streptomycin (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 1g

Moderate-Severe Infections

1-2 g/day IM divided q6-12hr; no more than 2 g/day

Tuberculosis

Daily therapy: 15 mg/kg IM qDay; no more than 1 g/day  

Twice weekly therapy: 25-30 mg/kg IM 2 times/week; no more than 1.5 g/day

Tularemia

1-2 g IM in divided doses for 7-10 days or until patient is afebrile for 5-7 days

Plague

15 mg/kg IM q12hr for minimum 10 days  

Streptococcal Endocarditis

1 g IM q12hr for 7 days, THEN 500 mg q12hr for 7 days, concomitant with penicillin

If >60 years old, 500 mg q12hr for entire 14 days

Enterococcal Endocarditis

1 g IM q12hr for 2 weeks, THEN 500 mg q12hr for 4 weeks, concomitant with penicillin

Brucellosis

1 g IM qDay/BID for 1 week, THEN qDay for 1 week in conjunction with doxycycline or tetracycline

Renal Impairment

Load: 1 g IM, THEN

CrCl: 50-80 mL/min: 7.5 mg/kg IM q24hr

CrCl: 10-50 mL/min: 7.5 mg/kg IM q24-72hr

CrCl <10 mL/min: 7.5 mg/kg IM q72-96hr

Hemodialysis: 50-75% of initial loading dose at end of dialysis period

Dosage Forms & Strengths

powder for injection

  • 1g

injectable solution

  • 400mg/mL

Moderate to Severe Infections

20-40 mg/kg/day IM divided q6-12 hr  

Tuberculosis

Daily therapy: 20-40 mg/kg IM qDay; no more than 1 g/day  

Twice wekly therapy: 20-40 mg/kg IM 2 times/week; no more than 1.5 g/day

Plague

15 mg/kg IM q12hr for minimum 10 days; no more than 2 g/day  

Brucellosis

>8 years old: 20 mg/kg IM divided q12hr during 7-14 days of tetracycline or co-trimoxazole therapy; no more than 1 g/day  

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Interactions

Interaction Checker

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              Serious - Use Alternative (18)

              • atracurium

                streptomycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • bacitracin

                streptomycin and bacitracin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Avoid concurrent use of bacitracin with other nephrotoxic drugs

              • BCG vaccine live

                streptomycin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated.

              • bumetanide

                bumetanide, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • cholera vaccine

                streptomycin, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

              • cisatracurium

                streptomycin increases effects of cisatracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • ethacrynic acid

                ethacrynic acid, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • furosemide

                furosemide, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • incobotulinumtoxinA

                streptomycin increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • onabotulinumtoxinA

                streptomycin increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • pancuronium

                streptomycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • quinidine

                quinidine will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

              • rapacuronium

                streptomycin increases effects of rapacuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • rocuronium

                streptomycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • succinylcholine

                streptomycin increases effects of succinylcholine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              • torsemide

                torsemide, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • typhoid vaccine live

                streptomycin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated.

              • vecuronium

                streptomycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

              Monitor Closely (63)

              • abobotulinumtoxinA

                streptomycin increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Aminoglycosides may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

              • amikacin

                amikacin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • amiodarone

                amiodarone will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • amphotericin B deoxycholate

                amphotericin B deoxycholate and streptomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

              • bazedoxifene/conjugated estrogens

                streptomycin will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • carboplatin

                carboplatin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • cidofovir

                cidofovir and streptomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

              • cisplatin

                cisplatin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • clarithromycin

                clarithromycin will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • clotrimazole

                clotrimazole will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • conjugated estrogens

                streptomycin will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • contrast media (iodinated)

                contrast media (iodinated) and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • cyclosporine

                cyclosporine and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • deferasirox

                deferasirox, streptomycin. Other (see comment). Use Caution/Monitor. Comment: Acute renal failure has been reported during treatment with deferasirox. Coadministration of deferasirox with other potentially nephrotoxic drugs, including aminoglycosides, may increase the risk of this toxicity. Monitor serum creatinine and/or creatinine clearance in patients who are receiving deferasirox and nephrotoxic drugs concomitantly.

              • dienogest/estradiol valerate

                streptomycin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.

              • digoxin

                streptomycin will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

              • dronedarone

                dronedarone will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                streptomycin and elvitegravir/cobicistat/emtricitabine/tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • erythromycin base

                erythromycin base will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin lactobionate

                erythromycin lactobionate will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin stearate

                erythromycin stearate will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • estradiol

                streptomycin will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estrogens conjugated synthetic

                streptomycin will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estropipate

                streptomycin will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • felodipine

                felodipine will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • fosphenytoin

                fosphenytoin will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • indinavir

                indinavir will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ioversol

                ioversol and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • ketoconazole

                ketoconazole will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • loratadine

                loratadine will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • magnesium supplement

                magnesium supplement, streptomycin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Each enhance the neuromuscular blocking effect of the other; may have negative respiratory effects.

