Product Monograph - Humatin
ACTION AND CLINICAL PHARMACOLOGY
HUMATIN* (Paromomycin Sulfate) is a broad spectrum aminoglycoside antibiotic produced by Streptomyces rimosus var. paromomycinus. The drug is structurally related to neomycin, streptomycin and kanamycin.
It is poorly absorbed after oral administration with almost 100% of the drug recoverable in the stool.
Paromomycin sulfate is considered a luminal or contact amebicide since it acts principally in the intestinal lumen.
Unlike tetracyclines, paromomycin is a direct-acting amebicide and is effective either in the presence or absence of bacteria.
Like other aminoglycosides, paromomycin is bactericidal and appears to inhibit protein synthesis in susceptible bacteria at the 30S segment of the ribosome.
Paromomycin sulfate has a broad spectrum of activity, including activity against protozoa, bacteria and cestodes.
Paromomycin sulfate is active against protozoa, especially E. histolytica. The drug is believed to act against both the trophozoite and encysted forms of Entamoeba.
Paromomycin sulfate has an antibacterial spectrum quite similar to that of neomycin and is bactericidal to many normal and pathogenic organisms in the gastrointestinal tract. Almost complete cross-resistance exists between paromomycin and kanamycin, neomycin and streptomycin.
INDICATIONS AND USAGE
HUMATIN* (Paromomycin Sulfate) is indicated for the treatment of intestinal amebiasis, acute and chronic.
(NOTE--It is not effective in extraintestinal amebiasis).
To reduce the development of drug-resistant microorganisms and maintain the effectiveness of HUMATIN* and other antimicrobial drugs, HUMATIN* should be used only to treat infections that are proven or strongly suspected to be caused by susceptible microorganisms. When culture and susceptibility information are available, they should be considered in selecting or modifying antimicrobial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
CONTRAINDICATIONS
Individuals with a history of previous hypersensitivity reactions to HUMATIN* (Paromomycin Sulfate). It is also contraindicated in intestinal obstruction.
PRECAUTIONS
Susceptibility/Resistance
Development of Drug Resistant Organisms
Prescribing HUMATIN* in the absence of a proven or strongly suspected microbial infection is unlikely to provide benefit to the patient and risks the development of resistant organisms.
The use of HUMATIN* (Paromomycin Sulfate), as with other antibiotics, may result in an overgrowth of nonsusceptible organisms, including fungi. Constant observation of the patient is essential. If new infections caused by nonsusceptible organisms appear during therapy, appropriate measures should be taken.
The drug should be used with caution in individuals with ulcerative lesions of the bowel to avoid renal toxicity through inadvertent absorption.
ADVERSE REACTIONS
Nausea, abdominal cramps and diarrhea have been reported in patients using HUMATIN* (Paromomycin Sulfate), on doses over 3 g daily.
DOSAGE AND ADMINISTRATION
Adults and Children: Usual dose of HUMATIN* (Paromomycin Sulfate) is 25 to 35 mg/kg body weight daily, administered in 3 doses with meals, for 5 to 10 days.
Capsule Composition
Each HUMATIN* (Paromomycin Sulfate) capsule contains: paromomycin sulfate equivalent to paromomycin 250 mg. Non-medicinal ingredients: Each capsule contains: colloidal silica, magnesium stearate. Capsule shell: yellow iron oxide, black iron oxide, red iron oxide, gelatin and titanium dioxide.
Stability and Storage Recommendations
Store HUMATIN* (Paromomycin Sulfate) at controlled room temperature 15 - 30°C. Protect from moisture.
AVAILABILITY OF DOSAGE FORMS
HUMATIN* (Paromomycin Sulfate) capsules are available in the dosage strength of 250 mg per capsule.
Each capsule has a coni-snap No1 brown cap and a yellow body with no print.
Available in bottles of 100.
PHARMACEUTICAL INFORMATION
Drug Substance
Proper Name: Paromomycin Sulfate
Chemical Name: O-2-amino-2-deoxy-α-D-glucopyranosyl-(1→4)-O-[O-2,6-diamino-2,6-dideoxy-β-L-idopyranosyl-(1→3)-β-D-ribofuranosyl-(1→5)]-2-deoxy-D-streptamine sulfate(salt).
Empirical Formula: C23H45N5O14 .xH2SO4
Molecular Weight: 615.64 (Base)
Structural Formula: 
Description: It is a white, amorphous, stable water-soluble product. Paromomycin
Sulfate is the sulfate salt of an antibiotic substance or substances produced by the growth of Streptomyces rimosus var. paromomycinus, or a mixture of two or more such salts. It has a potency equivalent to not less than 675 μg of paromomycin (C23H45N5O14) per mg, calculated on the dried basis.