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This medication carries several important safety considerations that patients and healthcare providers should be aware of. Below are key risks and precautions associated with its use:

• Kidney Risks: This medication may cause serious kidney issues, potentially leading to kidney failure. Risk factors include existing kidney problems, older age, dehydration, high doses, prolonged use, and concurrent use of other medications that affect the kidneys. Regular monitoring through kidney and urine tests is recommended to manage these risks.

• Hearing and Balance Issues: Neomycin can damage the ears, leading to irreversible hearing loss and balance difficulties. These effects can occur even after the medication is discontinued. Regular hearing and balance assessments are necessary, and immediate medical advice should be sought if symptoms such as hearing loss or dizziness occur.

• Nerve and Breathing Complications: In rare cases, neomycin can cause muscle weakness and respiratory paralysis, especially in individuals undergoing surgery or receiving blood transfusions. Symptoms like skin tingling, numbness, muscle twitching, or breathing difficulties require urgent medical attention.

• Drug Interactions: Neomycin should not be combined with other drugs that can harm the kidneys, nerves, or hearing, such as other aminoglycoside antibiotics, cisplatin, or furosemide. Discuss all medications with your healthcare provider to avoid harmful interactions.

• Digestive Effects: High doses of neomycin may disrupt the gut's bacterial balance, affecting nutrient absorption and leading to digestive issues like diarrhea, weight loss, or excessive gas. Consult your provider if these symptoms arise.

• Contraindications: Do not use this medication if you have a bowel obstruction, a known allergy to neomycin or other aminoglycosides, gastrointestinal inflammation, or stomach ulcers. Always discuss your medical history with your healthcare provider before starting this medication.

If you suspect an overdose or experience severe side effects, seek immediate medical assistance. Always follow your healthcare provider's instructions carefully while using this medication.

Common side effects:

• nausea
• vomiting
• diarrhea

Less common but important to monitor:

• hearing loss
• trouble maintaining balance
• muscle weakness

Serious side effects:

• swelling in the feet or ankles
• difficulty urinating
• fatigue
• confusion
• difficulty breathing
• skin tingling
• numbness
• muscle twitching
• slurred speech
• drowsiness
• headaches
• rash
• itching or swelling of the face, tongue, or throat
• severe dizziness
• trouble breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Amikacin
• Tobramycin
• Amphotericin B
• Cidofovir
• Cisplatin
• Polymyxin B

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• cephaloridine
• NSAIDs such as Ibuprofen