Two medicines, side by side
Amikacin vs plazomicin
Amikacin is labeled for bacterial infections; plazomicin for urinary tract infections. Their labels share no use, so they are not alternatives to each other. Drugs@FDA records approvals of amikacin since 2018 and of plazomicin since 2018.
Check it at the source: the amikacin FDA label on DailyMed (effective December 10, 2025); the plazomicin FDA label on DailyMed (effective December 20, 2024).
Highlights of the amikacin record
Amikacin (Arikayce) · label of December 10, 2025
Patients treated with parenteral aminoglycosides should be under close clinical observation because of the potential ototoxicity and nephrotoxicity associated with their use. Safety for treatment periods which are longer than 14 days has not been established.
Used for
From the label: indicationsAmikacin Sulfate Injection is indicated in the short-term treatment of serious infections due to susceptible strains of Gram-negative bacteria, including Pseudomonas species, Escherichia coli, species of indole-positive and indole-negative Proteus, Providencia species, Klebsiella-Enterobacter-Serratia species, and Acinetobacter ( Mima-Herellea ) species. […]
On the market
- Earliest approval on file
- September 28, 2018
- Generic labelers
- 6 labelers
- Pharmacy cost
- $2.33 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 4
Highlights of the plazomicin record
Plazomicin (Zemdri) · label of December 20, 2024
NEPHROTOXICITY, OTOTOXICITY, NEUROMUSCULAR BLOCKADE and FETAL HARM Nephrotoxicity has been reported with ZEMDRI. The risk of nephrotoxicity is greater in patients with impaired renal function, the elderly, and in those receiving concomitant nephrotoxic medications. Assess creatinine clearance in all patients prior to initiating therapy and daily during therapy [see Dosage and Administration (2.2) and Warnings and Precautions (5.1) ].
Used for
From the label: indicationsINDICATIONS AND USAGE ZEMDRI is an aminoglycoside antibacterial indicated for the treatment of patients 18 years of age or older with Complicated Urinary Tract Infections (cUTI) including Pyelonephritis. ( 1.1 ) As only limited clinical safety and efficacy data are available, reserve ZEMDRI for use in patients who have limited or no alternative treatment options. […]
On the market
- Earliest approval on file
- June 25, 2018
- Generic labelers
- none listed
- Pharmacy cost
- Not in the survey
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Amikacin label of December 10, 2025, Plazomicin label of December 20, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do amikacin and plazomicin differ on the record?
Both labels carry a boxed warning; the records quote them.
Generics: amikacin since 1981; plazomicin none approved (Drugs@FDA).
| Amikacin | Plazomicin | |
|---|---|---|
| Labeled for | Bacterial infections | Urinary tract infections |
| Pharmacologic class | Aminoglycoside Antibacterial | n/a |
| How it works (label) | n/a | ZEMDRI is an antibacterial drug [see Microbiology (12.4) ]. |
| Half-life (label) | General Pharmacokinetic studies in normal adult subjects reveal the mean serum half-life to be slightly over 2 hours with a mean total apparent volume of distribution of 24 liters (28% of the body weight). | n/a |
| Earliest approval on file (Drugs@FDA) | September 28, 2018 | June 25, 2018 |
| First generic approved | January 22, 1981 | none |
| Generic labelers (NDC) | 6 labelers | none listed |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $2.33 per mL (Amikacin sulf 500 mg/2 mL vial) | n/a |
| 12-month price change | -23% | n/a |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 4 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 18,617 | 3 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to amikacin
- every medicine labeled for the same conditions