Dosage of Neocenta in details
To minimize the risk of toxicity, use the lowest possible dose and the shortest possible treatment period to control the condition. Treatment for periods longer than two weeks is not recommended.
Hepatic Coma
For use as an adjunct in the management of hepatic coma, the recommended dose is 4-12 grams per day given in the following regimen:
1. Withdraw protein from diet. Avoid use of diuretic agents.
2. Give supportive therapy, including blood products, as indicated.
3. Give Neocenta Tablets in doses of 4-12 grams of Neocenta per day (eight to 24 tablets) in divided doses. Treatment should be continued over a period of five to six days, during which time protein should be returned incrementally to the diet.
4. If less potentially toxic drugs cannot be used for chronic hepatic insufficiency, neomycin in doses of up to four grams daily (eight tablets per day) may be necessary. The risk for the development of neomycin-induced toxicity progressively increases when treatment must be extended to preserve the life of a patient with hepatic encephalopathy who has failed to fully respond. Frequent periodic monitoring of these patients to ascertain the presence of drug toxicity is mandatory. Also, neomycin serum concentrations should be monitored to avoid potentially toxic levels. The benefits to the patient should be weighed against the risks of nephrotoxicity, permanent ototoxicity and neuromuscular blockade following the accumulation of neomycin in the tissues.
Preoperative Prophylaxis for Elective Colorectal Surgery
Listed below is an example of a recommended bowel preparation regimen. A proposed surgery time of 8:00 am. has been used.
Pre-op Day 3: Minimum residue or clear liquid diet. Bisacodyl, 1 tablet orally at 6:00 p. m.
Pre-op Day 2: Minimum residue or clear liquid diet. Magnesium sulfate, 30 mL, 50% solution (15 g) orally at 10:00 a.m., 2:00 p.m., and 6:00 p.m. Enema at 7:00 p.m. and 8:00 p.m.
Pre-op Day 1: Clear liquid diet. Supplemental (IV) fluids as needed. Magnesium sulfate, 30 mL, 50% solution (15 g) orally at 10:00 a. m., and 2:00 p.m. Neocenta (1 g) and erythromycin base (1 g) orally at 1:00 p. m., 2:00 p.m. and 11:00 p.m. No enema.
Day of Operation: Patient evacuates rectum at 6:30 a.m. for scheduled operation at 8:00 a.m.
How supplied
Neocenta Tablets, USP, 500 mg (equivalent to 350 mg of neomycin base per tablet) are available as round, off-white, unscored tablets, imprinted "BL" and "18", in bottles of 100 tablets.
Store at controlled room temperature 15°-30° C( 59°-86° F). Dispense in tight containers as defined in the USP/NF.
CAUTION: Federal law prohibits dispensing without prescription.
What other drugs will affect Neocenta?
Neomycin can harm your kidneys, and this effect is increased when you also use certain other medicines harmful to the kidneys. Before using neomycin, tell your doctor about all other medicines you use. Many other drugs (including some over-the-counter medicines) can be harmful to the kidneys.
Before you take neomycin, tell your doctor if you are using any other antibiotics, such as
- amikacin (Amikin)
- amphotericin-B (Amphotec);
- bacitracin (Baci IM);
- colistimethate (Coly Mycin M);
- gentamicin (Garamycin);
- kanamycin (Kantrex);
- paromomycin (Humatin, Paromycin);
- polymyxin B sulfate;
- penicillin V (PC Pen VK);
- streptomycin;
- tobramycin (Nebcin, Tobi); or
- vancomycin (Vancocin, Vancoled).
Tell your doctor about all other medicines you use, especially:
- cisplatin (Platinol);
- digoxin (digitalis, Lanoxin, Lanoxicaps);
- methotrexate (Rheumatrex, Trexall);
- vitamin B-12;
- antiviral medicines such as adefovir (Hepsera), cidofovir (Vistide), or tenofovir (Viread);
- a blood thinner such as warfarin (Coumadin, Jantoven);
- a botulism toxin medication (Botox, Dysport, Myobloc, Xeomin, and others); or
- a diuretic (water pill) such as bumetanide (Bumex), ethacrynic acid (Edecrin), furosemide (Lasix), or torsemide (Demadex).
This list is not complete and other drugs may interact with neomycin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Neocenta interactions
Caution should be taken in concurrent or serial use of other neurotoxic and/ or nephrotoxic drugs because of possible enhancement of the nephrotoxicity and/or ototoxicity of neomycin.
Caution should also be taken in concurrent or serial use of other aminoglycosides and polymyxins because they may enhance neomycin's nephrotoxicity and/or ototoxicity and potentiate Neocenta's neuromuscular blocking effects.
Oral neomycin inhibits the gastrointestinal absorption of penicillin V, oral vitamin B-12, methotrexate and 5-fluorouracil. The gastrointestinal absorption of digoxin also appears to be inhibited. Therefore, digoxin serum levels should be monitored.
Oral Neocenta may enhance the effect of coumarin in anticoagulants by decreasing vitamin K availability.
References
- DailyMed. "HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- FDA/SPL Indexing Data. "4BOC774388: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
- MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Neocenta are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Neocenta. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported frequency of use
No survey data has been collected yetConsumer reported doses
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Information checked by Dr. Sachin Kumar, MD Pharmacology
