Neo-Rx and GI inflammation

• Generic Name: neomycin
• Dosage Forms: n.a.
• Other Brand Names: Neo-Fradin, Neo-Tab, Mycifradin

Management of hepatic encephalopathy. Used to inhibit ammonia-forming bacteria in the GI tract in patients with hepatic (portal-systemic) encephalopathy as an adjunct to protein restriction and supportive therapy. Subsequent reduction in blood ammonia may result in neurologic improvement.

Although efficacy of such adjunctive treatment is not clearly established, it has been suggested that nonabsorbable disaccharides (lactulose) are first-line treatment to reduce blood ammonia in adults with acute hepatic encephalopathy and anti-infectives (e.g., oral neomycin or metronidazole) are alternatives.

Adjunct to mechanical cleansing of the large intestines for preoperative prophylaxis in patients undergoing colorectal surgery. Used in conjunction with oral erythromycin or oral metronidazole and with an appropriate diet and catharsis.

Preferred regimens for patients undergoing colorectal surgery are IV cefoxitin or IV cefotetan alone; IV cefazolin and IV metronidazole; oral erythromycin and oral neomycin; or oral metronidazole and oral neomycin.

Treatment of hypercholesterolemia. Therapeutic value may be due in part to reduction in GI absorption of cholesterol, resulting in enhanced elimination of cholesterol as neutral sterols in the feces.

Not a first- or second-line agent; use only after all conventional treatments have been tried.

Not recommended for treatment of any GI infections.