Plazomicin interactions

Plazomicin (Zemdri), an aminoglycoside has 47 documented interactions across the FDA labels and fact sheets we index: 16 major, 23 moderate, 8 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (16)

  • Atracuriumneuromuscular blockerMajor

    During therapy with ZEMDRI, monitor for adverse reactions associated with neuromuscular blockade, particularly in high-risk patients, such as patients with underlying neuromuscular disorders (including myasthenia gravis) or in patients concomitantly receiving neuromuscular blocking agents [see Warning and Precautions (5.3) ] . (Plazomicin label, Boxed warning)

  • Botulinum toxin type Aneuromuscular blockerMajor

    During therapy with ZEMDRI, monitor for adverse reactions associated with neuromuscular blockade, particularly in high-risk patients, such as patients with underlying neuromuscular disorders (including myasthenia gravis) or in patients concomitantly receiving neuromuscular blocking agents [see Warning and Precautions (5.3) ] . (Plazomicin label, Boxed warning)

  • Bumetanideloop diureticMajor

    Drug Interactions Drugs with Ototoxic Potential (see WARNINGS ) Especially in the presence of impaired renal function, the use of parenterally administered bumetanide in patients to whom aminoglycoside antibiotics are also being given should be avoided, except in life-threatening conditions. (Bumetanide label, Drug interactions)

  • Aminoglycosides : Avoid concomitant use with aminoglycosides. (Carboplatin label, Drug interactions)

  • Cisatracuriumneuromuscular blockerMajor

    During therapy with ZEMDRI, monitor for adverse reactions associated with neuromuscular blockade, particularly in high-risk patients, such as patients with underlying neuromuscular disorders (including myasthenia gravis) or in patients concomitantly receiving neuromuscular blocking agents [see Warning and Precautions (5.3) ] . (Plazomicin label, Boxed warning)

  • Dicloxacillinpenicillin antibioticMajor

    In vitro mixing of penicillins and aminoglycosides should be avoided during concomitant therapy and the drugs should be administered separately. (Dicloxacillin label, Drug interactions)

  • FoscarnetantiviralMajor

    Because of foscarnet's tendency to cause renal impairment, the use of FOSCAVIR should be avoided in combination with potentially nephrotoxic drugs such as aminoglycosides, amphotericin B, cyclosporine, acyclovir, methotrexate, tacrolimus and intravenous pentamidine (see above) unless the potential benefits outweigh the risks to the patient. (Foscarnet label, Drug interactions)

  • GentamicinaminoglycosideMajor

    As with other aminoglycosides, gentamicin sulfate is potentially nephrotoxic. (Gentamicin label, Boxed warning)

  • IncobotulinumtoxinAneuromuscular blockerMajor

    During therapy with ZEMDRI, monitor for adverse reactions associated with neuromuscular blockade, particularly in high-risk patients, such as patients with underlying neuromuscular disorders (including myasthenia gravis) or in patients concomitantly receiving neuromuscular blocking agents [see Warning and Precautions (5.3) ] . (Plazomicin label, Boxed warning)

  • NeomycinaminoglycosideMajor

    Concurrent and/or sequential systemic, oral or topical use of other aminoglycosides, including paromomycin and other potentially nephrotoxic and/or neurotoxic drugs such as bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin, should be avoided because the toxicity may be additive. (Neomycin label, Boxed warning)

  • OnabotulinumtoxinAneuromuscular blockerMajor

    During therapy with ZEMDRI, monitor for adverse reactions associated with neuromuscular blockade, particularly in high-risk patients, such as patients with underlying neuromuscular disorders (including myasthenia gravis) or in patients concomitantly receiving neuromuscular blocking agents [see Warning and Precautions (5.3) ] . (Plazomicin label, Boxed warning)

  • PentamidineQT-prolonging drugMajor

    Because the nephrotoxic effects may be additive, the concomitant or sequential use of Pentamidine Isethionate and other nephrotoxic drugs such as aminoglycosides, amphotericin B, cisplatin, foscarnet, or vancomycin should be closely monitored and avoided, if possible. (Pentamidine label, Drug interactions)

  • Rocuroniumneuromuscular blockerMajor

    During therapy with ZEMDRI, monitor for adverse reactions associated with neuromuscular blockade, particularly in high-risk patients, such as patients with underlying neuromuscular disorders (including myasthenia gravis) or in patients concomitantly receiving neuromuscular blocking agents [see Warning and Precautions (5.3) ] . (Plazomicin label, Boxed warning)

  • Succinylcholineneuromuscular blockerMajor

    During therapy with ZEMDRI, monitor for adverse reactions associated with neuromuscular blockade, particularly in high-risk patients, such as patients with underlying neuromuscular disorders (including myasthenia gravis) or in patients concomitantly receiving neuromuscular blocking agents [see Warning and Precautions (5.3) ] . (Plazomicin label, Boxed warning)

  • Torsemideloop diureticMajor

    Avoid concomitant use of torsemide and aminoglycoside antibiotics, if possible. (Torsemide label, Drug interactions)

  • Vecuroniumneuromuscular blockerMajor

    During therapy with ZEMDRI, monitor for adverse reactions associated with neuromuscular blockade, particularly in high-risk patients, such as patients with underlying neuromuscular disorders (including myasthenia gravis) or in patients concomitantly receiving neuromuscular blocking agents [see Warning and Precautions (5.3) ] . (Plazomicin label, Boxed warning)

Moderate interactions (23)

