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Merkacin

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Amikacin · World Medicine Ilac San. ve Tic. A.S.

1 form: solution. In force in Georgia: 1 of 1 (human register).

Forms and doses1 of 1 in force in Georgia

The dose from the product's label, by species and weight. Check the label of the pack you use.

Choose species and weight; the matching row will be highlighted.
Form Species Dose Frequency Georgia
500 mg/2 ml, Solution · Cat Cat Serious infection caused by susceptible bacteria · Intravenous: 10–15 mg/kgSerious infection caused by susceptible bacteria · Intramuscular: 10–15 mg/kg - Georgia Yes, human
In force until 25 Oct 2027
Human (Ministry of Health, RAMA)
In the register: მერკაცინი 500 მგ/2 მლ, 2 მლ IM/IV საინექციო ხსნარი, №1
№ R-036691
Verified on: 27 Oct 2026
500 mg/2 ml, Solution · Dog Dog Serious infection caused by susceptible bacteria · Intravenous: 15–30 mg/kgSerious infection caused by susceptible bacteria · Intramuscular: 15–30 mg/kg - Georgia Yes, human
In force until 25 Oct 2027
Human (Ministry of Health, RAMA)
In the register: მერკაცინი 500 მგ/2 მლ, 2 მლ IM/IV საინექციო ხსნარი, №1
№ R-036691
Verified on: 27 Oct 2026
Details: pack, label wording, sources, registration

Merkacin 500 mg/2 ml, Solution

amikacin 250 mg/ml, solution for IM/IV injection, 2 ml vial, human medicine
vetman assessment
vetman’s 10-point assessment brings together a product’s regulatory credibility, clinical efficacy, safety and practicality. Cost-effectiveness is assessed only when reliable data are available. It is informational and does not replace a veterinarian’s clinical judgment for an individual patient.
Dog IM or IV amikacin for a serious infection caused by a culture-confirmed susceptible bacterium when a safer effective antimicrobial is unsuitable
6.4/10
Situational / acceptable
vetman assessment

Merkacin

500 mg/2 ml, amikacin 250 mg/ml, solution for IM/IV injection, 2 ml vial, human medicine
Assessed clinical scopeDog · IM or IV amikacin for a serious infection caused by a culture-confirmed susceptible bacterium when a safer effective antimicrobial is unsuitable · IM,IV
Care settingVeterinary hospital or closely monitored clinic: culture and susceptibility, corrected hydration, baseline and serial renal assessment, and therapeutic drug monitoring where available
vetman score 6.4/10 Situational / acceptable
Evidence confidence: Medium Georgia: Yes, human · № R-036691 · Verified on 27 Oct 2026 Off-label use

A useful but deliberately reserved parenteral option for a serious, culture-confirmed susceptible infection when safer effective antimicrobials are unsuitable. The dose is practical in hospital, but off-label status, stewardship and substantial renal, auditory and neuromuscular risks demand active selection and monitoring.

Regulatory and scientific credibility6.5/10

The exact strength, vial, manufacturer and current Georgian human registration are traceable, but there is no internationally recognised veterinary authorisation or regulator SPC for exact Merkacin in dogs or cats. Current EU/EEA, UK and US register audits found no exact product while returning valid amikacin or aminoglycoside controls.

Clinical efficacy7.5/10

Amikacin has guideline-supported, concentration-dependent activity for selected susceptible severe infections, direct canine pharmacokinetics and current dog dosing guidance. Its role is deliberately narrow: culture-directed rescue for organisms resistant to safer choices, not routine empirical coverage; evidence is stronger for PK and microbiology than for comparative clinical outcomes across every infection site.

Safety and tolerability5.0/10

Once-daily exposure and active renal monitoring make risk more controllable, but nephrotoxicity, potentially irreversible cochlear or vestibular injury and neuromuscular blockade remain serious, duration- and exposure-sensitive hazards. Dehydration, renal impairment and concurrent nephrotoxic treatment materially worsen the margin.

Clinical practicality7.0/10

The ready-to-use 250 mg/ml solution and q24h regimen permit accurate hospital dosing at 0.06-0.12 ml/kg by an authorised product route without reconstitution. Practicality is reduced by small-volume precision, IV access or repeated IM administration, culture dependence, hydration correction and serial renal/urine monitoring; drug-level monitoring may not be locally available.

Full-course cost-effectiveness-

A current Georgian patient-weight-adjusted full-course cost and monitoring cost were not available; cost is excluded from the denominator.

