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Paromomycin sulfate
Systematic (IUPAC) name
(2R,3S,4R,5R,6S)-5-amino-6-[(1R,2S,3S,4R,6S)-
4,6-diamino-2-[(2S,3R,4R,5R)-4-[(2R,3R,4R,5R,6S)-
3-amino-6-(aminomethyl)-4,5-dihydroxy-oxan-2-yl]
oxy-3-hydroxy-5-(hydroxymethyl)oxolan-2-yl]oxy-
3-hydroxy-cyclohexyl]oxy-2-(hydroxymethyl)oxane-3,4-diol
Identifiers
CAS number 1263-89-4
ATC code A07AA06
PubChem 165580
DrugBank ?
Chemical data
Formula C23H47N5O18S 
Mol. mass 615.629 g/mol
Pharmacokinetic data
Bioavailability None
Metabolism None
Half life  ?
Excretion Fecal
Therapeutic considerations
Pregnancy cat.

C(US)
Legal status

Rx only U.S.
Routes Oral, intramuscular

Paromomycin sulfate (synonyms: monomycin, aminosidine[1]; brand name Humatin) is an aminoglycoside antibiotic, first isolated from Streptomyces krestomuceticus in 1950s.[2]

Contents

[edit] Uses

It is an antibiotic designed to fight intestinal infections such as cryptosporidiosis,[3] amoebiasis,[4] and leishmaniasis.[5]

The route of administration is intramuscular injection.

[edit] Mechanism

Paromomycin inhibits protein synthesis by binding to 16S ribosomal RNA.[6]

[edit] History and availability

Monomycin was demonstrated to be effective against cutaneous leishmaniasis in clinical studies in the USSR in the 1960s, and in trials with visceral leishmaniasis in early 1990s.[1]

It was developed as a therapeutic against visceral leishmaniasis by the Institute for OneWorld Health. Paromomycin was granted orphan drug status in 2005[7] and was approved by the Drug Controller General of India in September 2006 for treatment of visceral leishmaniasis.[8]

As of February 5th, 2008, King Pharmaceuticals is discontinuing the sale of Humatin, Paromomycin continues to be available in the United States from another manufacturer.[9]

[edit] References

  1. ^ a b Neal R.A. et al. (1994). "Aminosidine ointments for the treatment of experimental cutaneous leishmaniasis". Transactions of the Royal Society of Tropical Medicine and Hygiene 88 (2): 223–5. doi:10.1016/0035-9203(94)90307-7. 
  2. ^ Davidson R.N., den Boer M., Ritmeijer K. (2008). "Paromomycin". Transactions of the Royal Society of Tropical Medicine and Hygiene. doi:10.1016/j.trstmh.2008.09.008. 
  3. ^ Sweetman S.C. (Editor). (2002). Martindale: the complete drug reference. 33rd ed. London: Pharmaceutical Press
  4. ^ paromomycin at Dorland's Medical Dictionary
  5. ^ Sundar S, Jha TK, Thakur CP, Sinha PK, Bhattacharya SK (June 2007). "Injectable paromomycin for visceral leishmaniasis in India". N. Engl. J. Med. 356 (25): 2571–81. doi:10.1056/NEJMoa066536. PMID 17582067. http://content.nejm.org/cgi/pmidlookup?view=short&pmid=17582067&promo=ONFLNS19. 
  6. ^ Vicens, Quentin; Eric Westhof (August 2001). "Crystal Structure of Paromomycin Docked into the Eubacterial Ribosomal Decoding A Site". Structure 9 (8): 647–658. doi:10.1016/S0969-2126(01)00629-3. PMID 11587639. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VSR-43VBX2W-C&_user=10&_coverDate=08%2F31%2F2001&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=1b1e19d11ca34e14eca1603c2be009d5. Retrieved 2007-02-10. 
  7. ^ Institute for OneWorld Health (23 May 2005). "Institute for OneWorld Health Drug Receives “Orphan” Designation From U.S. and European Regulatory Agencies". Press release. http://www.oneworldhealth.org/media/details.php?prID=115. Retrieved 2007-02-10. 
  8. ^ Institute for OneWorld Health (8 September 2006). "New cure for deadly visceral leishmaniasis (kala-azar) approved by government of India". Press release. http://www.oneworldhealth.org/media/details.php?prID=154. Retrieved 2007-02-10. 
  9. ^ humatin_king.pdf at fda.gov
v • d • e
Antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07)
Intestinal anti-infectives
Intestinal adsorbents
Antipropulsives (opioids)

Opium (Laudanum) · Codeine · Morphine (Paregoric)

crosses BBB: Diphenoxylate · Difenoxin

does not cross BBB: Loperamide
Intestinal anti-inflammatory agents
Antidiarrheal micro-organisms
Other antidiarrheals
v • d • e
Antiparasitics – antiprotozoal agents – agents against amoebozoa/amebicide (P01)
Entamoeba
Nitroimidazole derivatives
Other
Hydroxyquinoline derivatives
Dichloroacetamide derivatives
Paromomycin
Other/ungrouped
Acanthamoeba
#WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
see also diseases
v • d • e
Antiparasitics – antiprotozoal agents – Excavata antiparasitics (P01)
Discicristata
Trichozoa
#WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
see also diseases
v • d • e
Antibacterials: protein synthesis inhibitors (J01A, J01B, J01F, J01G, QJ01XQ)
30S
-mycin (Streptomyces)
Tetracyclines
50S
EF-G
Steroid antibacterials
#WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
v • d • e
Types of Carbohydrates
General:
Geometry
Monosaccharides
Ketotriose (Dihydroxyacetone) · Aldotriose (Glyceraldehyde)
Ketotetrose (Erythrulose) · Aldotetroses (Erythrose, Threose)
>6
Multiple
Major families of biochemicals
Saccharides/Carbohydrates/Glycosides · Amino acids/Peptides/Proteins/Glycoproteins · Lipids/Terpenes/Steroids/Carotenoids · Alkaloids/Nucleobases/Nucleic acids · Cofactors/Phenylpropanoids/Polyketides/Tetrapyrroles


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