Paromomycin
Pronunciation: par-oh-moe-MYE-sin.
- Generic name
- paromomycin
- Brand names
- HUMATIN
- Drug class
- Aminoglycoside antibiotic
- Form
- Capsule
- Route
- Oral
- Legal status
- Prescription-only medicine
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What paromomycin is and how it works
Paromomycin is an oral aminoglycoside antibiotic that is poorly absorbed from the gut and acts mainly inside the intestine. In the United States it is labelled for intestinal amebiasis and as adjunctive therapy in the management of hepatic coma. (1)
It works locally in the bowel and does not treat infection that has spread outside the intestine. A clinician must confirm the diagnosis and decide whether paromomycin is appropriate. Information in this draft is drawn from the current U.S. capsule label; availability, brands, and approved uses in other countries are not established.
Mechanism of action: how paromomycin works
Paromomycin is a poorly absorbed aminoglycoside antibiotic. After oral administration, almost all of the drug is recoverable in the stool, with minimal systemic absorption in people with an intact gut lining. (1)
What paromomycin is used for
Intestinal amebiasis
Paromomycin is used for acute and chronic intestinal amebiasis. It is not effective against extraintestinal amebiasis. (1)
Adjunctive therapy in hepatic coma
It is labelled as adjunctive therapy in the management of hepatic coma. (1)
Before taking paromomycin
Do not take / not appropriate for
- Do not take paromomycin if you have a known hypersensitivity to paromomycin or any ingredient in the product. (all indications) (1)
- Do not take paromomycin if you have an intestinal obstruction. (all indications) (1)
Tell your clinician about
- Any previous allergic reaction to paromomycin or another antibiotic.
- A history of ulcerative bowel lesions, inflammatory bowel disease, or any condition that may affect the gut lining.
- Any sign of intestinal blockage, such as severe constipation, abdominal distension, or vomiting.
- Pregnancy, plans for pregnancy, or breastfeeding — the current evidence does not establish safety information for these situations; the prescriber needs to assess individual benefit and risk.
- All other medicines, supplements, and herbal products being taken so possible interactions can be assessed.
How to take paromomycin
- Take paromomycin exactly as prescribed. The dose, number of capsules per day, timing with meals, and duration are decided by the clinician for the specific infection.
- Swallow the capsules whole with a drink of water. The label-supported dosing schedule involves dividing the daily amount into separate doses taken with meals.
- Do not change the dose, frequency, or stop the course early on your own, even if you feel better.
- Keep capsules protected from moisture and store at room temperature as directed on the packaging.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
If a dose is missed, contact the prescribing clinician for advice. Do not take an extra dose or alter the next scheduled dose without specific instructions.
Overdose
If more than the prescribed number of capsules may have been taken, contact a poison-information service or seek emergency medical attention promptly. Because paromomycin can be absorbed through damaged bowel, assessment is important. (1)
Side effects
Reported side effects with oral paromomycin are mainly gastrointestinal. The current evidence does not provide a full adverse-reaction profile; individual response can vary.
Gastrointestinal symptoms
What to notice: Nausea, abdominal cramps, and diarrhoea. The label notes these were reported at daily doses above 3 grams.
What to do: Tell the prescribing clinician if these symptoms are severe, persistent, or interfere with completing the prescribed course. (1)
Overgrowth of nonsusceptible organisms or fungal infection
What to notice: New diarrhoea (especially if bloody or watery), oral thrush, vaginal irritation or discharge, or other signs of a new infection developing during or after treatment.
What to do: Contact the prescribing clinician promptly for assessment and management guidance. (1)
Possible renal effects from inadvertent absorption
What to notice: Reduced urine output, swelling, or a general sense of being unwell in a person with known ulcerative bowel disease or damaged gut lining.
What to do: Seek medical attention promptly and ensure the treating team knows about the paromomycin use and any bowel condition. (1)
Serious warnings
Hypersensitivity reaction — emergency
Symptoms: Rash, hives, itching, swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing.
Action: If a severe allergic reaction is suspected, call emergency services immediately. Do not delay while deciding whether the reaction is drug-related. (1)
Intestinal obstruction — emergency
Symptoms: Severe abdominal pain, cramping that does not settle, vomiting, inability to pass stool or gas, or severe bloating.
Action: Paromomycin is not to be taken in intestinal obstruction. Seek emergency care if these symptoms develop; ensure the treating team is told about the medicine. (1)
Renal toxicity risk with ulcerative bowel lesions — urgent_clinician_assessment
Symptoms: This is not a symptom checklist; it is a precaution. If paromomycin is absorbed through damaged bowel it may harm the kidneys.
Action: The prescriber must weigh this risk before starting treatment in anyone with ulcerative bowel disease. New urinary or systemic symptoms during treatment require prompt clinical review. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Other oral medicines, supplements, or herbal products | The interaction profile of oral paromomycin is not fully described by the current evidence. Because it acts in the gut, it could theoretically affect absorption or activity of other orally administered substances. | Give the prescribing clinician and pharmacist a complete list of everything taken by mouth so timing and dose adjustments can be considered. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
The current evidence does not establish safety information for paromomycin in pregnancy. The prescriber must assess individual benefit and risk. Do not start, stop, or adjust treatment based on pregnancy status without direct clinical guidance.
Breastfeeding
The current evidence does not establish safety information for paromomycin during breastfeeding. Discuss any breastfeeding questions with the prescribing clinician before taking this medicine.
People with ulcerative bowel lesions or damaged gut lining
Greater caution is needed because paromomycin may be absorbed into the bloodstream in these situations and could cause kidney toxicity. Ensure the prescriber knows about any inflammatory bowel disease, colitis, or other condition affecting the gut lining. (1)
Paediatric patients
The U.S. label includes paediatric dosing for intestinal amebiasis; the dose is determined by body weight by the prescribing clinician. Do not apply adult dosing to a child without a prescriber's instruction. (1)
Monitoring
Before starting
- Confirm the diagnosis and determine whether the infection is confined to the intestine; paromomycin is not effective for extraintestinal amebiasis.
- Assess for intestinal obstruction, ulcerative bowel disease, previous hypersensitivity to paromomycin or aminoglycosides, and kidney function.
- Review all current medicines, supplements, and herbal products for potential interactions.
- Consider microbiological culture and susceptibility where available, as recommended by the label.
During treatment
- Monitor for gastrointestinal side effects that may affect adherence or hydration.
- Watch for signs of new infection or fungal overgrowth that may require clinical assessment.
- In people with ulcerative bowel lesions, be alert for any sign of renal impairment due to unintended drug absorption.
- Reinforce the importance of completing the prescribed course even if symptoms improve.
Storage
Store at 20–25°C (68–77°F) and protect from moisture. Keep capsules in the original container and out of reach of children. Do not use if the packaging is damaged or the capsules appear discoloured or wet.
Professional information
Clinician-facing context drawn from the current U.S. Humatin capsule label. Does not replace the full local prescribing information, susceptibility data, or individual clinical assessment.
United States
Indication: Intestinal amebiasis — adult and paediatric
Dose summary: 25–35 mg/kg/day, divided into three doses taken with meals, for 5–10 days. Dose must be calculated by a clinician using actual body weight.
Renal context: Use with caution where ulcerative bowel lesions exist because absorption may cause renal toxicity. No specific renal-dose adjustment is described in the current evidence. (1)
United States
Indication: Adjunctive therapy in hepatic coma — adult
Dose summary: 4 g/day in divided doses for 5–6 days. This is prescriber-facing label information only.
Renal context: Renal impairment advice is not established by the current evidence; individual assessment is required. (1)
Hepatic guidance
The label includes a hepatic-coma adjunctive-therapy indication. Hepatic-impairment-specific dosing beyond the labelled regimen is not established by the current evidence.
Overdose note
If a significant overdose is suspected in a person with a compromised gut lining, assess renal function and manage supportively. Contact a poison-information centre for guidance. (1)
Frequently asked questions
What is paromomycin used for?
In the United States, paromomycin oral capsules are labelled for treating intestinal amebiasis and as additional therapy in managing hepatic coma. It works inside the bowel. (1)
Does paromomycin treat amebiasis that has spread outside the intestine?
No. The label states it is not effective against extraintestinal amebiasis. A different treatment plan is needed if the infection has moved beyond the gut. (1)
Why is it important to finish the full prescribed course?
Stopping early, even if symptoms improve, can mean the infection is not fully cleared and may return or lead to resistant organisms. Any decision to stop early must be made by the prescribing clinician. (1)
What should I do if I get nausea, cramps, or diarrhoea?
These are known side effects, especially at higher doses. Tell the prescribing clinician if they are severe, persistent, or stop you from taking the medicine as prescribed. (1)
Is paromomycin safe during pregnancy or breastfeeding?
The current evidence does not establish safety information for pregnancy or breastfeeding. This must be discussed directly with the prescribing clinician, who can assess individual benefit and risk.
Is paromomycin available in the UK, EU, Canada, Australia, or other countries?
Availability, approved brands, and licensed uses outside the United States are not established by the current evidence. A pharmacist or prescriber in your country can advise on local availability.
What is the mechanism of action of paromomycin?
Paromomycin is a poorly absorbed aminoglycoside antibiotic. After oral administration, almost all of the drug is recoverable in the stool, with minimal systemic absorption in people with an intact gut lining. (1)
What is the generic name of Paromomycin?
The generic name is paromomycin. It is sold under brand names including HUMATIN. (1)
What class of drug is paromomycin?
Paromomycin is classed as: Aminoglycoside antibiotic. (1)
References
- HUMATIN (paromomycin sulfate) capsules — prescribing informationU.S. National Library of Medicine DailyMed · United States · dated 2025-11-13 · accessed 2026-08-11 · source 1
- Humatin — FDA approval record (Drugs@FDA ANDA065173)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 2
- paromomycin — RxNorm normalized drug concept (RXCUI 66912)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 3
Brand names by country
Single-ingredient paromomycin names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Humatin250 mg · waylis therapeutics llc
Canada
- HUMATIN