Ophthalmic infections: Ophthalmic:
Ointment: Instill 1/2" (1.25 cm) 2 to 3 times daily
Solution: Instill 1 to 2 drops every 4 hours, up to 2 drops every hour for severe infections
There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.
(For additional information see "Gentamicin (ophthalmic): Pediatric drug information")
Ophthalmic infections: Infants, Children, and Adolescents: Ophthalmic:
Ointment: Instill 1/2 inch (1.25 cm) to affected eye(s) 2 to 3 times daily.
Solution: Instill 1 to 2 drops into affected eye(s) every 4 hours; up to 2 drops every hour for severe infections.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely necessary due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely necessary due to low systemic absorption.
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, Ophthalmic:
Gentak: 0.3% (3.5 g) [contains methylparaben, propylparaben]
Solution, Ophthalmic:
Generic: 0.3% (5 mL)
May be product dependent
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, Ophthalmic:
Generic: 0.3% (3.5 g)
Solution, Ophthalmic:
Generic: 0.3% (3.5 mL, 5 mL, 10 mL)
For topical ophthalmic use only; not for injection into the eye. Avoid contaminating tip of the solution container or ointment tube.
For topical ophthalmic use only; not for injection into the eye. Avoid contaminating tip of the solution container or ointment tube.
Solution: Gentamicin solution is not for subconjunctival injection. Solution may be instilled into the affected eye. Apply finger pressure to lacrimal sac during and for 1 to 2 minutes after instillation to decrease risk of absorption and systemic effects.
Ophthalmic infections: Topical treatment of ocular bacterial infections, including conjunctivitis, keratitis, keratoconjunctivitis, corneal ulcers, blepharitis, blepharoconjunctivitis, acute meibomianitis, and dacryocystitis caused by Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus pneumoniae, Klebsiella aerogenes (formerly Enterobacter aerogenes), Escherichia coli, Haemophilus influenza, Klebsiella pneumonia, Neisseria gonorrhoeae, Pseudomonas aeruginosa, and Serratia marcescens.
Gentamicin may be confused with gentian violet, kanamycin, vancomycin
KIDs List: Gentamicin ophthalmic ointment, when used in neonates, is identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be avoided due to risk of severe ocular reactions (strong recommendation; high quality of evidence)(PPA [Meyers 2020]).
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>1%: Ophthalmic: Burning sensation of eyes, eye irritation
<1%, postmarketing, and/or case reports: Corneal ulcer, hallucination, hypersensitivity reaction, purpura, thrombocytopenia
Hypersensitivity to gentamicin or any component of the formulation
Concerns related to adverse effects:
• Corneal healing: May delay corneal healing.
• Sensitization: Topical use has been associated with local sensitization (redness, irritation); discontinue if sensitization is noted.
• Superinfection: Prolonged use may result in fungal or bacterial superinfection; if purulent discharge, inflammation, or pain are increased, therapy should be re-evaluated.
Other warnings/precautions:
• Appropriate use: Not for injection into the eye.
• Long-term use: Not intended for long-term therapy.
Ointment should not be used as routine prophylaxis for ophthalmia neonatorum due to reports of severe ocular reactions described as eyelid erythema and swelling, ocular discharge, and periocular blistering, typically reported within 48 hours after administration (Binenbaum 2010; Nathawad 2011).
None known.
There are no known significant interactions.
Adverse events were observed following systemic administration of gentamicin in animal reproduction studies. The amount of gentamicin available systemically following application of the ophthalmic drops is below the limit of detection (<0.5 mcg/mL) (Trope 1979). In general, if ophthalmic agents are needed in pregnant women, the minimum effective dose should be used in combination with punctal occlusion to decrease systemic absorption (Samples 1988).
The amount of gentamicin available systemically following application of the ophthalmic drops is below the limit of detection (<0.5 mcg/mL) (Trope 1979). In general, if ophthalmic agents are needed in lactating women, the minimum effective dose should be used in combination with punctual occlusion to decrease systemic absorption (Samples 1988).
Interferes with bacterial protein synthesis by binding to 30S ribosomal subunit resulting in a defective bacterial cell membrane
Absorption: Ophthalmic drops: Systemic absorption: Undetected (<0.5 mcg/mL)
Ointment (Gentak Ophthalmic)
0.3% (per gram): $11.13
Solution (Gentamicin Sulfate Ophthalmic)
0.3% (per mL): $3.84 - $8.57
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