Amikacin: veterinary dose and monograph

At a glance

Drug class

Antibiotic

Also known as

Amikacin sulfate, Amiglyde-V

Species with doses

Dogs, Cats, Horses, Birds, Rabbits, Ferrets, Guinea pigs, Reptiles, Chinchillas, Hamsters, Rats, Mice, Hedgehogs, Sugar gliders and Primates

General dose range

10–30 mg/kg IV q24h — check the species tables for the indication

Routes

IV, IM, SC

Last reviewed

1 October 2026

Indications

• Resistant Gram-negative sepsis / pyelonephritis
• Pseudomonas otitis and soft-tissue infection
• Foal Gram-negative sepsis / septic arthritis
• Reptile and avian Gram-negative infections

Amikacin dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Resistant Gram-negative infection: Papich 5e: 15 mg/kg q24h IV, IM or SC. Plumb’s p.64: 15 mg/kg IV or 20 mg/kg SC/IM q24h — Greyhounds and possibly other sighthounds 10 mg/kg IV or 15 mg/kg SC/IM (KuKanich 2008); sepsis 20 mg/kg IV once daily; empiric 15–30 mg/kg. Neutropenic patients may need the daily dose divided q8h. Give IV over 20–30 min; monitor renal function and urine sediment.

Cats

• Resistant Gram-negative infection: Papich 5e: 10 mg/kg q24h IV, IM or SC. Plumb’s p.64: empiric 10–15 mg/kg (Autran de Morais 2009); 15 mg/kg once daily (Trepanier 1999); sepsis 20 mg/kg IV once daily (Hardie 2000). Nephrotoxic — hydrate; avoid with other nephrotoxins.

Horses

• Adult susceptible infection: Papich 5e and Plumb’s p.64 (Geor & Papich 2003): adults 10 mg/kg IV or IM once daily. Intrauterine: 2 g in 200 mL sterile saline daily for 3 days (label). Regional limb perfusion 500 mg–2 g (Plumb’s).
• Foal sepsis: Papich 5e: foals 20 mg/kg q24h IV. Plumb’s p.64: neonatal foals 21 mg/kg IV once daily (Magdesian 2004) or initially 25 mg/kg IV once daily with therapeutic drug monitoring (Bucki 2004); foals under 30 days 20–25 mg/kg IV or IM q24h (Geor & Papich 2003).

Birds

• Gram-negative infection (companion birds): Plumb’s p.64: 15 mg/kg IM or SC q12h (Hoeffer 1995); gentamicin-resistant Gram-negatives 15–20 mg/kg IM once or twice daily (Clubb 1986); macaw sinusitis 40 mg/kg IM once or twice daily with sinus flushing. Keep the bird hydrated; nephrotoxic. (The previous 2.5–5 mg/kg was well below these doses.)

Rabbits

• Resistant Gram-negative infection: Plumb’s p.64 (Ivey & Morrisey 2000): rabbits 8–16 mg/kg total daily dose SC, IM or IV (may be divided q8–24h — once daily is more effective and less toxic); if IV, dilute in 4 mL/kg saline over 20 min. Morrisey & Carpenter: 5–10 mg/kg divided q8–24h. Nephrotoxic — keep well hydrated.

Ferrets

• Resistant Gram-negative infection: Plumb's p.65 (Williams 2000; Morrisey & Carpenter 2004): 8–16 mg/kg IM/IV/SC once daily (or divided q8–24h). Once-daily preferred — better efficacy, less nephrotoxicity. Hydrate first.

Guinea pigs

• Resistant Gram-negative infection: Plumb's p.65 (Morrisey & Carpenter 2004): 10–15 mg/kg SC/IM/IV divided q8–24h.

Reptiles

• Gram-negative / respiratory infection (snakes): Plumb’s p.64: snakes 5 mg/kg IM (forebody) loading dose, then 2.5 mg/kg q72h for 7–9 treatments (Gauvin 1993; Mader 1985) — house at the high end of the preferred temperature range; lower dose for Python curtus. Turtles with shell disease 10 mg/kg daily (water turtles) or every other day (tortoises) for 7–10 days. Hydrate; monitor uric acid.

Chinchillas

• Resistant Gram-negative infection: Plumb’s p.64: 10–15 mg/kg SC, IM or IV divided q8–24h (Morrisey & Carpenter 2004); 2–5 mg/kg SC or IM q8–12h (Hayes 2000).

Hamsters

• Resistant Gram-negative infection: Plumb's p.65: hamsters/rats/mice 10 mg/kg SC/IM q12h.

Rats

• Resistant Gram-negative infection: Plumb's p.65: 10 mg/kg SC/IM q12h.

Mice

• Resistant Gram-negative infection: Plumb's p.65: 10 mg/kg SC/IM q12h.

