Acute Porphyria Drug Database

A07AA06 - Paromomycin
Propably not porphyrinogenic
PNP

Rationale
The classification PNP is only valid for oral administration of Paromomycin. Paromomycin when given orally is poorly absorbed from the gastrointestinal tract and most of the dose is eliminated unchanged in the faeces. The absorbed amount of Paromomycin is excreted unchanged in the urine by glomerular filtration. No data available for CYP metabolism. There is no clinical experience of Paromomycin used by porfyria patients.
Chemical description
Paromomycin sulfate is an aminoglycoside antibiotic. The aminoglycosides are polycationic compounds that contain an aminocyclitol, usually 2-deoxystreptamine, or streptidine in streptomycin and related compounds, with cyclic amino-sugars attached by glycosidic linkages.
Therapeutic characteristics
Paromomycin is an aminoglycoside antibiotic that has been given orally in the treatment of intestinal protozoal infections, including amoebiasis, cryptosporidiosis, and giardiasis. It has also been tried parenterally for visceral, and topically for cutaneous, leishmaniasis.
Hepatic exposure
Insignificant by oral administration.
Metabolism and pharmacokinetics
Paromomycin when given orally is poorly absorbed from the gastrointestinal tract and most of the dose is eliminated unchanged in the faeces. The absorbed dose is excreted unchanged in the urine by glomerular filtration. Aminoglycosides are generally well distributed in the body after parenteral dosage although penetration into the CSF is poor.

References

  1. Scientific articles
  2. Davidson RN, den Boer M, Ritmeijer K. Paromomycin. Thakur CP, Kanyok TP, Pandey AK, Sinha GP, Messick C, Olliaro P.Treatment of visceral leishmaniasis with injectable paromomycin (aminosidine). An open-label randomized phase-II clinical study. #3389
  3. Sundar S, Jha TK, Thakur CP, Sinha PK, Bhattacharya SK. Injectable paromomycin for Visceral leishmaniasis in India. N Engl J Med. 2007 Jun 21;356(25):2571-81. PMID 17582067. #3896
  4. Thakur CP, Kanyok TP, Pandey AK, Sinha GP, Zaniewski AE, Houlihan HH, Olliaro P. A prospective randomized, comparative, open-label trial of the safety and efficacy of paromomycin (aminosidine) plus sodium stibogluconate versus sodium stibogluconate alone for the treatment of visceral leishmaniasis. PMID 11127250. #4350
  5. Drug reference publications
  6. Martindale #3258
  7. Micromedex #3388

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