UNIBROL 250MG TABLET

Indications

• Visceral leishmaniasis
• Intestinal amebiasis
• Bacterial infections resistant to other antibiotics

Dosage

Children: Refer to the BNF for Children for specific dosing recommendations.

Adults: Refer to the BNF for specific dosing recommendations.

Mechanism of action

Paromomycin inhibits protein synthesis by binding to 16S ribosomal RNA. It interacts with the A site of the ribosomal structure, leading to the production of defective polypeptide chains. This disruption in protein synthesis ultimately results in bacterial cell death.

Pharmacodynamics

Paromomycin exhibits broad-spectrum antibacterial activity. Its mechanism of action closely resembles that of neomycin, contributing to its effectiveness against a range of bacterial pathogens. The drug's bactericidal effects are due to its ability to interfere with the normal function of bacterial ribosomes, resulting in the synthesis of non-functional proteins.

Pharmacokinetics

Paromomycin is poorly absorbed from the gastrointestinal tract, which is why it is often administered orally for local effects in the intestines or parenterally for systemic treatment. It has a limited volume of distribution and is primarily excreted unchanged in the urine. The drug's half-life and clearance can be influenced by the patient's renal function.

Contra-indications

• Hypersensitivity to paromomycin or any component of the formulation
• Severe renal impairment

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Rash
• Ototoxicity
• Nephrotoxicity

Interactions

• Other nephrotoxic drugs (e.g., aminoglycosides, vancomycin)
• Neuromuscular blocking agents may have enhanced effects

Precautions

• Use with caution in patients with renal impairment
• Monitor renal function during treatment
• Evaluate hearing before and during treatment, especially in those at risk for ototoxicity

Pregnancy

Paromomycin should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. There are limited data on the use of paromomycin in pregnant women.

Breast-feeding

Paromomycin is excreted in breast milk. Caution should be exercised when administering to breastfeeding women.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Oral tablets
• Injection for intramuscular or intravenous use

Mechanism of action

Paromomycin inhibits protein synthesis by binding to 16S ribosomal RNA. Bacterial proteins are synthesized by ribosomal RNA complexes which are composed of 2 subunits, a large subunit (50s) and small (30s) subunit, which forms a 70s ribosomal subunit. tRNA binds to the top of this ribosomal structure. Paramomycin binds to the A site, which causes defective polypeptide chains to be produced. Continuous production of defective proteins eventually leads to bacterial death.

Pharmacodynamics

Paromomycin is a broad spectrum aminoglycoside antibiotic produced by <i>Streptomyces rimosus</i> var. paromomycinus. The in vitro and in vivo antibacterial action of paromomycin closely parallels that of neomycin.