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Pronunciation
(par oh moe MYE sin)
Generic Available (U.S.)
Yes
Index Terms
Brand Names: Canada
Pharmacologic Category
Use: Labeled Indications
Treatment of acute and chronic intestinal amebiasis; hepatic coma
Use: Unlabeled/Investigational
Treatment of cryptosporidiosis
Pregnancy Considerations
Paromomycin is poorly absorbed when given orally. Because it does not reach the maternal serum, it would not be expected to adversely affect the fetus. No adverse effects were observed in two infants whose mothers took paromomycin during pregnancy.
Breast-Feeding Considerations
Paromomycin is poorly absorbed when given orally. Because it does not reach the maternal serum, it would not be expected to distribute into human milk.
Contraindications
Hypersensitivity to paromomycin or any component of the formulation; intestinal obstruction
Warnings/Precautions
Concerns related to adverse effects:
• Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.
Disease-related concerns:
• Renal impairment: Use with caution in patients with renal impairment.
• Ulcerative bowel lesions: Use with caution in patients with possible or proven ulcerative bowel lesions.
Adverse Reactions
1% to 10%: Gastrointestinal: Diarrhea, abdominal cramps, nausea, vomiting, heartburn
<1%: Headache, vertigo, exanthema, rash, pruritus, steatorrhea, secondary enterocolitis, eosinophilia, ototoxicity
Metabolism/Transport Effects
None known.
Drug Interactions
There are no known significant interactions.
Ethanol/Nutrition/Herb Interactions
Food: Paromomycin may cause malabsorption of xylose, sucrose, and fats.
Mechanism of Action
Acts directly on ameba; has antibacterial activity against normal and pathogenic organisms in the GI tract; interferes with bacterial protein synthesis by binding to 30S ribosomal subunits
Pharmacodynamics/Kinetics
Absorption: Poor oral absorption
Excretion: Feces (100% as unchanged drug)
Dosage
Oral:
Intestinal amebiasis: Children and Adults: 25-35 mg/kg/day in 3 divided doses for 5-10 days
Dientamoeba fragilis: Children and Adults: 25-30 mg/kg/day in 3 divided doses for 7 days
Cryptosporidium (unlabeled use): Adults with AIDS: 1.5-2.25 g/day in 3-6 divided doses for 10-14 days (occasionally courses of up to 4-8 weeks may be needed)
Tapeworm (fish, dog, bovine, porcine):
Children: 11 mg/kg every 15 minutes for 4 doses
Adults: 1 g every 15 minutes for 4 doses
Hepatic coma: Adults: 4 g/day in 2-4 divided doses for 5-6 days
Dwarf tapeworm: Children and Adults: 45 mg/kg/dose every day for 5-7 days
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause dizziness
Mental Health: Effects on Psychiatric Treatment
None reported
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Capsule, oral: 250 mg
References
Danziger LH, Kanyok TP, and Novak RM, “Treatment of Cryptosporidial Diarrhea in an AIDS Patient With Paromomycin,” Ann Pharmacother, 1993, 27(12):1460-2.
“Drugs for Parasitic Infections,” Med Lett Drugs Ther, 1998, 40(1017):1-12.
Liu LX and Weller PF, “Antiparasitic Drugs,” N Engl J Med, 1996, 334(18):1178-84.
International Brand Names
Lexi-Comp.com
Last full review/revision October 2011
Content last modified October 2011
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