Paromomycin

What is paromomycin?

Paromomycin (Gabbrovet®, Parofor®) is an aminoglycoside antibiotic used to treat intestinal parasites in dogs, cats, cattle, sheep, goats, pigs, amphibians, and reptiles. In dogs, paromomycin is also used topically to treat cutaneous leishmaniasis.

Gabbrovet® and Parofor® are licensed veterinary products that are available outside of North America. In the United States and Canada, human formulations (Humatin®, generics) may be prescribed for off-label use.

Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How do I give my pet paromomycin?

• Paromomycin is given orally (by mouth) and comes in the form of a capsule.
• This medication may also be compounded into other forms.
• Gabbrovet® and Parofor® come in the form of an oral solution to be mixed with drinking water or milk.
• Patients should be well-hydrated prior to treatment to minimize the risk of kidney damage.
• It is recommended to give paromomycin with food unless otherwise instructed.
• Follow your veterinarian’s directions and measure liquid forms of this medication carefully.

This medication should take effect within 1 to 2 hours; however, effects may not be noted outwardly until 1–2 days after starting treatment.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects from paromomycin?

Paromomycin may cause the following side effects:

• Diarrhea or loose stools
• Decreased appetite
• Vomiting

Serious adverse reactions associated with this drug may occur without warning and could, in rare cases, lead to death. If any of the following signs develop, stop giving paromomycin and contact your veterinarian immediately:

• Anorexia (loss of appetite)
• Persistent vomiting
• Blindness
• Hearing loss
• A head tilt
• Changes in thirst or urination

Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of the treatment and notify your veterinarian if you have any concerns.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE in:

• Pets that are allergic to it or any other aminoglycoside antibiotics
• Pets that are suffering from gastrointestinal conditions such as intestinal blockage (i.e., segments of intestine that are not functioning normally)
• Pets with existing liver or kidney disease

USE WITH CAUTION in:

• Cats
• Pets with gastrointestinal ulceration and/or bloody feces
• Neonatal animals

Are there any drug interactions I should be aware of?

The following drugs should be used WITH CAUTION when given with paromomycin:

• Any drug with the potential to cause injury to the kidneys
• Digoxin
• General anesthetics
• Methotrexate
• Strong diuretics

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Baseline testing should be done before starting treatment, including a full urinalysis, blood pressure measurement, and blood testing to assess for kidney insufficiency.
• Abdominal X-rays and ultrasound may be recommended before starting treatment.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.
• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• Monitor the pet for one week after discontinuing medication to detect any possible injury to the kidneys.

How do I store paromomycin?

• Ensure paromomycin is tightly stored in its original container in a cool, dry place and protected from light.
• Store this medication at room temperature between 68°F and 77°F (20°C and 25°C).
• Protect from freezing.
• Keep the container out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.