              • mestranol

                streptomycin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • nefazodone

                nefazodone will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • neomycin PO

                neomycin PO and streptomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

              • nicardipine

                nicardipine will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nifedipine

                nifedipine will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nilotinib

                nilotinib will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • oxaliplatin

                oxaliplatin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • peramivir

                streptomycin increases levels of peramivir by decreasing renal clearance. Use Caution/Monitor. Caution when peramivir coadministered with nephrotoxic drugs.

              • phenobarbital

                phenobarbital will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • phenytoin

                phenytoin will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • prabotulinumtoxinA

                streptomycin increases effects of prabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Aminoglycosides may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

              • quercetin

                quercetin will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • rifampin

                rifampin will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • rimabotulinumtoxinB

                streptomycin, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Aminoglycosides may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

              • ritonavir

                ritonavir will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • sirolimus

                sirolimus will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                streptomycin decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of streptomycin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of streptomycin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • St John's Wort

                St John's Wort will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • streptozocin

                streptomycin and streptozocin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • tacrolimus

                tacrolimus will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

                streptomycin and tacrolimus both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • teicoplanin

                streptomycin and teicoplanin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • tenofovir DF

                streptomycin and tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                streptomycin increases levels of tenofovir DF by decreasing elimination. Use Caution/Monitor.

              • tobramycin inhaled

                tobramycin inhaled and streptomycin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

              • tolvaptan

                tolvaptan will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • trazodone

                trazodone will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • trimagnesium citrate anhydrous

                streptomycin, trimagnesium citrate anhydrous. Either increases effects of the other by Other (see comment). Use Caution/Monitor. Comment: Coadministration of aminoglycosides with magnesium may increase risk of neuromuscular weakness and paralysis.

              • verapamil

                verapamil will increase the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • voclosporin

                voclosporin, streptomycin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

              • warfarin

                streptomycin increases effects of warfarin by unknown mechanism. Use Caution/Monitor.

              Minor (76)

              • aceclofenac

                aceclofenac increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • acemetacin

                acemetacin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • acyclovir

                acyclovir and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • adefovir

                adefovir and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • aspirin

                aspirin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • aspirin rectal

                aspirin rectal increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • aztreonam

                aztreonam, streptomycin. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Combination may be used synergistically against Pseudomonas spp. and Enterobacteriaceae.

              • balsalazide

                streptomycin will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • biotin

                streptomycin will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium acetate

                streptomycin decreases levels of calcium acetate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium carbonate

                streptomycin decreases levels of calcium carbonate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium chloride

                streptomycin decreases levels of calcium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium citrate

                streptomycin decreases levels of calcium citrate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • calcium gluconate

                streptomycin decreases levels of calcium gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • capreomycin

                capreomycin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • celecoxib

                celecoxib increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • cephaloridine

                cephaloridine and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • clotrimazole

                clotrimazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.

              • colistin

                colistin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • cordyceps

                cordyceps decreases toxicity of streptomycin by unspecified interaction mechanism. Minor/Significance Unknown.

              • cyanocobalamin

                streptomycin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • diclofenac

                diclofenac increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • diflunisal

                diflunisal increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • entecavir

                streptomycin, entecavir. Either increases effects of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.

              • etodolac

                etodolac increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • fenoprofen

                fenoprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • fluconazole

                fluconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.

              • flurbiprofen

                flurbiprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • foscarnet

                foscarnet and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • gentamicin

                gentamicin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • ibuprofen

                ibuprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • ibuprofen IV

                ibuprofen IV increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • indomethacin

                indomethacin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • ketoconazole

                ketoconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.

              • ketoprofen

                ketoprofen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • ketorolac

                ketorolac increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • ketorolac intranasal

                ketorolac intranasal increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • lornoxicam

                lornoxicam increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • magnesium chloride

                streptomycin decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.

              • magnesium citrate

                streptomycin decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.

              • magnesium hydroxide

                streptomycin decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • magnesium oxide

                streptomycin decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.

              • magnesium sulfate

                streptomycin decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.

              • meclizine

                meclizine, streptomycin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Ototoxicity of aminoglycoside may be masked.