Important safety and use flags

  • Reserved role: use systemic amikacin for a serious infection with a culture-confirmed susceptible organism when a safer effective antimicrobial is unsuitable. It is not routine empirical first-line therapy.
  • Obtain culture and susceptibility whenever feasible and review source control, penetration and a narrower alternative. EMA AMEG places amikacin in Category C — Caution: use only when Category D options are not clinically effective.
  • Every dog and cat use of this exact human Merkacin vial is extra-label. The veterinary doses come from MSD/ISCAID amikacin guidance and are converted using 250 mg/ml; they are not animal doses from the Merkacin human label.
  • Dose guide for this 250 mg/ml vial: dog 15-30 mg/kg = 0.06-0.12 ml/kg IM or IV q24h; cat 10-15 mg/kg = 0.04-0.06 ml/kg IM or IV q24h. Duration is infection- and response-specific; do not invent a fixed course.
  • Correct dehydration and haemodynamic instability before starting. Avoid in renal impairment unless culture-confirmed need and lack of a safer effective option justify the risk; document that decision and individualise the interval.
  • Record baseline creatinine/urea, urine specific gravity or sediment and urine output, then monitor serially during treatment. Stop and reassess for rising creatinine, reduced concentrating ability, casts or oliguria; monitoring frequency must reflect illness, exposure and renal risk.
  • Use therapeutic drug monitoring where available, especially with critical illness, altered volume of distribution, renal dysfunction or a prolonged course. Do not reduce a concentration-dependent peak reflexively; adjust exposure and interval from patient data.
  • Avoid concurrent nephrotoxic or strongly nephroactive treatment when possible, including amphotericin B, cisplatin, vancomycin, NSAIDs and intensive diuretic or osmotic therapy. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
  • Nephrotoxicity and cochlear or vestibular injury may be severe and auditory injury may be irreversible. Reassess for hearing change, nystagmus, head tilt or ataxia; cats may be more sensitive and deserve an especially conservative risk assessment.
  • Aminoglycosides can potentiate neuromuscular blockade. Use additional caution with myasthenia gravis, anaesthesia, magnesium or neuromuscular blockers and be ready to support ventilation. Do not mix amikacin with a beta-lactam in the same syringe or infusion solution; administer separately.
Assessment sources
  1. Merkacin exact product2026
  2. MSD amikacin dose2026
  3. ISCAID respiratory2017
  4. ISCAID pyoderma2025
  5. Dog amikacin PK1985
  6. CKD dose adjustment2022
  7. Amikacin human label2023
  8. EMA AMEG category C2025
  9. EU amikacin market audit2026
  10. UK amikacin market audit2026
  11. FDA amikacin market audit2026
Assessed: 27 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Cat IM or IV amikacin for a serious infection caused by a culture-confirmed susceptible bacterium when a safer effective antimicrobial is unsuitable
6.1/10
Situational / acceptable
vetman assessment

Merkacin

500 mg/2 ml, amikacin 250 mg/ml, solution for IM/IV injection, 2 ml vial, human medicine
Assessed clinical scopeCat · IM or IV amikacin for a serious infection caused by a culture-confirmed susceptible bacterium when a safer effective antimicrobial is unsuitable · IM,IV
Care settingVeterinary hospital or closely monitored clinic: culture and susceptibility, corrected hydration, baseline and serial renal assessment, and therapeutic drug monitoring where available
vetman score 6.1/10 Situational / acceptable
Evidence confidence: Medium Georgia: Yes, human · № R-036691 · Verified on 27 Oct 2026 Off-label use

A situational feline parenteral option for a serious, culture-confirmed susceptible infection when safer effective antimicrobials are unsuitable. A defined dose and direct feline PK support use, but limited outcome evidence, extra-label status and a narrow toxicity margin require especially careful monitoring.

Regulatory and scientific credibility6.5/10

The exact strength, vial, manufacturer and current Georgian human registration are traceable, but there is no internationally recognised veterinary authorisation or regulator SPC for exact Merkacin in dogs or cats. Current EU/EEA, UK and US register audits found no exact product while returning valid amikacin or aminoglycoside controls.

Clinical efficacy7.0/10

Current guidance provides a feline dose and a culture-directed role for selected susceptible severe infections, supported by direct feline pharmacokinetics. However, feline comparative clinical-outcome evidence is limited, site-specific efficacy cannot be assumed, and the drug should not be used as broad empirical first-line therapy.

Safety and tolerability4.5/10

Cats may be more sensitive to aminoglycoside toxicity. Nephrotoxicity, potentially irreversible auditory or vestibular injury and neuromuscular blockade are material hazards, with no exact-product feline safety dossier; dehydration, renal impairment, prolonged exposure and concurrent nephrotoxic treatment further narrow the margin.

Clinical practicality6.5/10

The ready-to-use 250 mg/ml solution and q24h regimen permit small, measurable hospital doses of 0.04-0.06 ml/kg by IM or IV route without reconstitution. Very small volumes, venous access or repeated IM restraint, culture dependence and intensive renal, urine and clinical monitoring make delivery more demanding in cats.

