Neomicina
Neomycin
Neomycin sulfate
También conocido como: Biosol · Neomix · Neo-325 · Neo-fradin · Neo-Sol 50 · Neovet · Canaural · Soframycin · Neopen · Maxitrol · Nivemycin · fradiomycin sulfate · neomycin sulphate · neomycini sulfas · neomycin B · Framycetin sulphate · Neomycin sulfate · Neomycinum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia de dosis v13 auditada
Evidencia estructurada para el cálculoSusceptible enteric infections (extra-label)
- q6-12h
NA
Contexto clínico obligatorio (3)
- ■ This medicine may be given by mouth with or without food. If your animal vomits or acts sick after receiving the medicine on an empty stomach, give with food or a small treat to see if this helps.
- Neomycin sulfate oral solution should be stored at room temperature (15°C-30°C [59°F-86°F]) in airtight, light-resistant containers.
- Unless otherwise instructed by the manufacturer, oral tablets/boluses should be stored in airtight containers at room temperature.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La neomicina es un antibiótico aminoglucósido bactericida de amplio espectro, eficaz principalmente contra bacterias aerobias gramnegativas.
Debido a que es significativamente más nefrotóxica que otros aminoglucósidos (como la gentamicina o la amikacina) cuando se administra por vía sistémica, su uso en medicina veterinaria se limita principalmente a:
- Aplicaciones tópicas (piel, ojos, oídos)
- Administración oral para infecciones entéricas o "esterilización intestinal" antes de una cirugía
- Manejo de la encefalopatía hepática (para reducir las bacterias productoras de amoníaco en el colon)
Perla clínica: Al igual que todos los aminoglucósidos, la neomicina exhibe una actividad bactericida dependiente de la concentración y un efecto post-antibiótico (PAE) significativo. Sin embargo, se absorbe poco en un tracto gastrointestinal intacto (solo ~3%), lo que la hace ideal para la acción local dentro de la luz intestinal mientras se minimiza la toxicidad sistémica.
Mecanismo de acción
Neomycin actively transports across the bacterial cell membrane (an oxygen-dependent process, hence its lack of efficacy against anaerobes). It irreversibly binds to the 30S ribosomal subunit → causes misreading of mRNA → inhibits protein synthesis → leads to rapid bacterial cell death.
Seguridad y advertencias
Contraindicaciones
- Intestinal obstruction (for oral use)
- Rabbits and hares (disrupts GI flora)
- Neonates (avoid oral use due to higher systemic absorption)
- Animals with a perforated tympanic membrane (eardrum)
- Concurrent use with other known ototoxic products
- Known hypersensitivity to aminoglycosides
- Pre-existing renal disease (for systemic use)
- Ruptured tympanic membrane (for otic preparations)
Efectos adversos
- Nephrotoxicity (severe if given parenterally)
- Ototoxicity (irreversible, parenteral or rarely oral)
- Severe diarrhea
- Intestinal malabsorption
- GI superinfections (with chronic oral use)
- Ototoxicity (deafness)
- Vestibular toxicity (ataxia, head tilt, nystagmus)
- Local irritation or erythema at the application site
- Ototoxicity (vestibular and auditory)
- Severe diarrhoea or malabsorption syndrome (oral use)
- Bacterial or fungal superinfections
- Local irritation (topical ophthalmic use)
Precauciones
Use with extreme caution in patients with renal dysfunction, even when given orally, as a small percentage is absorbed. Avoid parenteral use in working dogs due to the risk of irreversible ototoxicity. Use cautiously in patients with neuromuscular disorders (e.g., myasthenia gravis) due to the neuromuscular blocking activity of aminoglycosides. Geriatric and neonatal animals require careful monitoring and dosage adjustments if systemic absorption is expected.
Interacciones farmacológicas
Oral neomycin may decrease digoxin absorption. In a small subset of patients who metabolize digoxin in the GI tract, neomycin may increase serum digoxin levels.