              • meclofenamate

                meclofenamate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • mefenamic acid

                mefenamic acid increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • meloxicam

                meloxicam increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • methoxyflurane

                methoxyflurane and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • miconazole vaginal

                miconazole vaginal decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.

              • nabumetone

                nabumetone increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • naproxen

                naproxen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • oxaprozin

                oxaprozin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • pantothenic acid

                streptomycin will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • parecoxib

                parecoxib increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • paromomycin

                paromomycin and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • pentamidine

                pentamidine and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • piperacillin

                piperacillin increases effects of streptomycin by pharmacodynamic synergism. Minor/Significance Unknown.

              • piroxicam

                piroxicam increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • polymyxin B

                polymyxin B and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • posaconazole

                posaconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.

              • pyridoxine

                streptomycin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pyridoxine (Antidote)

                streptomycin will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • salicylates (non-asa)

                salicylates (non-asa) increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • salsalate

                salsalate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • sulfasalazine

                sulfasalazine increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • sulindac

                sulindac increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • thiamine

                streptomycin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • ticarcillin

                ticarcillin decreases effects of streptomycin by altering metabolism. Minor/Significance Unknown. Increased risk in renal impairment.

              • tobramycin

                streptomycin and tobramycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • tolfenamic acid

                tolfenamic acid increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • tolmetin

                tolmetin increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • vancomycin

                streptomycin and vancomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

              • voriconazole

                voriconazole decreases levels of streptomycin by unknown mechanism. Minor/Significance Unknown.

              • zoledronic acid

                streptomycin, zoledronic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypocalcemia.

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              Adverse Effects

              Frequency Not Defined

              Hypotension

              Neurotoxicity

              Drowsiness

              Headache

              Drug fever

              Paresthesia

              Skin rash

              Nausea

              Vomiting

              Eosinophilia

              Anemia

              Arthralgia

              Weakness

              Tremor

              Ototoxicity (auditory)

              Ototoxicity (vestibular)

              Nephrotoxicity

              Difficulty in breathing

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              Warnings

              Black Box Warnings

              May cause nephrotoxicity and neurotoxicity. Avoid concurrent use of nephrotoxic/neurotoxic drugs.

              May cause neuromuscular blockade and respiratory paralysis, especially when given after anesthesia or muscle relaxants. Use the parenteral form only where appropriate audiometric and laboratory testing facilities are available.

              Contraindications

              Hypersensitivity to streptomycin or other aminoglycosides; severe hypersensitivity to sulfites

              Concomitant live bacterial vaccines

              Cautions

              For tuberculosis, do not exceed 120 g total over course of Tx; discontinue in case of toxicity or organism resistance

              For endocarditis, discontinue in case of ototoxicity

              Reduce dosage in case of renal impairment: serum conc. should not exceed 20-25 mcg/mL

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              Pregnancy & Lactation

              Pregnancy Category: D

              Lactation: enters breast milk (AAP Committee states compatible w/ nursing)

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Absorption: IM: well absorbed; not absorbed from gut

              Distribution: to extracellular fluid including serum, abscesses, ascitic, pericardial, pleural, synovial, lymphatic, & peritoneal fluids; crosses placenta; small amounts enter breast milk

              Protein Bound: 34%

              Half-life elimination: newborns: 4-10 hr; adults: 2-4.7 hr, prolonged with renal impairment

              Peak Plasma Time: within 1 hr

              Excretion: urine (90% as unchanged drug); feces, saliva, sweat, & tears (<1%)

              Mechanism of Action

              Interferes with normal bacterial protein synthesis by binding to the 30S ribosomal subunits

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              Administration

              IV Compatibilities

              Additive: bleomycin

              Syringe: penicillin G

              Y-site: esmolol

              IV Incompatibilities

              Additive: amobarbital, amphotericin B, chlorothiazide, heparin, methohexital, norepinephrine, pentobarbital, phenobarbital, phenytoin, sodium bicarbonate

              Syringe: ampicillin(?), heparin

              IV Preparation

              Dissolve powder with 4.2, 3.2, or 1.8 mL of SWI to prepare 200 mg/mL, 250 mg/mL, or 400 mg/mL

              IV/IM Administration

              IM: inject deep IM into large muscle mass

              IV: not recommended; has been administered intravenously 12-15 mg/kg in 100 mL of NS over 30-60 min

              Storage

              Injection: store at 2-8°C

              Powder: store at room temp & protect from light

              Reconstituted soln stable for 1 wk at room temp; protect from light

              Exposure to light causes darkening of solution without apparent loss of potency

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              streptomycin intramuscular
              -
              1 gram vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              streptomycin intramuscular

