Amikacin (Am)

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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
    (kg)

    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.
    (500 mg in 2 ml = 250 mg/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.
    • Administer with caution to patients 60 years and over or patients with pre-existing renal, vestibular, auditory or severe hepatic impairment.
    • May cause:
      • nephrotoxicity, ototoxicity, electrolyte disturbances; rarely, 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.