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Grasil injection is a brand form of amikacin (an aminoglycoside antibiotic). It is used to treat serious bacterial infections caused by organisms susceptible to amikacin. The 1 ml ampoule delivers 25 mg of amikacin. The injectable formulation ensures rapid and direct systemic availability.
Active ingredient: Amikacin sulfate equivalent to 25 mg per 1 ml ampoule
Excipients / inactives: Water for injection, stabilizers, buffers, etc. (as per manufacturer)
Aminoglycoside antibiotic (bactericidal, concentration-dependent)
Sterile injectable solution — 1 ml ampoule containing 25 mg amikacin
Grasil (amikacin) is indicated for serious infections caused by Gram-negative bacteria or those resistant to other antibiotics, such as:
Bacteremia / sepsis
Lower respiratory tract infections
Intra-abdominal infections
Urinary tract infections
Bone and joint infections
Skin & soft tissue infections
Postoperative infections
Others where a potent aminoglycoside is needed
The dose for amikacin is typically calculated based on patient weight and renal function.
A commonly used regimen is 15 mg/kg per day, divided into multiple doses or sometimes once daily, depending on severity and pharmacokinetics.
In your product case (25 mg per 1 ml ampoule), multiple ampoules might be used to reach the needed dose depending on weight, under medical guidance.
Dose adjustments in renal impairment are critical.
Potential symptoms: hearing damage (ototoxicity), kidney damage (nephrotoxicity), neuromuscular blockade (weakness), vestibular toxicity (dizziness)
Treatment: supportive care, stopping the drug, monitoring kidney function, hearing tests, hydration, monitoring of electrolytes.
In clinical settings, missing a dose must be evaluated by the treating physician.
Do not double up the next dose to compensate.
Administer intravenous (IV) or intramuscular (IM) routes.
For IV, infusion over 30–60 minutes is common to reduce toxicity risk.
Use aseptic technique.
Monitor patient during and after administration (renal function, hearing, balance, vital signs).
Known hypersensitivity or allergic reaction to amikacin or aminoglycosides
Severe renal impairment (unless dose adjustment)
Myasthenia gravis or neuromuscular diseases (risk of neuromuscular blockade)
Pregnancy and lactation: use only if benefits outweigh risks (aminoglycosides can cross placenta)
Use with caution in the elderly
Common / less serious:
Nausea, vomiting
Loss of appetite
Dizziness
Injection site reactions
Headache
Mild renal function changes
Serious / toxic:
Ototoxicity (hearing loss, tinnitus, vestibular damage)
Nephrotoxicity (renal damage)
Neuromuscular blockade, especially in susceptible individuals
Allergic reactions (rash, anaphylaxis)
Regularly monitor renal function (serum creatinine, BUN)
Monitor auditory and vestibular function (hearing tests)
Hydration is important to reduce nephrotoxicity
Avoid use with other nephrotoxic or ototoxic drugs
Use the lowest effective dose for shortest duration
Inform surgical / dental teams of amikacin use
Concurrent use of other nephrotoxic agents (e.g., aminoglycosides, vancomycin, cisplatin, loop diuretics) increases kidney risk
Other ototoxic drugs (e.g., loop diuretics) may add hearing risk
Neuromuscular blocking agents (e.g., suxamethonium, tubocurarine) may have additive effects on muscle weakness
Store at controlled room temperature, below recommended maximum (often ≤ 25–30 °C)
Protect from light, moisture
Do not freeze
Use before expiry
Dispose unused/expired ampoules safely as medical waste
Amikacin is not a narcotic or controlled drug but is a prescription-only antibiotic, requiring medical oversight
Always adjust dose for renal function
Use slow infusion to minimize toxicity
Monitor hearing and kidney parameters during therapy
Avoid combining with other harmful drugs
Use minimal effective duration
Inform patients of signs of hearing loss or dizziness
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