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Update: January 2022
Forms, strengths and route of administration
- 500 mg amikacin base in 2 ml ampoule (250 mg/ml), for IM injection
Dosage
- Child and adult: 15 to 20 mg/kg once daily
- Patient 60 years and over: 15 mg/kg 3 times a week
- Maximum dose: 1000 mg daily
- Renal insufficiency: 12 to 15 mg/kg 2 or 3 times a week
|
Weight |
Daily dose (mg) |
Daily dose (ml) - IM injection
(a)
Citation
a.
For doses less than 1 ml, use a 1 ml syringe graduated in 0.01 ml.
|
|---|---|---|
|
5 |
75-100 |
0.4 ml |
|
6 |
90-120 |
0.4 ml |
|
7 |
105-140 |
0.6 ml |
|
8 |
120-160 |
0.6 ml |
|
9 |
135-180 |
0.6 ml |
|
10 |
150-200 |
0.8 ml |
|
11 |
165-220 |
0.8 ml |
|
12 |
180-240 |
0.8 ml |
|
13 |
195-260 |
1 ml |
|
14 |
210-280 |
1 ml |
|
15 |
225-300 |
1 ml |
|
16 |
240-320 |
1.2 ml |
|
17 |
255-340 |
1.2 ml |
|
18 |
270-360 |
1.2 ml |
|
19 |
285-380 |
1.5 ml |
|
20 |
300-400 |
1.5 ml |
|
21 |
315-420 |
1.5 ml |
|
22 |
330-440 |
1.5 ml |
|
23 |
345-460 |
1.5 ml |
|
24 |
360-480 |
1.5 ml |
|
25 |
375-500 |
2 ml |
|
26 |
390-520 |
2 ml |
|
27 |
405-540 |
2 ml |
|
28 |
420-560 |
2 ml |
|
29 |
435-580 |
2 ml |
|
|
||
|
30-35 |
625 |
2.5 ml |
|
36-45 |
750 |
3 ml |
|
46-55 |
875 |
3.5 ml |
|
56-70 |
1000 |
4 ml |
|
> 70 |
1000 |
4 ml |
Contra-indications, adverse effects, precautions
- Do not administer to patients with hypersensitivity to aminoglycosides.
- Amikacin should only be used when no alternative is available, especially in children and adolescents under 18 years.
- Administer with caution to patients 60 years and over or patients with renal, vestibular, auditory or severe hepatic impairment.
- May cause:
- nephrotoxicity, ototoxicity, electrolyte disturbances;
- hypersensitivity reactions;
- local pain after injection.
- For the management of adverse effects, see Appendix 17.
- Avoid or monitor combination with other ototoxic and/or nephrotoxic drugs (furosemide, amphotericin B, tenofovir, etc.).
- Pregnancy: CONTRA-INDICATED
- Breastfeeding: no contra-indication
Monitoring
- Symptomatic monitoring.
- Audiometry, serum creatinine and electrolytes (K, Ca, Mg).
Patient instructions
- Maintain a good fluid intake to limit renal problems.
Remarks
- Use a different site for each injection (absorption may be delayed if the same site is used repeatedly).
Storage
– Below 25 °C
Solution may darken from colourless to a pale yellow, but this does not indicate a loss of potency.
- (a)For doses less than 1 ml, use a 1 ml syringe graduated in 0.01 ml.