Monitoring the blood level is the standard safeguard for this class, and for a person carrying one mitochondrial change it does not work — the hearing can go after a single ordinary dose at a normal level.
Avoid in a carrier of m.1555A>G unless the infection is life-threatening and no safe alternative exists. Hearing loss can follow a single standard dose at a therapeutic blood level, so monitoring drug levels does not protect this person — which is the point most easily missed, because level monitoring is the usual safeguard for this class. The guideline covers the whole class rather than only the drugs a hospital reaches for most often: dibekacin, netilmicin, paromomycin and ribostamycin carry the same warning as gentamicin.
CPIC Guideline for the Use of Aminoglycosides Based on MT-RNR1 Genotype (Clin Pharmacol Ther 2022, PMID 34032273).
Whose work this rests on
Every guideline above was written by people. Named here because they are contributors to this page in the same sense anybody else on this site is.
Clinical pharmacology and therapeutics · 2022 · PMID 34032273
Variants MyGeneLog reports for these genes
These are the positions in your own file that carry the genes above. Not every gene in a guideline is one we report — where that is the case the gene appears above without a variant here, and the note says so.
This page is educational and contains no dosing information. Where a clinical guideline covers one of these gene-drug pairs it is written for prescribers and works through validated algorithms alongside clinical monitoring. Nothing here is a reason to start, stop, or change a medication — that conversation belongs with the clinician or pharmacist managing your treatment.