Kanamycin (Km)

Therapeutic action

– Antibacterial (aminoglycoside) with bactericidal activity

Presentation

– Kanamycin sulfate, eq. 1 g base, vial of powder for injection, for IM injection
Also comes in 1 g base ampoule (250 mg/ml, 4 ml), for IM injection

Dosage

– Child under 30 kg: 15 to 30 mg/kg once daily
– Child over 30 kg and adult: 15 to 20 mg/kg once daily
– Maximum dose: 1000 mg daily
– Patient over 60 years: 10 mg/kg once daily (max. 750 mg daily)
– Patient with severe renal impairment: 12 to 15 mg/kg/dose, 2 or 3 times per week

For the powder for injection, the daily doses take into account the displacement volume (see the note on displacement volume - powders for injection).

Weight
(kg)

Daily dose
(mg))

Daily dose - IM injection1
solution 250 mg/ml

Daily dose - IM injection1
(1 g powder in 4 ml of water for injection;
final volume
4.71 ml; 212 mg/ml)

5

75-150

0.5 ml

0.6 ml

6

90-180

0.5 ml

0.6 ml

7

105-210

0.5 ml

0.6 ml

8

120-240

0.5 ml

0.6 ml

9

135-270

0.8 ml

0.9 ml

10

150-300

0.8 ml

0.9 ml

11

165-330

0.8 ml

0.9 ml

12

180-360

1 ml

1.2 ml

13

195-390

1 ml

1.2 ml

14

210-420

1 ml

1.2 ml

15

225-450

1 ml

1.2 ml

16

240-480

1 ml

1.2 ml

17

255-510

1.5 ml

1.8 ml

18

270-540

1.5 ml

1.8 ml

19

285-570

1.5 ml

1.8 ml

20

300-600

1.5 ml

1.8 ml

21

315-630

1.5 ml

1.8 ml

22

330-660

1.5 ml

1.8 ml

23

345-690

1.5 ml

1.8 ml

24

360-720

1.5 ml

1.8 ml

25

375-750

2 ml

2.4 ml

26

390-780

2 ml

2.4 ml

27

405-810

2 ml

2.4 ml

28

420-840

2 ml

2.4 ml

29

435-870

2 ml

2.4 ml


30-33

500

2 ml

2.4 ml

34-40

625

2.4 ml

3 ml

41-45

750

3 ml

3.4 ml

46-50

875

3.4 ml

4 ml

51-70

1000

4 ml

Entire volume

> 70

1000

4 ml

Entire volume

Contra-indications, adverse effects, precautions

– Do not administer to patients with history of allergy to an aminoglycoside.
– Administer with caution to patients over 60 years or with pre-existing renal, vestibular or auditory impairment.
– May cause:
• nephrotoxicity, ototoxicity (auditory and vestibular toxicity), electrolyte disturbances; rarely hypersensitivity reactions;
• local pain after injection.
– For the management of adverse effects, see Appendix 10.
– Avoid or monitor combination with other ototoxic and/or nephrotoxic drugs (furosemide, amphotericin B, tenofovir, etc.).
Pregnancy: CONTRA-INDICATED. Use capreomycin if an injectable agent is required.
Breast-feeding: no contra-indication

Monitoring

– Symptomatic monitoring, serum creatinine and electrolytes, audiometric test before and during treatment

Patient instructions

– Maintain a good fluid intake to limit renal problems.

Remarks

– Do not mix with other drugs in the same syringe.
Storage: below 25°C
Reconstituted solution can be kept 24 hours below 25°C; it may darken during the storage but this does not indicate a loss of potency.



Footnotes
Ref Notes
1

For doses less than 1 ml, use a 1 ml syringe graduated in 0.01 ml.

[ a b ]