What is neomycin?

This substance is produced by Streptomyces faradia fungi. Neomycin is an aminoglycoside bactericidal antibiotic that binds to the 30S part of the ribosome of neomycin-sensitive microorganisms and thus interferes with the binding of mRNA to the tRNA acceptor site and produces toxic or non-functional peptides.

Mechanism of action

Aminoglycosides such as neomycin bind irreversibly to the 30S subunit protein and 16S rRNA. Neomycin specifically binds to four nucleotides of 16S rRNA and one amino acid of S12 protein.
This binding to the decoding region adjacent to nucleotide 1400 in the 16S rRNA of the 30S subunit interferes with the moving parts of the anticodon portion of the tRNA, thereby disrupting the initiation complex and mistranslation of the mRNA, resulting in the wrong amino acid being inserted. It becomes a polypeptide and toxic or non-functional peptides are created and the polysome is broken down into non-functional monosomes.


Neomycin is an aminoglycoside antibiotic that causes misreading of tRNA by binding to the 30S ribosomal subunit and inhibits the production of proteins necessary for the growth of microorganisms.
Aminoglycosides are effective in infections caused by aerobic Gram-negative bacteria such as Pseudomonas, Acinetobacter and Enterobacter.
In addition, some mycoplasmas, such as the causative agent of tuberculosis, are sensitive to aminoglycosides. Gram-positive bacterial infections can be treated with aminoglycosides, but antibiotics from other classes are more effective and have fewer side effects.


Absorption: A small amount (3%) is absorbed from the healthy digestive tract. Significant amounts are absorbed in inflammation or gastrointestinal damage.

Time to reach the maximum plasma concentration: oral: 1-4 hours, intramuscular injection: 2 hours

Volume of distribution: 0.36 liters per kilogram of body weight

Protein binding: It is low and varies from 0 to 30% depending on the method used in the experiments.

Metabolism: A small amount occurs in the liver.

Half-life: 2-3 hours


Feces: 97% of the oral dose unchanged

Urinary: 30-50% of absorbed drug in unchanged form

Dosage of Neomycin

Hepatic encephalopathy

Acute: 4-12 g/day in four divided doses orally for 5-6 days or 3-6 g/day for 1-2 weeks

Chronic: maximum 4 grams per day orally

Hepatic coma:

4-12 grams per day divided every 4-6 hours orally for 5-6 days

Diarrhea caused by enteropathogenic E.coli

3 grams per day divided into four doses orally

Preparation of intestines before surgery

1 gram orally every one hour for four doses and then 1 gram every four hours for five doses

Alternate dose: 6 g/day divided at 4-hour intervals for 2-3 days

Steroid-induced dermatosis with infection

Use the cream 2-4 times a day for a maximum of 7 days.

Its safety and efficacy have not been confirmed in children under 18 years of age, but it can be appropriate in some situations.

Encephalopathy and hepatic coma

1 month to 18 years: daily 50-100 mg per kilogram of body weight divided in 6-8 hour intervals for 5-6 days


Under 1 month: daily 50 mg per kilogram of body weight orally divided into four doses

1 month to 18 years: daily 50 mg per kilogram of body weight orally divided into four doses for 2-3 days

Preparation of bowels before surgery

Under 1 month: daily 50 mg per kilogram of body weight divided into four doses

1 month to 18 years: daily 50-100 mg per kilogram of body weight divided into four doses

Drug interactions

Succinylcholine, vitamin A, bacitracin, rapacuronium, kanamycin, tobramycin, suxamtonium, fenindione | Phenindione, meglumine compound, colistin, cefamandol, mivacurium, doxacurium, capreomycin, diatrizoate (amidoterizoic acid), gallium nitrate, utalamate, typhoid vaccine, cordyceps, cholera vaccine, ioxaglate


– If you have ulcerative colitis, Crohn’s disease, intestinal obstruction or other inflammatory bowel diseases, you should not use this medicine.
– Before taking Neomycin, tell your doctor if you have kidney disease, myasthenia gravis, or Parkinson’s disease.
Neurotoxicity, which manifests as vestibular or bilateral hearing toxicity, in patients with kidney damage or patients with healthy kidneys who are treated with high doses of this drug or who use the drug for a long time. can be created. Initially, high-frequency deafness may occur, which is only detected by hearing tests.
Aminoglycosides are nephrotoxic. Its possibility can occur in patients with kidney damage or patients with healthy kidneys under high dose treatment or long-term drug use. Rarely, nephrotoxicity may appear in the first few days after stopping treatment.
– In children and premature babies, due to the lack of development of the kidneys and as a result, the drug should be used with caution.
– Neuromuscular block and paralysis of respiratory muscles have been reported in injectable, topical and oral forms, especially when prescribed with a short distance from anesthetic or muscle relaxant drugs. In these cases, calcium salts can fix it, but breathing equipment may also be necessary.
– Avoid simultaneous or consecutive use of neurotoxic or renal drugs such as other aminoglycosides. (Amikacin, streptomycin, neomycin, kanamycin, gentamicin and paramomycin)
– A list of drugs that should not be taken with aminoglycosides includes: amphotericin B, bacitracin, cephaloridine, cisplatin, colistin, polymyxin B, vancomycin and viomycin.
Avoid simultaneous administration with strong diuretics such as furosemide and ethacrynic acid because they increase the possibility of phone toxicity. Diuretics can increase the toxicity of aminoglycosides by changing the concentration of aminoglycosides in serum and tissue.

Recommended tips

– Blood function should be checked if recommended by the doctor.
– Do not take neomycin for more than the prescribed time because the possibility of secondary infection increases.
– If your age is more than 65 years, use the medicine with caution because the possibility of side effects is higher.
– You should not use neomycin if you are pregnant. This medicine may harm the fetus.
If you are pregnant or plan to become pregnant, inform your doctor so that the benefits and harms of prescribing it in pregnancy can be evaluated.
Similar drugs
Streptomycin, Nitrofurazone, Kanamycin, Spectinomycin, Paromomycin, Nethylmycin sulfate

Use of neomycin during breastfeeding

There is no information on the secretion of the drug in milk, so it should be used with caution.

side effects

Using this medicine for frequent or prolonged periods may cause new fungal eye infections and may cause other eye problems such as glaucoma and cataracts or delayed healing of wounds.
If you have eye discharge, vision problems, or eye pain, tell your doctor immediately.

Remember that the doctor has prescribed this drug for you because its benefits outweigh its disadvantages, of course, each drug has its own side effects.

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