Nephrotoxicity, Ototoxicity

• The use of capreomycin in patients with renal insufficiency or pre-existing auditory impairment must be undertaken with great caution, and the risk of additional cranial nerve VIII impairment or renal injury should be weighed against the benefits to be derived from therapy.
• Since other parenteral antituberculosis agents (streptomycin, viomycin) also have similar and someties irreversible toxic effects, particularly on cranial nerve VIII and renal function, simultaneous administration of these agents with capreomycin is not recommended.
• Use with nonantituberculosis drugs (e.g., polymixin A sulfate, colisitin sulfate, amikacin, gentamicin, tobramycin, vancompycin, kanamycin, and neomycin) having ototoxic or nephrotoxic potential should be undertaken only with great caution.

Pregnancy

• The safety of capreomycin in pregnancy has not been determined.

Pediatric Usage

• Safety and effectiveness in pediatric patients has not been established.