[3] Common side effects when taken by mouth include loss of appetite, vomiting, abdominal pain, and diarrhea.

[4] Paromomycin is in the aminoglycoside family of medications and causes microbe death by stopping the creation of bacterial proteins.

Paromomycin topical cream with or without gentamicin is an effective treatment for ulcerative cutaneous leishmaniasis, according to the results of a phase-3, randomized, double-blind, parallel group–controlled trial.

[15] The most common adverse effects associated with paromomycin sulfate are abdominal cramps, diarrhea, heartburn, nausea, and vomiting.

Other less common adverse events include myasthenia gravis, kidney damage, enterocolitis, malabsorption syndrome, eosinophilia, headache, hearing loss, ringing in the ear, itching, severe dizziness, and pancreatitis.

[17] Concurrent use of colistimethate and paromomycin can cause a dangerous slowing of breathing known as respiratory depression, and should be done with extreme caution if necessary.

[17] Paromomycin is a protein synthesis inhibitor in nonresistant cells by binding to 16S ribosomal RNA.

Paromomycin binding provides enough energy for residue expulsion and thus results in the ribosome incorporating the incorrect amino acid into the nascent peptide chain.

Any obstructions or factors which impair GI motility may increase the absorption of the drug from the digestive tract.

In addition, any structural damage, such as lesions or ulcerations, will tend to increase drug absorption.