No

Amebicide

Treatment of acute and chronic intestinal amebiasis; preoperatively to suppress intestinal flora; tapeworm infestations; treatment of Cryptosporidium

C

Intestinal obstruction, renal failure, known hypersensitivity to paromomycin or components

Use with caution in patients with impaired renal function or possible or proven ulcerative bowel lesions

1% to 10%: Gastrointestinal: Diarrhea, abdominal cramps, nausea, vomiting, heartburn

<1%: Headache, vertigo, exanthema, rash, pruritus, steatorrhea, secondary enterocolitis, eosinophilia, ototoxicity

Symptoms of overdose include nausea, vomiting, diarrhea

Following GI decontamination, if possible; care is supportive and symptomatic

Decreased effect of digoxin, vitamin A, and methotrexate

Increased effect of oral anticoagulants, neuromuscular blockers, and polypeptide antibiotics

Acts directly on ameba; has antibacterial activity against normal and pathogenic organisms in the GI tract; interferes with bacterial protein synthesis by binding to 30S ribosomal subunits

Absorption: Not absorbed via oral route

Elimination: 100% unchanged in feces

Oral:

Dientamoeba fragilis: Children and Adults: 25-30 mg/kg/day in 3 divided doses for 7 days

Cryptosporidium: Adults with AIDS: 1.5-2.25 g/day in 3-6 divided doses for 10-14 days (occasionally courses of up to 4-8 weeks may be needed)

Tapeworm (fish, dog, bovine, porcine):

Children: 11 mg/kg every 15 minutes for 4 doses

Adults: 1 g every 15 minutes for 4 doses

Hepatic coma: Adults: 4 g/day in 2-4 divided doses for 5-6 days

Dwarf tapeworm: Children and Adults: 45 mg/kg/dose every day for 5-7 days

Paromomycin may cause malabsorption of xylose, sucrose, and fats

May cause dizziness

None reported

No information available to require special precautions

No effects or complications reported

Take as directed, for full course of therapy. Do not skip doses. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake) and nutrition. If GI upset occurs, small frequent meals, frequent mouth care, sucking lozenges, or chewing gum may help. Report unresolved or severe nausea or vomiting, dizziness, ringing in ears, or loss of hearing. Pregnancy precautions: Inform prescriber if you are pregnant.

Monitor hearing loss before and during therapy

Capsule, as sulfate: 250 mg

Danziger LH, Kanyok TP, and Novak RM, "Treatment of Cryptosporidial Diarrhea in an AIDS Patient With Paromomycin," Ann Pharmacother, 1993, 27(12):1460-2.

"Drugs for Parasitic Infections," Med Lett Drugs Ther, 1998, 40(1017):1-12.

Liu LX and Weller PF, "Antiparasitic Drugs," N Engl J Med, 1996, 334(18):1178-84.