Neomycin: uses, dosing, side effects & brands
Neomycin is an aminoglycoside antibacterial sold in the U.S. under 2 brand and generic names, for escherichia coli infections, hepatic encephalopathy and bacterial skin diseases. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Aminoglycoside Antibacterial
- Treats (across its forms)
- Escherichia Coli Infections, Hepatic Encephalopathy and Bacterial Skin Diseases
- Available as
- Topical · Tablet · Solution
- Sold as
- 2 products — Neomycin Sulfate and Mycifradin
- Prescription?
- Prescription only
- Generic available?
- Yes
- What the pharmacy pays
- about $25 for a 30-count supply — not your price
- Boxed warning
- Boxed warning
How Neomycin Sulfate is dosed
From the FDA label for Neomycin Sulfate (application ANDA060304). Other neomycin products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
To minimize the risk of toxicity, use the lowest possible dose and the shortest possible treatment period to control the condition. Treatment for periods longer than two weeks is not recommended. Hepatic Coma For use as an adjunct in the management of hepatic coma, the recommended dose is 4 to 12 grams per day given in the following regimen: Withdraw protein from diet. Avoid use of diuretic agents. Give supportive therapy, including blood products, as indicated. Give neomycin sulfate tablets in doses of 4 to 12 grams of neomycin sulfate per day (eight to 24 tablets) in divided doses. Treatment should be continued over a period of five to six days, during which time protein should be returned incrementally to the diet. If less potentially toxic drugs cannot be used for chronic hepatic insufficiency, neomycin in doses of up to four grams daily (eight tablets per day) may be necessary. The risk for the development of neomycin-induced toxicity progressively increases when treatment must be extended to preserve the life of a patient with hepatic encephalopathy who has failed to fully respond. Frequent periodic monitoring of these patients to ascertain the presence of drug toxicity is mandatory (see PRECAUTIONS ). Also, neomycin serum concentrations should be monitored to avoid potentially toxic levels. The benefits to the patient should be weighed against the risks of…
Everything below is the FDA label for Neomycin Sulfate (topical, tablet). Neomycin is also sold as solution, and those are different medicines to take — follow the label for the one you were prescribed.
Neomycin Sulfate side effects
The most common adverse reactions to oral neomycin sulfate are nausea, vomiting and diarrhea. The “Malabsorption Syndrome” characterized by increased fecal fat, decreased serum carotene and fall in xylose absorption has been reported with prolonged therapy. Nephrotoxicity, ototoxicity and neuromuscular blockage have been reported (see boxed WARNINGS and PRECAUTIONS sections).
Who shouldn’t take Neomycin Sulfate
Neomycin sulfate oral preparations are contraindicated in the presence of intestinal obstruction and in individuals with a history of hypersensitivity to the drug. Patients with a history of hypersensitivity or serious toxic reaction to other aminoglycosides may have a cross-sensitivity to neomycin. Neomycin sulfate oral preparations are contraindicated in patients with inflammatory or ulcerative gastrointestinal disease because of the potential for enhanced gastrointestinal absorption of neomycin.
Neomycin Sulfate drug interactions
Caution should be taken in concurrent or serial use of other neurotoxic and/or nephrotoxic drugs because of possible enhancement of the nephrotoxicity and/or ototoxicity of neomycin (see boxed WARNINGS ). Caution should also be taken in concurrent or serial use of other amino-glycosides and polymyxins because they may enhance neomycin’s nephrotoxicity and/or ototoxicity and potentiate neomycin sulfate’s neuromuscular blocking effects. Oral neomycin inhibits the gastrointestinal absorption of penicillin V, oral vitamin B-12, methotrexate and 5-fluorouracil. The gastrointestinal absorption of digoxin also appears to be inhibited. Therefore, digoxin serum levels should be monitored. Oral neomycin sulfate may enhance the effect of coumarin in anticoagulants by decreasing vitamin K availability.
Every neomycin product we track (2)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 48/100 | Prescription | Topical | Generic | $25 | View → | |
| 2 | Not yet rated | Prescription | Tablet | Generic | $25 | View → |
Combination products containing neomycin
A combination is a different drug — different dosing, different warnings. It is listed here so you can find it, not so you can substitute it.
How long neomycin keeps
No neomycin label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does neomycin expire? The in-use limits and storage rules from its labelsNeomycin and breastfeeding
From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.
Full LactMed record for neomycin: levels in milk, effects in breastfed infants, and the drugs it would consider insteadAlthough no information exists on the excretion of neomycin into milk, other aminoglycoside antibiotics are poorly excreted into breastmilk. Newborn infants apparently absorb small amounts of aminoglycosides, but serum levels are far below those attained when treating newborn infections and systemic effects of neomycin are unlikely. Older infants would be expected to absorb even less neomycin. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (e.g., thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis.
National Institute of Child Health and Human Development, record revised July 15, 2024. LactMed states its information is not a substitute for professional judgement.
What people report to the FDA about neomycin
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 2,995 reports naming neomycin, and the FDA flagged 74% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- drug hypersensitivity602 reports
- macular degeneration557 reports
- nausea492 reports
- malaise474 reports
- infusion related reaction459 reports
- pyrexia362 reports
- therapeutic product effect incomplete355 reports
- dyspnoea338 reports
Read these as a signal, not a rate. A report does not mean neomycin caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved August 25, 2026.
Related calculators
Frequently asked questions
What is Neomycin Sulfate?
Neomycin Sulfate is an aminoglycoside antibacterial used to treat Escherichia Coli Infections, Hepatic Encephalopathy, Bacterial Skin Diseases.
What kind of drug is neomycin?
The FDA classifies neomycin as an aminoglycoside antibacterial. Aminoglycosides kill bacteria by latching onto the germ's protein-making machinery (the 30S ribosomal subunit). This jams and misreads the bacterial genetic code so the microbe builds faulty proteins it can't survive on, which is why these drugs destroy the bacteria rather than just stopping their growth. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take neomycin with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run neomycin against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is neomycin sold under?
We track 2 neomycin-containing products in the U.S.: Neomycin Sulfate and Mycifradin. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does neomycin come in?
Across the brands we track, neomycin is currently marketed as topical, tablet and solution, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic neomycin?
Yes. Our catalog lists 2 generic neomycin products alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Neomycin: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/neomycin
- MLA
- “Neomycin: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/neomycin.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for neomycin on DailyMed (NIH) ↗ — including its boxed warning in full.