Summary
Treatment with neomycin sulphate 1.5 g/d for 8 weeks significantly lowered total serum cholesterol by an average of 19% in 15 out of 19 patients with primary hypercholesterolaemia and LDL-cholesterol by 21%, without significantly changing the corresponding triglyceride and HDL-cholesterol concentrations. Combined treatment with neomycin sulphate 1.5 g/d and d-thyroxine 6 mg/d for 8 weeks lowered total serum cholesterol in the same patients by an average of 30%, LDL-cholesterol by 27% and serum triglycerides by 18%, without significantly changing the HDL-cholesterol concentration. Continued treatment of 10 patients with neomycin sulphate 1.5 g/d for up to 13 months did not further change the reduced serum cholesterol level. 10 of 19 patients complained of side effects after 4–8 weeks of treatment with neomycin: 8 of recurrent diarrhoea, abdominal pain or poor appetite, and 4 of acute attacks of vertigo with nystagmus. All side effects were reversed a few days after stopping the neomycin treatment. No additional serious side effects due to d-thyroxine were observed. These serious side effects of neomycin sulphate limit its use to selected high risk patients with hypercholesterolaemia, who have failed to respond successfully to other LDL-cholesterollowering drugs. They stress the necessity for frequent monitoring for the side effects described.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Miettinen TA (1979) Effects of neomycin alone and in combination with cholestyramine on serum cholesterol and fecal steroids in hypercholesterolemia subjects. J Clin Invest 64: 1485–93
Samuel P (1979) Current concepts. Treatment of hypercholesterolemia with neomycin — a time for reappraisal. N Engl J Med 301: 595–7
Samuel P, Holtzman CM, Meilman E, Sekowski I (1970) Reduction of serum cholesterol and triglyceride levels by the combined administration of neomycin and clofibrate. Circulation 41: 109–14
Teoh PC (1973) Effect of combined administration of clofibrate and neomycin on serum cholesterol levels in familial type II hyperlipoproteinemia. Curr Med Res Opin 1: 535–9
Faergeman O (1973) Effects and side-effects of treatment of hypercholesterolemia with cholestyramine and neomycin. Acta Med Scand 194: 165–7
Eigler FW (1977) Ergebnisse der mikrobiellen Dekontamination in der Magen-und Darmchirurgie. Krankenhausarzt 50: 373–8
Manual of Laboratory Operations. Lipid Research Clinics Program. Volume 1: Lipid and lipoprotein analysis. National Heart and Lung Institute, National Institutes of Health, Bethesda, Maryland DHEW Publication number (NIH) 1974; pp 75–628
Hein H (1970) Verfahren zur Bestimmung kleiner Mengen von Neomycin. Zbl Bakteriol Parasitenkd Infektionskr Hyg Abt. 1 Orig Reihe B 214: 259–61
Brownlee KA (1965) Statistical theory and methodology in science and engineering, 2nd edition. Wiley, New York
Samuel P, Steiner A (1959) Effect of neomycin on serum cholesterol level in man. Proc Soc Exp Biol Med 100: 193–5
Samuel P, Meilman E (1967) Dietary lipids and reduction of serum cholesterol levels by neomycin in man. J Lab Clin Med 1967; 70: 471–9
Samuel P, Holtzman CM, Goldstein J (1967) Long-term reduction of serum cholesterol levels of patients with atherosclerosis by small doses of neomycin. Circulation 35: 938–45
Samuel P, Holtzman CM, Meilman E (1973) Effect of neomycin and other antibiotics on serum cholesterol levels and on 7 α-dehydroxylation of bile acids by the fecal bacterial flora in man. Circ Res 33: 393–402
Sedaghat A, Samuel P, Crouse JR, Ahrens EH jr (1975) Effects of neomycin on absorption synthesis, and/or flux of cholesterol in man. J Clin Invest 55: 12–21
Berk DP, Chalmers T (1970) Deafness complicating antibiotic therapy of hepatic encephalopathy. Ann Intern Med 73: 393–6
Goldner AI (1958) Profound deafness from neomycinsulfate. N Stat Med 22: 26–28
Gries FA, Miettinen TA (1974) Experience with non-absorbable drugs. In: Schettler G, Weizel A (eds) Atheroscleros III. Springer, Berlin Heidelberg New York, pp 816–821
Miettinen TA (1975) Mechanism of action of non-absorbable lipid-lowering drugs. Proceedings of the 6th International Congress of Pharmacology. Finn Pharmacol Soc 4: 149–58
Breen KJ, Bryant RE, Levinson JD, Schenker S (1972) Neomycin absorption in man. Studies of oral and enema administration and effect of intestinal ulceration. Ann Int Med 76: 211–8
Weinstein AJ, McHenry M, Gavan TL (1977) Systemic absorption of neomycin irrigating solution. J Am Med Assoc 238: 152–3
Schneiders H, Haralambie E, Towfigh H, Eigler FW, Linzenmeier G (1976) Über die Wirksamkeit der Antibioticavorbereitung in der Colonchirurgie. Der Chirurg 47: 33–8
Wagner WH (1975) Spezifische Ototoxizität von Aminoglykosid-Antibiotika. Immun Infekt 3: 241–51
Klemens UH, Löwis of Menar P (1974) Behandlung primärer Hyperlipoproteinämien vom Typ II a, II b mit hochgereinigtem D-Thyroxin. Dtsch Med Wochenschr 99: 487–94
The Coronary Drug Project Research Group (1972) The coronary drug project — Findings leading to further modification of its protocol with respect to dextrothyroxine. J Am Med Assoc 220: 996–1017
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vogelberg, K.H., Koschinsky, T., Hein, H. et al. Effect of neomycin sulphate alone and in combination with d-thyroxine on serum lipoproteins in hypercholesterolaemic subjects. Eur J Clin Pharmacol 22, 33–38 (1982). https://doi.org/10.1007/BF00606422
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00606422