Indications & Dose: HEPATIC ENCEPHALOPATHY PO Adult 0.5-2g q6-8h or 4-12 g/day divided q4-6h 5-6 days Child 50-100mg/kg/day in divided doses q6-8h or 2.5-7 g/m2/day divided q4-6h 5-6days, max 12g/day | HEPATIC INSUFFICIENCY Chronic PO Adult 4g/day for indefinite period | OPHTHALMIC INFECT Combination therapy TP Adult Ointment: A small amount is placed into the conjunctival sac 1 or more times daily q3-4h, Solution/suspension: Instill 1 or 2 drops onto the affected eye q3-4h or more frequently as required with various drugs | OTITIS EXTERNA Combination therapy TP Adult Solution/suspension: Instill into the external ear TID/QID 10 days with other anti-infectives & corticosteroids | PREOPERATIVE INTESTINAL ANTISEPSIS PO Adult 1g/h for 4 doses then 1g q4h for 5 doses or 6g/day divided q4h 2-3 days | SUPERFICIAL BACTERIAL INFECT Combination therapy TP Adult Ointment: Apply sparingly to affected areas 3 times daily with 250IU bacitracin Child > 2yr: Same as adult dose

Precautions: Renal impairment, hearing impairment, neuromuscular disorders, obese patients, children, elderly, avoid prolonged local use

ADR: Serious: Neuromuscular blockade, nephrotoxicity, ototoxicity, malabsorption syndrome, Others: nausea, vomiting, diarrhea, superinfect

DDI: Serious Iron compounds absorption alters by drug, Vit A absorption is markedly reduced, Neuromuscular blockers causes fatal respiratory depression, Acarbose efficacy and GI adverse effects are increased, Digoxin levels can be reduced by drug, Penicillin V levels reduced

Monitor: Renal function tests, audiometry in symptomatic patients