Morupar

Uses

Prophylaxis (immnnisatinn) agamst measles

Active immunisation against mumps

Neomycin is an aminoglycoside antibiotic agent used orally and topically to treat a wide variety of infections in the body.

Oral neomycin sulfate is indicated as an adjunctive therapy in hepatic coma (portal-system encephalopathy) by reducing ammonia-forming bacteria in the intestinal tract. It is strongly recommended that oral neomycin is only used in infections that are proven or strongly suspected to be caused by susceptible bacteria to reduce the risk of the development of drug-resistant bacteria.

Neomycin, in combination with polymyxin B sulfates and hydrocortisone in otic suspensions, is used in the treatment of superficial bacterial infections of the external auditory canal caused by organisms susceptible to the antibiotics. This otic formulation is also used in the treatment of infections of mastoidectomy and fenestration cavities caused by organisms susceptible to the antibiotics.

The ophthalmic solution containing neomycin in combination with polymyxin B sulfates and dexamethasone is used to treat steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial infection exists.

Morupar is also used to associated treatment for these conditions: Acne pustular, Allergic Contact Dermatitis, Allergy Skin, Atopic Dermatitis (AD), Atopic Dermatitis (AD) of the external ear canal, Bacterial diarrhoea, Burns, Carbuncle, Cradle Cap, Dermatitis, Dermatitis, Contact, Dermatitis, Eczematous, Diarrhoea, Discoid Lupus Erythematosus (DLE), Ear infection bacterial, Ear infection bacterial caused by susceptible bacteria, Gastrointestinal Infections, Hepatic coma, Hidradenitis Suppurativa (HS), Hot Water Burns (Scalds), Impetigo, Impetigo contagious, Infantile Eczema, Infected Wounds, Infected skin ulcer, Infection of the outer ear caused by susceptible bacteria, Infectious diarrhea, Inflammatory Reaction caused by Acne, Intertrigo, Itching caused by Infection, Lichen Planus (LP), Localized Infection caused by susceptible bacteria, Nail infection, Neurodermatitis, Otitis Externa, Postoperative Wound Infection, Psoriasis Vulgaris (Plaque Psoriasis), Pustular Dermatosis, Radiodermatitis, Secondarily Infected Eczema, Secondary Bacterial Infection, Skin Burns, Skin Infections, Skin Infections, Bacterial, Skin Irritation, Skin Ulcer, Solar erythema, Abrasions, Blistering caused by Staphylococcus, Erythematous eruptions, Intertriginous erythema of the anogenital, Ocular bacterial infections caused by susceptible bacteria, Resistant to other corticosteroids Dermatosis, Susceptible Bacterial Infections

How Morupar works

Like other aminoglycoside antibiotic drugs, neomycin inhibits bacterial ribosomes by binding to the 30S ribosomal subunit of susceptible bacteria and disrupting the translational machinery of bacterial protein synthesis. Bacterial translation is normally initiated by the mRNA binding to the 30S ribosomal subunit and subsequent binding with 50S subunit for elongation.

Dosage

Morupar dosage

Adult: 0.5 ml by IM or SC injection

Child: Under 1 year, not recommended; others same as adult.

Active immunisation against mumps-

• Adult:0.5 mL as a single dose via SC admin, preferably into the outer aspect of the upper arm.
• Child:Given as a combination with measles and rubella vaccines: ≥12 mth: 2 doses of 0.5 ml via IM admin (SC admin if there is bleeding disorder). 1st dose is usually given after 1st birthday (recommended age: 12-15 mth) and 2nd dose at 3-5 yr or prior to school entry. Doses should be separated by at least 4 wk. May be given at any age if routine admin has been omitted. Immunisation dose given before 12 mth of age may not be effective long term and patients should be revaccinated with the 2 dose schedule.

Side Effects

Fever, parotits.

Skin rashes, pharyngitis, fever, and lymphadenopathy; arthralgia and arthritis may occur.

Toxicity

The oral LD₅₀ of neomycin sulfate in mouse is > 8 g/kg. The subcutaneous LD₅₀ is 200 mg/kg in rat and 190 mg/kg in mouse. The intraperitoneal LD₅₀ in mouse is 305 mg/kg. The oral Lowest published toxic dose (TDLo) in woman is 12600 mg/kg/7D.

Because of low absorption, acute overdosage from oral neomycin is not likely to occur. However, prolonged administration of neomycin should be avoided because of the possibility of some systemic absorption and the risk of neurotoxicity, ototoxicity, and/or nephrotoxicity. Hemodialysis will remove neomycin from the blood. While nephrotoxicity and ototoxicity have been reported in otherwise patients without compromised renal function, the risk for developing these toxicities is increased in patients with renal impairment. Like other aminoglycosides, neomycin may cause fetal harm and total irreversible bilateral congenital deafness when administered in pregnant women.

Precaution

Children with history of convulsions. parental history of epilepsy. Avoid administration within 3 weeks of other live vaccines or 12 weeks of transfusions or immunoglobulin injection.

Women of child-bearing age should be vaccinated if they are seronegative; those who are found to be seronegative during pregnancy should be vaccinated in the early postpartum period. Not advisable to become pregnant within 1 mth of vaccination. Not recommended for children <1 yr. Allow alcohol or disinfectant that is used for skin cleansing to evaporate before vaccination to prevent inactivation of live vaccines. Bleeding disorders (use SC route).

Interaction

Not to be given within 1 mth of admin of other live vaccines. Live vaccines should only be given at least 3 wk before or 3 mth after the use of immunoglobulin. Avoid admin during immunosuppressant or high dose systemic corticosteroid therapy.

Volume of Distribution

The small fraction of absorbed neomycin is rapidly distributed in the tissues. The amount of systemically absorbed neomycin is reported to increase cumulatively with each repeated dose administered until a steady state is reached.

Elimination Route

Neomycin is poorly absorbed from the gastrointestinal tract. Gastrointestinal absorption of the drug may be increased if inflammatory or ulcerative gastrointestinal disease is present.

Half Life

There is limited information on the half-life of neomycin.

Clearance

There is limited information on the clearance rate of neomycin.

Elimination Route

The small absorbed fraction of neomycin is excreted by the kidney. The unabsorbed portion of the drug is excreted unchanged in the feces.

Pregnancy & Breastfeeding use

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Contraindication

Pregnancy; infection (overt or incubating), malignant disease, active tuberculosis; allergy to hens eggs; hypog-ammaglobulinaexma; treatment with corti-costeroids; cytotoxic drugs, irradiation

Pregnancy. Hypersensitivity. Severe primary immunodeficiency; current treatment with chemotherapy or radiotherapy and within 6 mth of stopping such therapy; solid organ transplant patients receiving immunosuppressants, bone marrow transplant and for at least 12 mth after stopping immunosuppressive therapy, patients on high-dose systemic corticosteroids, HIV patients with immunosuppression.

Storage Condition

Store at 2-8° C. After reconstitution, discard if not used within 8 hr.

Innovators Monograph

You find simplified version here Morupar