Hedgehogs

• Resistant Gram-negative infection: Carpenter Exotic Animal Formulary 6th ed, Table 8-1 (p.512): hedgehogs 2.5–5 mg/kg IM q8–12h. Maintain hydration — aminoglycoside nephrotoxicity risk.

Sugar gliders

• Severe Gram-negative infection: Carpenter Exotic Animal Formulary 6th ed, Table 7-1 (p.497): sugar gliders 3 mg/kg SC/IM q12h; up to 10 mg/kg SC/IM q12h ×5 days for Gram-negative pneumonia. Give SC fluids concurrently — nephrotoxicity risk.

Primates

• Resistant Gram-negative infection (monkeys): Carpenter Exotic Animal Formulary 6th ed, Table 13-1 (p.680): monkeys 5 mg/kg IM q8h; chimpanzees 2.3 mg/kg IM q24h. Poor oral absorption; nephrotoxic/ototoxic — hydrate well.

Contraindications

Pre-existing renal impairment, dehydration, concurrent nephrotoxins (NSAIDs, furosemide, amphotericin B). Avoid in food animals (prolonged tissue residues). Myasthenia gravis (neuromuscular blockade).

Adverse effects

• Nephrotoxicity — proximal tubular damage (often reversible if caught early)
• Ototoxicity — vestibular and cochlear (may be irreversible)
• Neuromuscular blockade (rare, under anaesthesia)

Drug interactions

• Beta-lactams (penicillins, cephalosporins): synergistic against some organisms, but physically inactivate aminoglycosides in vitro — NEVER mix in the same syringe or line; inactivation also occurs in vivo in renal failure
• Cephalosporins: possible additive nephrotoxicity, though Plumb's notes this was only well documented with cephaloridine and cephalothin (both withdrawn)
• Loop diuretics (furosemide, torsemide) and osmotic diuretics (mannitol): increase nephrotoxic and ototoxic potential
• NSAIDs: additive nephrotoxic risk — many clinicians avoid the combination
• Other nephrotoxic drugs (cisplatin, amphotericin B, polymyxin B, vancomycin): increased nephrotoxicity risk
• General anaesthetics and neuromuscular blocking agents: may potentiate neuromuscular blockade
• Laboratory: amikacin assay results read falsely LOW if the patient is concurrently on a beta-lactam

Pregnancy and lactation

Aminoglycosides cross the placenta and are potentially nephro/ototoxic to the foetus — use only when no safer alternative exists.

Monitoring

• Renal: urine sediment (casts) daily, BUN/creatinine q48–72h
• Trough levels < 2–5 µg/mL to confirm clearance before the next dose where assay is available
• Hydration status — never dose a dehydrated patient
• Vestibular signs (head tilt, nystagmus)

Toxicity and overdose

Plumb's p.63: for inadvertent overdose, haemodialysis is very effective at reducing serum levels but is rarely practical in veterinary patients; peritoneal dialysis works but far less well. Complexing the drug with carbenicillin or ticarcillin is reportedly nearly as effective as haemodialysis, though amikacin is less susceptible to this effect than gentamicin or tobramycin, so the reduction achieved will be smaller. The clinically important toxicities are cumulative rather than acute: nephrotoxicity (proximal tubular), ototoxicity (vestibular and cochlear, often irreversible) and neuromuscular blockade. Risk rises sharply with pre-existing renal disease, neonatal or geriatric age, fever, sepsis and dehydration. NEVER dose a dehydrated patient.

Clinical pearls

• Once-daily dosing is both more effective (peak-dependent killing) and less nephrotoxic than divided dosing
• Always pair with IV fluid support and recheck renal values — discontinue at the first sign of tubular casts
• Synergistic with beta-lactams against Enterococcus / Pseudomonas — give in separate syringes

Mechanism of action

Aminoglycoside. Plumb's p.63: binds irreversibly to the 30S ribosomal subunit, inhibiting protein synthesis — bactericidal and CONCENTRATION-dependent (hence once-daily dosing, which maximises peak:MIC while allowing a drug-free trough for tubular recovery). Spectrum covers most E. coli, Klebsiella, Proteus, Pseudomonas, Salmonella, Enterobacter, Serratia, Shigella, Mycoplasma and Staphylococcus. Crucially, several Pseudomonas aeruginosa, Proteus and Serratia strains that are RESISTANT to gentamicin remain susceptible to amikacin — this is its main niche. Activity is enhanced in an alkaline environment and reduced in acidic or anaerobic conditions (e.g. abscess cavities).

Formulations and products

• Amikacin sulfate 50 mg/mL injection
• Amikacin sulfate 250 mg/mL injection

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other antibiotics

• Amoxicillin
• Amoxicillin / Clavulanic Acid
• Ampicillin
• Apramycin
• Azithromycin
• Cefadroxil
• Cefazolin
• Cefixime

Frequently asked questions