Full-course cost-effectiveness-

A current Georgian patient-weight-adjusted full-course cost and monitoring cost were not available; cost is excluded from the denominator.

Important safety and use flags

  • Reserved role: use systemic amikacin for a serious infection with a culture-confirmed susceptible organism when a safer effective antimicrobial is unsuitable. It is not routine empirical first-line therapy.
  • Obtain culture and susceptibility whenever feasible and review source control, penetration and a narrower alternative. EMA AMEG places amikacin in Category C — Caution: use only when Category D options are not clinically effective.
  • Every dog and cat use of this exact human Merkacin vial is extra-label. The veterinary doses come from MSD/ISCAID amikacin guidance and are converted using 250 mg/ml; they are not animal doses from the Merkacin human label.
  • Dose guide for this 250 mg/ml vial: dog 15-30 mg/kg = 0.06-0.12 ml/kg IM or IV q24h; cat 10-15 mg/kg = 0.04-0.06 ml/kg IM or IV q24h. Duration is infection- and response-specific; do not invent a fixed course.
  • Correct dehydration and haemodynamic instability before starting. Avoid in renal impairment unless culture-confirmed need and lack of a safer effective option justify the risk; document that decision and individualise the interval.
  • Record baseline creatinine/urea, urine specific gravity or sediment and urine output, then monitor serially during treatment. Stop and reassess for rising creatinine, reduced concentrating ability, casts or oliguria; monitoring frequency must reflect illness, exposure and renal risk.
  • Use therapeutic drug monitoring where available, especially with critical illness, altered volume of distribution, renal dysfunction or a prolonged course. Do not reduce a concentration-dependent peak reflexively; adjust exposure and interval from patient data.
  • Avoid concurrent nephrotoxic or strongly nephroactive treatment when possible, including amphotericin B, cisplatin, vancomycin, NSAIDs and intensive diuretic or osmotic therapy. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
  • Nephrotoxicity and cochlear or vestibular injury may be severe and auditory injury may be irreversible. Reassess for hearing change, nystagmus, head tilt or ataxia; cats may be more sensitive and deserve an especially conservative risk assessment.
  • Aminoglycosides can potentiate neuromuscular blockade. Use additional caution with myasthenia gravis, anaesthesia, magnesium or neuromuscular blockers and be ready to support ventilation. Do not mix amikacin with a beta-lactam in the same syringe or infusion solution; administer separately.
Assessment sources
  1. Merkacin exact product2026
  2. MSD amikacin dose2026
  3. ISCAID respiratory2017
  4. Cat amikacin PK1988
  5. CKD dose adjustment2022
  6. Amikacin human label2023
  7. EMA AMEG category C2025
  8. EU amikacin market audit2026
  9. UK amikacin market audit2026
  10. FDA amikacin market audit2026
Assessed: 27 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Composition / strength
Amikacin250 mg/ml
Formulation Type
Solution
Administration route
Intramuscular, Intravenous
Registration
Georgia Yes, human
In force until 25 Oct 2027
Human (Ministry of Health, RAMA)
In the register: მერკაცინი 500 მგ/2 მლ, 2 მლ IM/IV საინექციო ხსნარი, №1
№ R-036691
Verified on: 27 Oct 2026
 EU No
Verified on: 27 Oct 2026
 UK No
Verified on: 27 Oct 2026
 US No
Verified on: 27 Oct 2026
Controlled in Georgia
Unknown
Cat
WeightSerious infection caused by susceptible bacteria · IntravenousSerious infection caused by susceptible bacteria · Intramuscular
Any weight 10–15 mg/kg 10–15 mg/kg
  • Serious infection caused by susceptible bacteria · Intravenous (every 24 hours): Extra-label veterinary use derived from the public MSD/ISCAID amikacin guidance, not from the human Merkacin label. At 250 mg/ml this equals 0.04-0.06 ml/kg IV every 24 hours. Cats may be more sensitive to toxicity; reserve for serious culture-confirmed susceptible infection and monitor renal and auditory/vestibular status.
  • Serious infection caused by susceptible bacteria · Intramuscular (every 24 hours): Extra-label veterinary use derived from the public MSD/ISCAID amikacin guidance, not from the human Merkacin label. At 250 mg/ml this equals 0.04-0.06 ml/kg IM every 24 hours. Cats may be more sensitive to toxicity; reserve for serious culture-confirmed susceptible infection and monitor renal and auditory/vestibular status.
Source:
MSD amikacin dose
Guideline or consensus statement
Recommendations agreed by a panel of veterinary specialists after reviewing the evidence. They guide practice and do not authorise a product.
Dosages of aminoglycosides - amikacin in dogs and cats
MSD Veterinary Manual, 2026
Dog
WeightSerious infection caused by susceptible bacteria · IntravenousSerious infection caused by susceptible bacteria · Intramuscular
Any weight 15–30 mg/kg 15–30 mg/kg
  • Serious infection caused by susceptible bacteria · Intravenous (every 24 hours): Extra-label veterinary use derived from the public MSD/ISCAID amikacin guidance, not from the human Merkacin label. At 250 mg/ml this equals 0.06-0.12 ml/kg IV every 24 hours. Reserve for serious culture-confirmed susceptible infection; assess hydration and kidney function and monitor during therapy.
  • Serious infection caused by susceptible bacteria · Intramuscular (every 24 hours): Extra-label veterinary use derived from the public MSD/ISCAID amikacin guidance, not from the human Merkacin label. At 250 mg/ml this equals 0.06-0.12 ml/kg IM every 24 hours. Reserve for serious culture-confirmed susceptible infection; assess hydration and kidney function and monitor during therapy.
Source:
MSD amikacin dose
Guideline or consensus statement
Recommendations agreed by a panel of veterinary specialists after reviewing the evidence. They guide practice and do not authorise a product.
Dosages of aminoglycosides - amikacin in dogs and cats
MSD Veterinary Manual, 2026

