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"   What is it used for?  Sterilising the gut before surgery on the bowel. Preventing impairment of brain function (hepatic encephalopathy and hepatic coma) in severe liver disease such as cirrhosis or liver failure.    How does it work? Nivemycin tablets contain the active ingredient neomycin, which is a type of medicine called an aminoglycoside antibiotic. Neomycin is also available without a brand name, ie as the generic medicine. Neomycin is very poorly absorbed into the bloodstream after being taken by mouth. The tablets act locally in the gut. They are given before surgery on the gut to kill the bacteria in the gut that could potentially cause infection.  Neomycin tablets are also used in liver failure to kill the bacteria in the gut that produce ammonia. The liver normally breaks down ammonia, but in liver failure the blood may bypass the liver, allowing this poisonous substance to pass to the brain. Here it can impair brain function, causing confusion, drowsiness and finally coma. By killing the bacteria that produce ammonia, neomycin can help prevent this complication of liver failure. Neomycin works by affecting the bacteria&amp;#039;s production of certain proteins that are necessary for their survival. It causes the bacteria to produce abnormal and faulty proteins. This ultimately kills the bacteria.    How do I take it?  The dose prescribed depends on what the medicine is being used for, your age and your kidney function. Follow the instructions given by your doctor regarding how many tablets to take, how often and for how long. These will also be printed on the dispensing label that your pharmacist has put on the packet of medicine. If you are unsure about anything, ask for advice from your pharmacist or doctor. Neomycin tablets can be taken either with or without food. They should be swallowed with a drink of water. If you forget to take a dose, take it as soon as you remember then carry on as before. However, if you are more than two hours late taking a dose, leave out the missed dose and just take the next dose when it is due. Do not take a double dose to make up for a missed dose.    Warning!  This type of medicine can cause side effects on the kidneys and ears, particularly if used in high doses or for prolonged periods of time. For this reason, your kidney function and hearing should be monitored during treatment.  You should let your doctor know if you experience any hearing loss, sensation of ringing or other noise (tinnitus) in the ears, dizziness or unsteadiness at any point during treatment.     Use with caution in  Children. Elderly people. People with decreased kidney function. People with decreased liver function. People with hearing problems.  Obesity.  Cystic fibrosis. People with low blood pressure (hypotension). People with low fluid volume in the body, eg due to diuretic therapy, diarrhoea, vomiting or dehydration. Neuromuscular disorders, for example Parkinson&amp;#039;s disease.    Not to be used in  Infants under one year of age. People who are allergic to aminoglycoside antibiotics, eg gentamicin, tobramycin. People with a blockage in the gut (intestinal obstruction). A condition called myasthenia gravis, in which there is abnormal muscle weakness.  This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.   Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.  Small amounts of this medicine are absorbed into the bloodstream from the gut and so could be passed to a developing baby via the placenta. As a result, this medicine is not recommended for use during pregnancy unless the potential benefits to the mother outweigh any possible risks to the developing baby. Seek further medical advice from your doctor. This medicine may pass into breast milk. The manufacturer recommends that it is not used to treat women who are breastfeeding, unless the potential benefits to the mother outweigh any possible risks to the nursing baby. Seek further medical advice from your doctor.    Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.  Nausea and vomiting. Diarrhoea. Increased salivation. Sore mouth. Damage to hearing.  Damage to vestibular function within the ear. Symptoms include giddiness or dizziness, spinning sensation, unsteadiness, or loss of balance.  Damage to kidney function. Problems with liver function.  Disturbances in the normal numbers of blood cells in the blood. Skin reactions such as rash or itching. Confusion. Pins and needles sensations. Twitching of the eyeball (nystagmus).  If used for prolonged treatment, impaired absorption of food and nutrients from the intestines, leading to fatty stools and diarrhoea.  The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.   How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before using any new medicines while taking this one, to make sure that the combination is safe.  This medicine may reduce the absorption of the following medicines from the gut:  digoxin methotrexate penicillin V  vitamin A (retinol).  This medicine may enhance the blood sugar lowering effect of acarbose, a medicine used to treat type 2 diabetes. It may also increase the digestive side effects associated with this medicine, such as wind, stomach cramps and diarrhoea. This medicine may oppose the effects of neostigmine and pyridostigmine used to treat a condition called myasthenia gravis. There may be an increased risk of side effects on the ear (such as hearing or balance problems) if neomycin is used in combination with the following medicines:   capreomycin cisplatin loop diuretics such as furosemide and etacrynic acid  teicoplanin  vancomycin.   There may be an increased risk of side effects on the kidneys if neomycin is used in combination with the following medicines:   amphotericin capreomycin cephalosporin antibiotics, eg cephaloridine  ciclosporin cisplatin colistimethate other aminoglycoside antibiotics, eg gentamicin  polymixin tacrolimus  teicoplanin   vancomycin.   There may be an increased risk of side effects if this medicine is used in combination with botulinum toxin. There may be an increased chance of the level of calcium in the blood dropping too low (hypocalcaemia) if this medicine is used in combination with bisphosphonates, eg alendronate. This medicine may alter the anti-blood-clotting effect of anticoagulant medicines such as warfarin. Your blood clotting time (INR) may need to be monitored more frequently if you are taking these medicines together. Oral typhoid vaccine (Vivotif) should not be taken until at least three days after you have finished a course of this antibiotic, because the antibiotic could make this vaccine less effective.  In the past, women using hormonal contraception such as the pill or patch would be advised to use an extra method of contraception (eg condoms) while taking an antibiotic like this one and for seven days after finishing the course. However, this advice has now changed. You no longer need to use an extra method of contraception with the pill, patch or vaginal ring while you take a course of antibiotics. This change in advice comes because to date there is no evidence to prove that antibiotics (other than rifampicin or rifabutin) affect these contraceptives. This is the latest guidance from the Faculty of Sexual &amp;amp;amp; Reproductive Healthcare.  However, if you are taking the contraceptive pill and experience vomiting or diarrhoea as a result of taking this antibiotic, you should follow the instructions for vomiting and diarrhoea described in the leaflet provided with your pills.    Other medicines containing the same active ingredient   Neomycin cream.  Neomycin tablets are also available without a brand name, ie as the generic medicine. Last updated 16.06.2013 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/infections/a7223/nivemycin-neomycin/>