Intramuscularly or intravenously (struyno, for 2 min or drip). Adults and children over 6 years of age - 5 mg / kg every 8 hours or 7.5 mg / kg every 12 hours; bacterial urinary tract infections (uncomplicated) - 250 mg every 12 hours; after the hemodialysis session, an additional dose of 3-5 mg / kg may be prescribed. The maximum dose for adults is up to 15 mg / kg / day, but not more than 1.5 g / day for 10 days.
The duration of treatment with iv introduction is 3-7 days, with a / m - 7-10 days.
Preterm neonates with an initial dose of 10 mg / kg, then 7.5 mg / kg every 18-24 hours; newborns and children under 6 years of age, the initial dose is 10 mg / kg, then 7.5 mg / kg every 12 hours for 7-10 days.
Patients with renal failure require a correction of the dosing regimen: a dose reduction or an increase in the interval between administrations is necessary. Treatment should be carried out under the control of the content of the drug in the plasma (the therapeutic concentration is 15-25 μg / ml).
Patients with burns may need a dose of 5-7.5 mg / kg every 4 to 6 hours due to shorter T1/2 (1-1.5 h) in these patients.
For the / m introduction use a solution prepared ex tempore from the powder with the addition of 2-3 ml of water for injections to the contents of the vial. For IV infusion, 4-5 ml of water for injection, 0.9% of sodium chloride solution or 5% of dextrose solution are added to the contents of the vial. For IV injection apply the same solutions as for IM, previously diluted with 200 ml of a 5% solution of dextrose or 0.9% solution of sodium chloride. The concentration of amikacin in the solution for intravenous administration should not exceed 5 mg / ml.
In violation of excretory function of the kidneys it is necessary to reduce doses or increase the intervals between administrations.
In the case of an increase in the interval between administrations (if the level of creatinine clearance is not known and the patient's condition is stable), the interval between drug intake is established as follows:
Interval (hours) = serum creatinine concentration * 9.
If the serum creatinine concentration is 2 mg / 100 ml, the recommended single dose (7.5 mg / kg) should be administered every 18 hours. When the interval is increased, the single dose is not changed.
In the case of a single dose reduction with an unchanged dosing regimen, the first dose for patients with renal insufficiency is 7.5 mg / kg.To calculate the subsequent doses, it is necessary to separate the clearance value (ml / min) in patients for creatinine clearance in norm, then multiply the obtained figure by the amount of the initial dose in mg:
the subsequent dose (mg) = the creatinine clearance found in the patient (ml / min) / creatinine clearance in norm (ml / min) x initial dose (mg).