Last update: Nov. 4, 2018

Paromomycin Sulfate

Very Low Risk for breastfeeding


Compatible.
Not risky for breastfeeding or infant.

An antibacterial aminoglycoside used orally in the treatment of intestinal infestations by protozoa (giardia, amoeba and cryptosporidiosis) and by tapeworms. It is also administered orally to suppress intestinal flora prior to surgical interventions and encephalopathy and hepatic coma.
It is used topically in cutaneous leishmaniasis (Garnier 2002) and intramuscularly in visceral leishmaniasis (Musa 2010).

Since the last update we have not found published data on its excretion in breastmilk.

Its practically zero oral bioavailability (Kip 2018, Bissuel 1994) and cutaneous bioavailability (Ravis 2013) impede transfer to the mother’s plasma and therefore it is unlikely that it will be excreted in breastmilk in amounts that could be significant.
Still injected intramuscularly, its lack of lipid solubility (Kit 2018) and short half-life would greatly hinder excretion in breastmilk.

This same low oral bioavailability hinders transfer to infant plasma from breastmilk, except in premature babies and the immediate neonatal period when there may be increased intestinal permeability.

The possible negativity of cultures in febrile infants whose mothers take antibiotics should be taken into account, as well as the possibility of gastroenteritis due to alteration of the intestinal flora (Ito 1993).

Alternatives

We do not have alternatives for Paromomycin Sulfate since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Tradenames

Main tradenames from several countries containing Paromomycin Sulfate in its composition:

Pharmacokinetics

Variable Value Unit
Bioavailability < 1 %
Molecular weight 616 daltons
Protein Binding 33 %
VD 0,22 l/Kg
pKa 9,94 -
T1/2 2,62 hours

References

  1. Kip AE, Schellens JHM, Beijnen JH, Dorlo TPC. Clinical Pharmacokinetics of Systemically Administered Antileishmanial Drugs. Clin Pharmacokinet. 2018 Abstract Full text (link to original source) Full text (in our servers)
  2. Ravis WR, Llanos-Cuentas A, Sosa N, Kreishman-Deitrick M, Kopydlowski KM, Nielsen C, Smith KS, Smith PL, Ransom JH, Lin YJ, Grogl M. Pharmacokinetics and absorption of paromomycin and gentamicin from topical creams used to treat cutaneous leishmaniasis. Antimicrob Agents Chemother. 2013 Abstract
  3. Musa AM, Younis B, Fadlalla A, Royce C, Balasegaram M, Wasunna M, Hailu A, Edwards T, Omollo R, Mudawi M, Kokwaro G, El-Hassan A, Khalil E. Paromomycin for the treatment of visceral leishmaniasis in Sudan: a randomized, open-label, dose-finding study. PLoS Negl Trop Dis. 2010 Abstract
  4. Garnier T, Croft SL. Topical treatment for cutaneous leishmaniasis. Curr Opin Investig Drugs. 2002 Abstract
  5. Bissuel F, Cotte L, de Montclos M, Rabodonirina M, Trepo C. Absence of systemic absorption of oral paromomycin during long-term, high-dose treatment for cryptosporidiosis in AIDS. J Infect Dis. 1994 Abstract
  6. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract

Total visits

2,351

Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write to us at elactancia.org@gmail.com

e-lactancia is a resource recommended by Academy of Breastfeeding Medicine from United States of America

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM