Dosing
CrCl > 80:
Hepatic coma: 2-4 g/day po every 4-6 hr for 5-6 days, maximum 12 g/day; do not use longer than 2 weeks.
Pre-operative bowel preparation: 1 g po q hour for 4 hours, then 1 g every 4 hr for the remaining 24 hr, or 1 g po 19, 18, and 9 hrs prior to surgery with oral erythromycin.
CrCl 80-50:
CrCl 50-10:
CrCl < 10:
Hemodialysis:
Peritoneal dialysis:
Important side effects
Diarrhea, nausea, vomiting, nephrotoxicity, neuromuscular blockade, respiratory paralysis (concomitant anesthesia, muscle relaxants), ototoxicity.
Even when used for irrigation there can be toxic blood levels.
Important drug interactions
Anisindione, bumetanide, cidofovir, cyclosporine, dicumarol, digoxin, furosemide, methotrexate, nondepolarizing neuromuscular blockers, phenprocoumon, tacrolimus, warfarin.
Rants and Screeds
Pearls
Treatment of choice
Use for
Preoperative bowel decontamination, hepatic encephalopathy.
Don't use for
Class
Aminoglycoside.
Curious Cases
Relevant links to my Medscape blog
Last update 11/29/19