Known Contraindications

  • Critical
    Do not use in a patient with known hypersensitivity to amikacin or another aminoglycoside.
    Sources: FDA
  • Critical
    Avoid amikacin when renal function is impaired unless culture-confirmed need and the absence of a safer effective alternative justify it. If it must be used, monitor renal function and drug exposure and extend the interval rather than automatically reducing the peak dose.
    Sources: ISCAID · MSD Vet Manual
  • Critical
    Do not start amikacin in a dehydrated or haemodynamically unstable patient before restoring perfusion and reassessing renal risk, unless a life-threatening infection leaves no safer effective option.
    Sources: ISCAID
  • Warning
    Amikacin can cause nephrotoxicity and irreversible cochlear or vestibular toxicity. Stop and reassess for rising creatinine, declining urine concentration, casts, oliguria, hearing change, nystagmus, head tilt or ataxia.
    Sources: ISCAID · MSD Vet Manual
  • Warning
    Aminoglycosides can potentiate neuromuscular blockade. Use additional caution with myasthenia gravis, anaesthesia, magnesium or neuromuscular blocking agents, and be prepared to support ventilation.

Known Drug Interactions

  • Major warning Amikacin + Amphotericin B
    Concurrent amikacin and Amphotericin B can increase nephrotoxic and/or ototoxic risk.
    Recommendation: Avoid the combination when a safer effective alternative exists. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
    Sources: ISCAID · MSD Vet Manual
  • Major warning Amikacin + Carprofen
    Concurrent amikacin and Carprofen can increase nephrotoxic and/or ototoxic risk.
    Recommendation: Avoid the combination when a safer effective alternative exists. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
    Sources: ISCAID · MSD Vet Manual
  • Major warning Amikacin + Cisplatin
    Concurrent amikacin and Cisplatin can increase nephrotoxic and/or ototoxic risk.
    Recommendation: Avoid the combination when a safer effective alternative exists. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
    Sources: ISCAID · MSD Vet Manual
  • Major warning Amikacin + Furosemide
    Concurrent amikacin and Furosemide can increase nephrotoxic and/or ototoxic risk.
    Recommendation: Avoid the combination when a safer effective alternative exists. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
    Sources: ISCAID · MSD Vet Manual
  • Major warning Amikacin + Mannitol
    Concurrent amikacin and Mannitol can increase nephrotoxic and/or ototoxic risk.
    Recommendation: Avoid the combination when a safer effective alternative exists. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
    Sources: ISCAID · MSD Vet Manual
  • Major warning Amikacin + Meloxicam
    Concurrent amikacin and Meloxicam can increase nephrotoxic and/or ototoxic risk.
    Recommendation: Avoid the combination when a safer effective alternative exists. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
    Sources: ISCAID · MSD Vet Manual
  • Major warning Amikacin + Vancomycin
    Concurrent amikacin and Vancomycin can increase nephrotoxic and/or ototoxic risk.
    Recommendation: Avoid the combination when a safer effective alternative exists. If unavoidable, correct hydration and intensify renal, urine and clinical monitoring.
    Sources: ISCAID · MSD Vet Manual

Professional reference for veterinary professionals. Not advertising and not a substitute for the product label/SPC.

For veterinary professionals only. It does not replace clinical judgement or the product label; check the dose in the official label (SPC). vetman is not liable for harm caused by using this information.

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This reference is still growing. Missing a product? Let us know. · Report an error or request an addition · Updated: 27 Oct 2026

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