HD                     :Dialysed. Administer 2 mg/kg at the end of each dialysis session. Monitor levels
HDF/high flux   :Dialysed. Administer 2 mg/kg at the end of each dialysis session. Monitor levels
CAV/VVHD      :Dialysed. Dose as in GFR=10–20 mL/min. Monitor levels
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsBotulinum toxin: neuromuscular block enhanced (risk of toxicity)
Ciclosporin: increased risk of nephrotoxicityCytotoxics: increased risk of nephrotoxicity and possibly of ototoxicity with platinum compounds
Diuretics: increased risk of ototoxicity with loop diureticsMuscle relaxants: effects of non- depolarising muscle relaxants and suxamethonium enhancedParasympathomimetics: antagonism of effect of neostigmine and pyridostigmine
Tacrolimus: increased risk of nephrotoxicity
ADMINISTRATION
Reconstition
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Route
IM, IP, IV bolus or infusion
Rate of Administration
IV bolus: Administer over 3–5 minutes
IV infusion
: Administer over 0.5–2 hours
Comments
Add to 50–200 mL of sterile water for injection, sodium chloride 0.9%, glucose 5% or 10%IM and IV dose are identical. Calculate on mg/kg lean body weight, or actual weight, whichever is lower
OTHER INFORMATION
Netilmicin serum concentrations should be monitored and used for basis of dosage adjustment, otherwise follow guidelines in the SPC according to serum creatinine/creatinine clearanceOnce-daily administration of netilmicin may lead to transient peak concentrations of 20–30 micrograms/mL. Other dosage regimens will result in peak levels not exceeding 12 micrograms/mL. Prolonged levels above 16 micrograms/mL should be avoided. If trough levels are monitored they will usually be 3 micrograms/mL or less with the recommended dosage. Increasing trough concentrations above 4 micrograms/mL should be avoided.
