An aminoglycoside antibiotic used for gut amoebae and leishmaniasis
Paromomycin
An aminoglycoside antibiotic used to treat gut amoebae and, as an injection, leishmaniasis.
What is Paromomycin?
Paromomycin is an aminoglycoside antibiotic used to treat certain parasite infections. Taken by mouth, it works mainly inside the gut, with very little absorbed into the rest of the body, which is why it is used for amoebae living in the bowel and gives mainly tummy-related side effects. Given as an injection, it is used for leishmaniasis, and in that form it carries the kidney and hearing risks typical of aminoglycoside antibiotics. It is a specialist medicine used under medical supervision.
Education and reference only. This is a plain-language guide to Paromomycin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Paromomycin is an antibiotic belonging to the aminoglycoside family. It is used against certain parasites rather than ordinary bacterial infections. When it is taken by mouth, it is barely absorbed and stays mostly in the gut, so it is used for amoebae that live in the bowel; because it works locally, its main side effects are tummy-related. When it is given as an injection, it is used to treat leishmaniasis, a parasitic infection spread by sandfly bites, and in this form enough is absorbed that the kidney and hearing risks linked to aminoglycoside antibiotics become relevant. It is a specialist medicine prescribed under medical or specialist supervision.
How it works
Paromomycin, like other aminoglycoside antibiotics, interferes with the way the parasite makes the proteins it needs to survive, which stops it growing and helps clear the infection. Taken by mouth, it is hardly absorbed, so it acts directly on parasites within the gut while little reaches the bloodstream — this is why it suits bowel amoebae and tends to cause gut upset rather than body-wide effects. Given by injection, it reaches the bloodstream and tissues to act against leishmaniasis, but this also exposes the kidneys and hearing to the risks that come with aminoglycosides, which is why injectable use needs monitoring.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist antibiotic used in the UK for certain gut parasites and, as an injection, for leishmaniasis.
Practical use
How to take Paromomycin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the oral form exactly as prescribed, usually with or after food, and finish the whole course even if you feel better.
- Understand that the oral form works mainly in the gut, so its main side effects are tummy-related.
- If you are given the injection for leishmaniasis, attend appointments for kidney and hearing checks as advised.
- Tell your prescriber about any kidney or hearing problems before starting, as these affect the injectable form.
- Mention other medicines you take, especially any that can affect the kidneys or hearing.
Weighing it up
Advantages & disadvantages of Paromomycin
Advantages
- An effective treatment for certain gut parasites and for leishmaniasis.
- The oral form works mainly in the gut, with very little absorbed into the rest of the body.
- A useful option where other treatments are unsuitable, used under specialist guidance.
Disadvantages
- The oral form commonly causes tummy upset such as nausea and diarrhoea.
- The injectable form carries the kidney and hearing risks typical of aminoglycoside antibiotics.
- It is a specialist medicine that needs medical supervision and, for the injection, monitoring.
Practical use
Good to know
The most useful thing to understand is that paromomycin behaves very differently depending on how it is given. Taken by mouth, it stays in the gut and is barely absorbed, so it is used for parasites living in the bowel and its main side effects are tummy ones such as stomach upset and diarrhoea. As an injection, it is used for leishmaniasis and, because it then reaches the rest of the body, it carries the kidney and hearing risks typical of aminoglycoside antibiotics, so monitoring of kidney function and hearing may be needed. It is important to finish the course you are given, even once you feel better, so the parasite is fully cleared. Tell your prescriber about kidney or hearing problems and about other medicines, especially any that can affect the kidneys or hearing.
Who should not take it / use with caution
- People who have had a serious allergic reaction to paromomycin or other aminoglycosides should not take it.
- The injectable form is used with great care, or avoided, in people with kidney or hearing problems.
- It is used with care in pregnancy, where the specialist team weighs the benefits and risks.
- It is used only under medical or specialist supervision.
Monitoring
- With the injection, checking kidney function with blood tests during treatment.
- With the injection, watching for any effects on hearing or balance.
- Reviewing how well the infection responds to treatment.
Side effects
- Tummy upset such as nausea, stomach cramps and diarrhoea, especially with the oral form.
- With the injection, possible effects on the kidneys, shown by blood tests.
- With the injection, possible effects on hearing or balance, such as ringing in the ears or dizziness.
- Rarely, allergic-type reactions, which should be reported promptly.
Key interactions
- Other medicines that can affect the kidneys may add to the risk with the injectable form, so tell your team about them.
- Other medicines that can affect hearing or balance may add to the risk with the injection.
- Tell your prescriber about all your medicines, as some may need careful review.
Available as: Capsules taken by mouth, and a solution for injection.
Answers
Paromomycin: frequently asked questions
What is paromomycin used for?
It is an aminoglycoside antibiotic used to treat certain gut parasites (amoebae) when taken by mouth, and leishmaniasis when given as an injection.
Why does the oral form mainly upset my stomach?
Taken by mouth, paromomycin is barely absorbed and stays mostly in the gut, so it acts there and its main side effects are tummy-related.
Does it harm the kidneys or hearing?
The oral form is barely absorbed, but the injectable form reaches the body and carries the kidney and hearing risks typical of aminoglycoside antibiotics, so monitoring is used.
Should I finish the whole course?
Yes. Finish the course you are given, even once you feel better, so the parasite is fully cleared and less likely to come back.
Is it a normal antibiotic for chest or urine infections?
No. It belongs to the antibiotic family but is used against specific parasites, not for ordinary bacterial infections such as chest or urine infections.
The wider class
About Aminoglycoside antibiotic (antiprotozoal use)
Paromomycin belongs to the aminoglycoside antibiotic (antiprotozoal use) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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