Amikacin
Amikacin is a potent aminoglycoside antibiotic used to treat serious bacterial infections, particularly those caused by resistant Gram-negative organisms. It works by binding to bacterial ribosomes and interrupting protein synthesis, effectively killing susceptible bacteria.
A powerful injectable antibiotic for treating serious Gram-negative bacterial infections by disrupting bacterial protein synthesis.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- D06AX12
- RxNorm
- 641
- Generic
- Amikacin
- Class
- atc-d06
- Brands
- Arikayce
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection, suspension, solution
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
13 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks, aminoglycosides can cause fetal harm
regular fetal monitoring including ultrasound for fetal well-being
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second trimesteravoid if possible
avoid use unless benefits significantly outweigh risks
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
third trimesteravoid if possible
avoid use unless benefits outweigh risks, close monitoring required if used
fetal monitoring, consider amniotic fluid assessment
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedinguse with caution
consider暂停哺乳或密切监测婴儿
monitor infant for signs of ototoxicity or nephrotoxicity
Use with caution and monitor for adverse effects.
geriatric
elderlydose reduction and extended interval based on renal function
adjust dose based on creatinine clearance, monitor renal function and hearing
regular renal function tests, therapeutic drug monitoring, audiological assessments
Use with caution and monitor for adverse effects.
pediatric_age
neonatesweight-based dosing with extended intervals in newborns
use only for serious infections, monitor serum levels closely
therapeutic drug monitoring essential, monitor renal function and hearing
Use with caution and monitor for adverse effects.
pediatric_age
childrenweight-based dosing, monitor renal function
use for serious infections when alternatives unavailable
therapeutic drug monitoring, regular renal and auditory monitoring
Use with caution and monitor for adverse effects.
renal_impairment
mildreduce dose or extend interval
monitor serum creatinine, adjust dose based on renal function
therapeutic drug monitoring, monitor renal function weekly
Use with caution and monitor for adverse effects.
renal_impairment
moderatesignificant dose reduction required
reduce dose to 50-70% of normal, extend dosing interval
frequent therapeutic drug monitoring, renal function monitoring
Use with caution and monitor for adverse effects.
renal_impairment
severeavoid if possible, if required use very low doses with extreme caution
consider alternative antibiotics, if used requires extensive dose adjustment and monitoring
intensive therapeutic drug monitoring, daily renal function assessment
Use of this medication in this population requires careful consideration of risks and benefits.
hepatic_impairment
mildno significant adjustment needed
standard dosing may be used
routine monitoring as clinically indicated
hepatic_impairment
moderatemay require slight dose adjustment
use with caution, monitor liver function
monitor hepatic function tests
Use with caution and monitor for adverse effects.
hepatic_impairment
severeuse lower end of dosing range
use with caution, monitor for accumulation
therapeutic drug monitoring recommended
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approved
Arikayce (liposomal amikacin for inhalation) approval date
Drug class
Drug class information
Primary indication
Therapeutic indication for Arikayce
Mechanism of action
Pharmacological mechanism
Used to treat serious Gram-negative bacterial infections including respiratory tract infections, urinary tract infections, septicemia, bone and joint infections, and meningitis when caused by susceptible organisms. Often reserved for infections resistant to other antibiotics.
Amikacin binds to the 30S ribosomal subunit of bacterial cells, disrupting protein synthesis by causing misreading of mRNA. This results in bactericidal activity against susceptible Gram-positive and Gram-negative bacteria.
Administered via injection (IV or IM) due to poor oral absorption. Requires therapeutic drug monitoring to ensure adequate levels while minimizing toxicity. Key risks include nephrotoxicity (kidney damage) and ototoxicity (hearing/loss of balance). Use with caution in patients with pre-existing kidney problems or hearing disorders.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy