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Gentamicin eye/ear drops


Eye and Ear drops containing gentamicin sulfate.

Drugs List

  • gentamicin 0.3% eye/ear drops
  • Therapeutic Indications


    Eye infection - topical treatment
    Ocular prophylaxis after trauma
    Otitis externa - infective
    Prophylaxis against otitis externa following trauma



    Instil 1 or 2 drops up to six times a day into the affected eye(s), or more frequently if required.
    Instil 2 or 3 drops up to three to four times a day and at night into the affected ear(s), or more frequently if required.


    See Dosage; Adult

    Additional Dosage Information

    Severe infections may require 1 or 2 drops every fifteen to twenty minutes initially, reducing the frequency of instillation gradually as the infection is controlled.


    Myasthenia gravis
    Perforated tympanic membrane

    Precautions and Warnings

    Soft contact lenses
    Hepatic impairment
    Known or suspected mitochondrial disorder
    Renal impairment

    Do not use if tympanostomy tube (grommet) is in situ
    Exclude tympanic membrane perforation before initiating treatment
    Advise patient blurred vision may affect ability to drive/operate machinery
    Contains benzalkonium chloride
    Avoid contact with middle ear
    In combined therapy, administer eye products at least five minutes apart
    To reduce systemic absorption compress lacrimal sac during administration
    Advise patient to report signs of deafness
    Possible ototoxicity when used at high doses in susceptible groups
    Possible systemic absorption
    Discontinue if irritation or sensitisation occur
    Discontinue if superinfection occurs
    Avoid long term use
    Advise patient to avoid touching the eye/other surfaces with container tip
    Remove contact lenses before use and re-insert 15 minutes after use

    When used in the ears clean the area before use.

    Serious adverse reactions including neurotoxicity, ototoxicity and nephrotoxicity have occurred in patients receiving systemic gentamicin therapy. Although these effects have not been reported following topical otic use of gentamicin, caution is advised when used concomitantly with systemic aminoglycosides.

    Severe infections may require a concurrent systemic antibiotic regime.

    It must be established whether the patient has a known mitochondrial disorder or a family history of ototoxicity before use.

    There have been reports of cases of an increased risk of ototoxicity with aminoglycosides administered to patients with mitochondrial mutations, including cases where the patient's aminoglycoside serum levels were within the recommended range. No cases were identified with topical preparations, however there is a potential risk with gentamicin and other aminoglycosides administered at the site of toxicity.

    The use of aminoglycoside treatment versus alternative options in patients with susceptible mutations should be considered. Genetic testing should also be considered especially in patients requiring recurrent or long term treatment with aminoglycosides; however urgent treatment should not be delayed. To minimise the risks of adverse effects, continuous monitoring of renal and auditory function, as well as hepatic and laboratory parameters, is recommended for all patients.

    Avoid application to open wounds or damaged skin as systemic absorption can cause irreversible partial or total deafness. This effect is enhanced in patients with renal or hepatic impairment and the elderly.

    Direct contact of gentamicin with the middle and inner ear can result in irreversible toxic effects and any benefits need to be considered against the risk of infection itself causing hearing loss.

    Use with caution in an inflamed eye as increased systemic absorption may occur through the conjunctiva.

    Use with caution in dry eye patients and in patients where the cornea may be compromised.

    Pregnancy and Lactation


    Use gentamicin with caution during pregnancy.

    The manufacturer recommends that gentamicin should only be used in pregnancy when considered essential by the physician, after careful assessment of the potential risks and benefits.

    Schaefer (2015) concludes that aminoglycosides may be administered locally because systemic absorption is minimal.


    Use gentamicin with caution during breastfeeding.

    The manufacturer recommends that gentamicin should only be used in breastfeeding when considered essential by the physician, after careful assessment of the potential risks and benefits.

    Lactmed states that maternal use of an ear drop or eye drop that contains gentamicin presents little or no risk for the nursing infant.

    Side Effects

    Blurred vision (transient)
    Burning sensation (local)
    Hypersensitivity reactions
    Irritation (localised)
    Itching sensation (local)
    Stinging (transient)
    Systemic effects


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: August 2022

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Summary of Product Characteristics: Genticin Eye/Ear drops. ADVANZ Pharma. Revised May 2021.

    NICE Evidence Services Available at: Last accessed: 21 July 2022.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    gentamicin Last revised: 16 August 2021
    Last accessed: 21 July 2022

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