Amikacin
Also known as: Amikin · Amikacine · Amikacinum · Amikacin sulfate
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Susceptible bacterial infections | 15-30 mg/kg | IV/IM/SC | q24h | Not specified | 🌍 EU |
| Susceptible bacterial infections in Greyhounds and sight hounds | 12 mg/kg | IV/IM/SC | q24h | Not specified | 🌍 EU |
| Sepsis | Higher than standard doses | IV/IM/SC | q24h | Not specified | 🌍 EU |
| Local infections (e.g., joints, bladder) | Varies | topical | Varies | Not specified | 🌍 EU |
- Susceptible bacterial infections: IV doses should be given slowly over 30-60 minutes.
- Susceptible bacterial infections in Greyhounds and sight hounds: Lower dose recommended due to a lower volume of distribution in these breeds.
- Sepsis: Recommended by some authors, but carries an increased risk of adverse effects.
- Local infections (e.g., joints, bladder): Considered if the site is easily accessible and if the animal shows signs of systemic nephrotoxicity.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Susceptible bacterial infections | 10-15 mg/kg | IV/IM/SC | q24h | Not specified | 🌍 EU |
| Sepsis | Higher than standard doses | IV/IM/SC | q24h | Not specified | 🌍 EU |
| Local infections (e.g., joints, bladder) | Varies | topical | Varies | Not specified | 🌍 EU |
- Susceptible bacterial infections: IV doses should be given slowly over 30-60 minutes.
- Sepsis: Recommended by some authors, but carries an increased risk of adverse effects.
- Local infections (e.g., joints, bladder): Considered if the site is easily accessible and if the animal shows signs of systemic nephrotoxicity.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Amikacin is a potent aminoglycoside antibiotic primarily active against severe Gram-negative bacterial infections, Staphylococcus aureus, and Nocardia spp. It is particularly valuable for treating infections resistant to other aminoglycosides like gentamicin.
Clinical Pearl: Streptococci and anaerobic bacteria are typically resistant. Activity is significantly reduced in low-oxygen environments (e.g., abscesses, necrotic tissue).
Warning: Amikacin has poor penetration across biological membranes; systemic levels require parenteral administration, and it achieves very limited concentrations in the CNS and ocular fluids. It carries significant risks of nephrotoxicity and ototoxicity.
Mechanism of action
Aminoglycosides irreversibly bind to the 30S ribosomal subunit of susceptible bacteria, inhibiting bacterial protein synthesis.
They exhibit concentration-dependent killing → leading to a marked post-antibiotic effect (PAE). This allows for prolonged dosing intervals (e.g., q24h), which maximizes bacterial kill rates while minimizing accumulation in renal tubular cells, thereby reducing toxicity.
Safety & warnings
Contraindications
- Animals with pre-existing reduced renal function (unless benefits outweigh risks)
- Dehydrated patients (without concurrent fluid therapy)
Adverse effects
- Nephrotoxicity (tubular necrosis)
- Ototoxicity (vestibular and auditory dysfunction)
- Neuromuscular blockade (rare but possible)
Precautions
Intravenous Administration: IV doses should be given slowly, generally over 30-60 minutes.
Fluid Therapy: Concurrent fluid therapy is strongly advised to maintain glomerular filtration and reduce nephrotoxicity.
Monitoring: Therapeutic drug monitoring (peak and trough serum levels) should be considered to ensure efficacy and minimize toxicity, especially in neonates, geriatric patients, and those with compromised renal function.
Drug interactions
In vivo synergism against susceptible bacteria; however, they can cause in vitro inactivation of amikacin. Do not mix in the same syringe.
Increased risk of severe nephrotoxicity.
Increased risk of ototoxicity and nephrotoxicity.
In vitro inactivation of amikacin. Do not mix in the same syringe.
Potentiation of neuromuscular blockade.
Monitoring
- Serum amikacin levels (peak for efficacy, trough for toxicity)
- Renal function (BUN, serum creatinine, urinalysis for casts/proteinuria)
- Hydration status
- Auditory and vestibular function (if possible)
Pharmacokinetics
Half-life
Absorption
Poorly absorbed from the gastrointestinal tract; requires parenteral administration for systemic levels.
Distribution
Limited movement across biological membranes. Access to sites such as the CNS and ocular fluids is very limited. Greyhounds have a lower volume of distribution compared to other dog breeds.
Metabolism
Minimal hepatic metabolism.
Elimination
Excreted almost entirely unchanged via glomerular filtration in the kidneys.
Overdose
Overdosage significantly increases the risk of acute tubular necrosis (nephrotoxicity) and vestibular/auditory damage (ototoxicity). Treatment is supportive. Discontinue the drug immediately and initiate aggressive intravenous fluid therapy to promote diuresis and maintain glomerular filtration rate.
Available products
Formulations
- Injectable solution: 50 mg/ml
- Injectable solution: 250 mg/ml
Veterinary
- Amikacin 50 mg/ml injectable solution
- Amikacin 250 mg/ml injectable solution
Human-labeled
- Amikin 50 mg/ml injection
- Amikin 250 mg/ml injection
Regulatory status
Approved for intrauterine use in horses and systemic use in dogs.
POM-V (Prescription Only Medicine - Veterinarian).
POM-V. Use should be based on susceptibility testing.
No regulatory data for: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store at room temperature. Observe normal precautions for handling and storage as per manufacturer guidelines.
Client information
Amikacin is a powerful antibiotic used for serious infections and is usually administered by your veterinarian.
- Kidney Health: This drug can affect the kidneys. Ensure your pet has constant access to fresh water. Contact your vet immediately if you notice changes in your pet's drinking habits or urine output (drinking/urinating too much or too little).
- Hearing and Balance: Rarely, this medication can affect hearing or balance. Let your vet know if your pet seems dizzy, uncoordinated, or unresponsive to sounds.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.