How is amikacin compounded and administered intravenously (IV)?

From the Guidelines

Amikacin is typically compounded as an aqueous solution and administered intravenously (IV) at a dose of 10-15 mg/kg per day, adjusted according to drug level monitoring.

Administration Details

• The dose can be adjusted to 15-25 mg/kg per day, three times a week, depending on the patient's condition and serum amikacin concentration 1.
• For obese patients, the dose can be adjusted using ideal body weight plus 40% of the excess weight 2.
• In children, the usual dose is 15-30 mg/kg daily or 15-30 mg/kg three times a week 2.

Key Considerations

• Amikacin is administered parenterally through slow intravenous infusion or through intramuscular injection 3.
• The drug should be administered with caution in patients with renal impairment, and the dose should be reduced or the dosing interval increased accordingly 1.
• Monitoring of serum amikacin concentration is crucial to adjust the dose and minimize the risk of toxicity 1, 2.

Compounding and Preparation

• Amikacin is available as an aqueous solution in 500 mg and 1 g vials for IM or IV administration 4.
• The solution should be prepared and administered according to the manufacturer's instructions and hospital protocols.
• It is essential to follow proper preparation and administration techniques to ensure the stability and efficacy of the drug.

From the FDA Drug Label

The solution for intravenous use is prepared by adding the contents of a 500 mg vial to 100 or 200 mL of sterile diluent such as 0. 9% sodium chloride injection or 5% dextrose injection or any of the compatible solutions listed below. The solution is administered to adults over a 30 to 60 minute period.

The intravenous administration of amikacin is prepared by adding the contents of a 500 mg vial to a sterile diluent, and the solution is administered over a 30 to 60 minute period.

• The total daily dose should not exceed 15 mg/kg/day and may be divided into either 2 or 3 equally-divided doses at equally-divided intervals.
• In pediatric patients, the amount of fluid used will depend on the amount of amikacin ordered for the patient, and it should be a sufficient amount to infuse the amikacin sulfate injection over a 30 to 60 minute period.
• Infants should receive a 1 to 2 hour infusion.
• Amikacin should not be physically premixed with other drugs but should be administered separately according to the recommended dose and route 5.

From the Research

Amikacin Compounding and Administration

• Amikacin can be compounded and administered intravenously (IV) through a drip infusion, with a typical dose of 200 mg administered over 1-2 hours, twice a day 6, 7, 8.
• The serum concentrations of amikacin after IV drip infusion have been studied, with mean peak serum concentrations ranging from 14.20 to 25.4 micrograms/ml 6, 9.
• The half-life of amikacin after IV administration has been reported to be around 1.55 to 4.8 hours 6, 10.
• Amikacin can be administered as a loading dose followed by a continuous infusion to maintain serum concentrations 9.
• Once-daily dosing of amikacin has also been studied, with a dose of 11 mg/kg or 15 mg/kg body weight administered as a short-term IV infusion 10.

Dosage and Administration Considerations

• The dosage and administration of amikacin may need to be adjusted based on the patient's renal function and other factors 9, 10.
• Amikacin clearance provides more direct information about elimination of amikacin than does serum half-life 10.
• Monitoring of serum concentrations of amikacin is recommended, even with once-daily dosing 10.