiting protein synthesis; it suppresses urease producing bacteria, reducing ammonia absorption from gut

References

UpToDate, Epocrates