Absorption may be reduced by oral neomycin.
Concurrent use increases the risk of additive toxicity, even with oral neomycin, and should be done with caution.
Concurrent use may cause malabsorption of the penicillin.
Oral neomycin may decrease vitamin K absorption from the gut, potentially increasing anticoagulant effects.
Increased risk of cumulative ototoxicity (deafness and vestibular dysfunction)
Decreased absorption of potassium
Decreased absorption of vitamin K
Synergistic ototoxicity and nephrotoxicity
Monitorización
- Clinical efficacy
- Systemic and GI adverse effects with prolonged use
- Renal function parameters (BUN, creatinine, urinalysis) if used parenterally
- Resolution of clinical signs of otitis
- Integrity of the tympanic membrane (via otoscopy)
- Hearing function and vestibular signs (head tilt, ataxia, nystagmus)
- Renal function (BUN, Creatinine, Urinalysis for casts/protein)
- Hearing and vestibular function (head tilt, nystagmus, ataxia)
- Gastrointestinal signs (diarrhoea)
Farmacocinética
Vida media
Absorción
Approximately 3% of a dose is absorbed after oral or rectal administration. Absorption increases if gut motility is slowed or if the bowel wall is damaged. Therapeutic systemic levels are not attained via oral administration.
Distribución
Distributes to tissues similarly to other aminoglycosides. Does not cross the blood-brain barrier well.
Metabolismo
Not significantly metabolized.
Eliminación
Orally administered neomycin is nearly all excreted unchanged in the feces. Parenterally administered drug is eliminated primarily through renal mechanisms.
Sobredosis
Parenteral overdosage carries a high risk of severe nephrotoxicity and ototoxicity. Oral overdosage is less likely to cause systemic toxicity unless the gut wall is compromised, but can lead to severe diarrhea and malabsorption.
Productos disponibles
Formulaciones
- Oral liquid
- Soluble powder
- Oral tablets
- Topical formulations (ophthalmic, otic, dermatologic)
- Topical: 5 mg/g suspension (often combined with fusidic acid, nystatin, and prednisolone as Canaural)
- Oral: 500 mg tablets
- Parenteral: 100 mg/ml neomycin combined with 200 mg/ml penicillin G
- Topical: 0.25-0.5% dermatological, ophthalmic, and otic preparations
Veterinario
- Neomycin Sulfate Oral Liquid: 200 mg/mL
- Neomycin Sulfate Soluble Powder: 325 grams/lb (Neo-325, Neovet 325/100, Neo-Sol 50)
- Canaural Ear Drops (Framycetin 5 mg/g, Fusidic acid 5 mg/g, Nystatin 100,000 IU/g, Prednisolone 2.5 mg/g)
- Neopen (100 mg/ml neomycin + 200 mg/ml penicillin G injection)
Etiquetado para humanos
- Neomycin Sulfate Tablets: 500 mg
- Neomycin Sulfate Oral Solution: 25 mg/mL (Neo-fradin)
- Soframycin (Framycetin sulfate 1% topical/ophthalmic preparations - availability varies by region)
- Nivemycin (500 mg tablets)
- Maxitrol (ophthalmic drops/ointment)
Estado regulador
Subject to responsible antimicrobial use guidelines.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store oral solutions and tablets at room temperature (15-30°C) in tight, light-resistant containers. In the dry state, neomycin is stable for at least 2 years at room temperature.
Información para el cliente
- Uso oral: Puede causar diarrea o alterar la flora intestinal normal. Siga cuidadosamente las instrucciones de su veterinario.
- Advertencia de toxicidad: Si este medicamento se administra mediante inyección, existe un riesgo significativo de daño renal (nefrotoxicidad) y pérdida de audición o problemas de equilibrio (ototoxicidad).
- Asegúrese de que su mascota tenga acceso a abundante agua fresca.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.