amikacin sulfate at a glance
Medicine class
Aminoglycoside antibiotic
How it is given
Injection or infusion; a separate liposomal product is inhaled using a specific nebuliser
Monitoring
Kidney function, hearing, balance and, during systemic treatment, blood amikacin concentrations
What is amikacin sulfate used for?
Licensed uses vary by formulation and product.
Injectable amikacin may treat serious susceptible bacterial infections, particularly those involving Gram-negative organisms.
Selected injection products cover hospital-acquired pneumonia, complicated urinary or abdominal infection, infected burns and associated bloodstream infection.
It may be combined with other antibiotics for endocarditis or used when bacterial infection is suspected in a neutropenic patient with fever.
Liposomal inhaled amikacin is used with other active antibiotics for Mycobacterium avium complex lung infection in selected adults with limited treatment options who do not have cystic fibrosis.
How does amikacin sulfate work?
Amikacin binds to bacterial 30S ribosomes, disrupting protein production and causing bacterial death. The liposomal inhaled formulation delivers amikacin to the airways and generally limits blood exposure compared with injection.
amikacin sulfate preparations and strengths
Inhaled preparation
Route: Inhaled
Strengths: 590 mg
Injection
Route: Parenteral
Strengths: 250 mg/mL
How to take amikacin sulfate
Injectable amikacin is given by a healthcare professional into a muscle or by intravenous infusion. Liposomal amikacin is inhaled through the mouth using only the Lamira Nebuliser System; do not swallow, inject, use another nebuliser, or mix it with other medicines in the handset.
Follow the supplied Lamira assembly, cleaning and disinfection instructions.
Allow a refrigerated vial to reach room temperature and shake vigorously until uniformly mixed.
Sit upright and breathe through the mouthpiece as instructed.
If prescribed, a bronchodilator is generally used before liposomal amikacin.
amikacin sulfate side effects
Common or expected effects
- With liposomal inhalation: cough, hoarseness or voice change, breathlessness, or blood-streaked sputum.
- Throat discomfort, wheezing, headache, dizziness, altered taste, nausea, diarrhoea, reduced appetite, tiredness or fever may occur with the inhaled product.
- Tinnitus, hearing changes, balance disturbance, rash, itching and impaired kidney function are also reported with liposomal inhaled amikacin.
Get urgent medical advice
- Severe allergy or anaphylaxis, including facial or throat swelling and severe breathing difficulty.
- New hearing loss, persistent tinnitus, disabling dizziness or loss of balance; hearing damage can be permanent.
- Kidney injury, including reduced urine or abnormal blood tests.
- Bronchospasm, allergic lung inflammation or worsening underlying lung disease with liposomal inhalation.
- Neuromuscular blockade causing weakness or breathing difficulty, mainly with systemic exposure and interacting medicines.
amikacin sulfate in pregnancy
Amikacin may be considered during pregnancy when treatment of a serious infection is necessary and expected benefit outweighs possible risk. Placental transfer and a potential risk of hearing damage require specialist assessment. Liposomal inhaled amikacin is preferably avoided as a precaution.
amikacin sulfate while breastfeeding
Evidence is limited, and product information is not fully consistent about transfer into breast milk. The prescriber should decide with the patient whether breastfeeding or treatment needs to be interrupted.
amikacin sulfate interactions
Review prescribed, non-prescription and recent medicines because some combinations can increase toxicity.
Other aminoglycosides
Toxic effects may add together; concurrent use with liposomal inhaled amikacin is contraindicated regardless of route.
Cisplatin and other platinum compounds
May increase kidney toxicity and possibly hearing damage.
Amphotericin B, ciclosporin, tacrolimus, vancomycin or colistin
May add to kidney, hearing or neurological toxicity and generally requires avoidance or close monitoring.
Common questions about amikacin sulfate
Answers are fully visible for fast scanning and source review.
Why are blood tests needed?
They assess kidney function and, for systemic treatment, measure amikacin concentrations to help avoid excessive exposure and toxicity.
Can it permanently affect hearing?
Yes. Aminoglycoside-related hearing damage can be irreversible. Report tinnitus, hearing change, dizziness or balance problems promptly.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.