              STREPTOMYCIN - INJECTION

              (strep-toe-MYE-sin)

              WARNING: This medication can sometimes cause serious nerve damage, possibly resulting in permanent hearing loss and balance problems. The risk is higher if you have kidney disease, if you are receiving high doses of this medication, if you use this drug for a long time, if you are an older adult (older than 60 years), or if you develop a severe loss of body water (become dehydrated). To reduce the risk of dehydration, drink plenty of fluids while using this medication unless your doctor directs you otherwise. Before starting streptomycin, tell your doctor if you already have kidney or hearing problems.Tell your doctor right away if you notice ringing/roaring in the ears, headache, hearing loss, balance problems, unusual drowsiness, dizziness, vision changes, or numbness/tingling of the skin.Your doctor will monitor your progress to reduce the risk of these side effects and may test your hearing, kidneys, and streptomycin blood level. This medication may be stopped if you develop kidney problems or hearing problems.If possible, you should avoid using any other medications that may harm the kidneys or nerves while using streptomycin (e.g., cidofovir, cisplatin, cyclosporine, other aminoglycoside antibiotics such as gentamicin/tobramycin, among others).Before having surgery, tell your doctor or dentist that you are using this medication. This drug may affect many of the drugs used during surgery and may increase your risk of side effects.

              USES: This medication is used with other medications to treat active tuberculosis (TB) infection if you cannot take other drugs for TB or if you have a type of TB that cannot be treated with other drugs (drug-resistant TB). Streptomycin belongs to a class of drugs known as aminoglycoside antibiotics. It works by killing the organisms that cause the infection.This drug may also be used to treat other serious infections (e.g., Mycobacterium avium complex-MAC, tularemia, endocarditis, plague) along with other medications.

              HOW TO USE: This medication is given by injection, usually into a muscle as directed by your doctor. When you start treatment for TB, it is usually given once a day or as directed by your doctor. It is important to change the location of the injection site daily to avoid problem areas under the skin. If you have any questions about using this medication properly, consult your doctor or pharmacist.Dosage is based on the kind of infection, your weight, medical condition, streptomycin blood levels, and side effects. How often you receive injections and the length of your treatment will depend on the type of infection you have and your response to treatment.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.Medication to treat tuberculosis is usually used for 9 months or longer. After you receive streptomycin daily for 1 to 2 months, your doctor may direct you to receive this medication less often (e.g., 2 to 3 times a week). Your doctor may direct you to stop using this medication before stopping your other TB medications. It is very important to continue using streptomycin and your other medications exactly as prescribed by your doctor.Do not stop taking this medication (or other TB medicines/antibiotics) even for a short time unless directed to do so by your doctor. Skipping or changing your dose without approval from your doctor may worsen side effects or make the infection (especially TB) more difficult to treat (resistant). If TB becomes resistant to this medication, it might also become resistant to other TB medications.For the best effect, use this antibiotic at evenly spaced times. Be sure to keep all appointments for receiving this drug.Tell your doctor right away if your infection symptoms return (e.g., fever, chills, body aches) while you are using this medication or after you stop using it.

              SIDE EFFECTS: See also Warning section.Nausea, vomiting, stomach upset, or loss of appetite may occur. Pain/irritation/redness may occur at the injection site. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: muscle weakness, persistent diarrhea even after stopping this medication, easy bleeding/bruising, fast heartbeat, new signs of infections (e.g., high fever, persistent cough), signs of kidney problems (such as change in the amount of urine), unusual tiredness.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: See also Warning section.Before using streptomycin injection, tell your doctor or pharmacist if you are allergic to it; or to other aminoglycoside antibiotics (e.g., tobramycin, gentamicin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, hearing problems, dehydration, a certain muscle problem (myasthenia gravis), burns over a large area of skin, cystic fibrosis.Streptomycin may cause live bacterial vaccines (such as BCG, typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.Before having surgery, tell your doctor or dentist that you are taking this medication.Caution is advised when using this drug in older adults because they may have decreased kidney function. Older adults may be more sensitive to the kidney and hearing side effects.Streptomycin is not recommended for use during pregnancy. Consult your doctor for more details.This medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also Warning section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: amphotericin B, high doses of aspirin/NSAIDs such as ibuprofen/naproxen.If your doctor has directed you to take low doses of aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should continue to take the aspirin. Consult your doctor or pharmacist for more details.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms may include: extreme drowsiness, slow/shallow breathing, inability to move.

              NOTES: Do not share this medication with others.Laboratory and/or medical tests (e.g., kidney tests, hearing tests, streptomycin levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

              STORAGE: Store unmixed medication at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.