Before Receiving This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For aminoglycosides, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to any of the aminoglycosides. Also tell your health care professional if you are allergic to any other substances, such as foods, sulfites, or other preservatives.

Pregnancy—Studies on most of the aminoglycosides have not been done in pregnant women. Some reports have shown that aminoglycosides, especially streptomycin and tobramycin, may cause damage to the infant's hearing, sense of balance, and kidneys if the mother was receiving the medicine during pregnancy. However, this medicine may be needed in serious diseases or other situations that threaten the mother's life. Be sure you have discussed this with your doctor.

Breast-feeding—Aminoglycosides pass into breast milk in small amounts. However, they are not absorbed very much when taken by mouth. To date, aminoglycosides have not been reported to cause problems in nursing babies.

Children—Children are especially sensitive to the effects of aminoglycosides. Damage to hearing, sense of balance, and kidneys is more likely to occur in premature infants and neonates.

Older adults—Elderly people are especially sensitive to the effects of aminoglycosides. Serious side effects, such as damage to hearing, sense of balance, and kidneys may occur in elderly patients.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving aminoglycosides it is especially important that your health care professional knows if you are taking any of the following:

• Aminoglycosides, used on the skin or mucous membranes and by injection at the same time; or more than one aminoglycoside at a time or
• Anti-infectives by mouth or by injection (medicine for infection) or
• Capreomycin (e.g., Capastat) or
• Carmustine (e.g., BiCNU) or
• Chloroquine (e.g., Aralen) or
• Cisplatin (e.g., Platinol) or
• Combination pain medicine containing acetaminophen and aspirin (e.g., Excedrin) or other salicylates (with large amounts taken regularly) or
• Cyclosporine (e.g., Sandimmune) or
• Deferoxamine (e.g., Desferal) (with long-term use) or
• Gold salts (medicine for arthritis) or
• Hydroxychloroquine (e.g., Plaquenil) or
• Inflammation or pain medicine, except narcotics, or
• Lithium (e.g., Lithane) or
• Methotrexate (e.g., Mexate) or
• Penicillamine (e.g., Cuprimine) or
• Plicamycin (e.g., Mithracin) or
• Quinine (e.g., Quinamm) or
• Streptozocin (e.g., Zanosar) or
• Tiopronin (e.g., Thiola)—Use of any of these medicines with aminoglycosides may increase the chance of hearing, balance, or kidney side effects.

Other medical problems—The presence of other medical problems may affect the use of the aminoglycosides. Make sure you tell your doctor if you have any other medical problems, especially:

• Kidney disease—Patients with kidney disease may have increased aminoglycoside blood levels and increased chance of side effects

• Loss of hearing and/or balance (eighth-cranial-nerve disease)—High aminoglycoside blood levels may cause hearing loss or balance disturbances

• Myasthenia gravis or
• Parkinson's disease—Aminoglycosides may cause muscular problems, resulting in further muscle weakness