  • AdefovirantiviralModerate

    However, this is of special importance in patients at risk of or having underlying renal dysfunction and patients taking concomitant nephrotoxic agents such as cyclosporine, tacrolimus, aminoglycosides, vancomycin and non-steroidal anti-inflammatory drugs [See Adverse Reactions (6.2) and Clinical Pharmacology (12.3) ]. (Adefovir label, Warnings and precautions)

  • CefepimecephalosporinModerate

    Aminoglycosides: Increased potential of nephrotoxicity and ototoxicity. (Cefepime label, Drug interactions)

  • CefotaximecephalosporinModerate

    Drug Interactions As with other cephalosporins, cefotaxime may potentiate the nephrotoxic effects of nephrotoxic drugs such as aminoglycosides, NSAIDs and furosemide. (Cefotaxime label, Drug interactions)

  • CefotetancephalosporinModerate

    If CEFOTAN® and an aminoglycoside are used concomitantly, renal function should be carefully monitored, because nephrotoxicity may be potentiated. (Cefotetan label, Precautions)

  • CefoxitincephalosporinModerate

    Aminoglycosides: Increased potential of nephrotoxicity. (Cefoxitin label, Drug interactions)

  • CefprozilcephalosporinModerate

    Drug Interactions Nephrotoxicity has been reported following concomitant administration of aminoglycoside antibiotics and cephalosporin antibiotics. (Cefprozil label, Drug interactions)

  • CeftazidimecephalosporinModerate

    Drug Interactions Nephrotoxicity has been reported following concomitant administration of cephalosporins with aminoglycoside antibacterial drugs or potent diuretics such as furosemide. (Ceftazidime label, Drug interactions)

  • CeftriaxonecephalosporinModerate

    Vancomycin, Amsacrine, Aminoglycosides, and Fluconazole Vancomycin, amsacrine, aminoglycosides, and fluconazole are physically incompatible with ceftriaxone in admixtures [see Dosage and Administration (2.3) ]. (Ceftriaxone label, Drug interactions)

  • CidofovirantiviralModerate

    The safety of cidofovir injection has not been evaluated in patients receiving other known potentially nephrotoxic agents, such as intravenous aminoglycosides (e.g., tobramycin, gentamicin, and amikacin), amphotericin B, foscarnet, intravenous pentamidine, vancomycin, and non-steroidal anti-inflammatory agents (see DOSAGE AND ADMINISTRATION ). (Cidofovir label, Warnings)

  • Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Efavirenz, lamivudine, and tenofovir label, Drug interactions)

  • Some examples of drugs that are eliminated by active tubular secretion include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Elvitegravir, cobicistat, emtricitabine, and tenofovir label, Drug interactions)

  • Emtricitabine and tenofovirantiretroviralModerate

    Some examples of drugs that are eliminated by active tubular secretion include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Emtricitabine and tenofovir label, Drug interactions)

  • Some examples of drugs that are eliminated by active tubular secretion include, but are not limited to, acyclovir, adefovir dipivoxil, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.5) ] . (Emtricitabine, rilpivirine, and tenofovir label, Drug interactions)

  • Ethacrynic acidloop diureticModerate

    Ethacrynic acid may increase the ototoxic potential of other drugs such as aminoglycoside and some cephalosporin antibiotics. (Ethacrynic acid label, Drug interactions)

  • Furosemideloop diureticModerate

    Reports usually indicate that furosemide ototoxicity is associated with rapid injection, severe renal impairment, the use of higher than recommended doses, hypoproteinemia or concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs. (Furosemide label, Warnings and precautions)

  • MeropenemantibioticModerate

    In Trial 1, the incidence of adverse reactions associated with renal function (acute kidney injury, serum creatinine increased, chronic kidney disease, creatinine clearance decreased, renal failure, renal impairment) was 3.6% (11/303) in ZEMDRI-treated patients compared with 1.3% (4/301) in meropenem-treated patients [see Adverse Reactions (6.1) ]. (Plazomicin label, Warnings and precautions)

  • MycophenolateimmunosuppressantModerate

    Examples Cyclosporine A, trimethoprim/sulfamethoxazole, bile acid sequestrants (cholestyramine), rifampin as well as aminoglycoside, cephalosporin, fluoroquinolone and penicillin classes of antimicrobials Drugs Modulating Glucuronidation Clinical Impact Concomitant use with drugs inducing glucuronidation decreases MPA systemic exposure, potentially reducing mycophenolate… (Mycophenolate label, Drug interactions)

  • Piperacillin and tazobactampenicillin antibioticModerate

    In vivo inactivation : When aminoglycosides are administered in conjunction with piperacillin to patients with end-stage renal disease requiring hemodialysis, the concentrations of the aminoglycosides (especially tobramycin) may be significantly reduced and should be monitored. (Piperacillin and tazobactam label, Drug interactions)

  • SirolimusimmunosuppressantModerate

    Caution should be exercised when using agents (e.g., aminoglycosides and amphotericin B) that are known to have a deleterious effect on renal function. (Sirolimus label, Warnings and precautions)

  • TacrolimusimmunosuppressantModerate

    The risk for nephrotoxicity may increase when ASTAGRAF XL is concomitantly administered with CYP3A inhibitors (by increasing tacrolimus whole blood concentrations) or drugs associated with nephrotoxicity (e.g., aminoglycosides, ganciclovir, amphotericin B, cisplatin, nucleotide reverse transcriptase inhibitors, protease inhibitors). (Tacrolimus label, Warnings and precautions)

  • TenofovirantiretroviralModerate

    Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.2) ]. (Tenofovir label, Drug interactions)

  • VancomycinantibioticModerate

    The risk is higher in older patients, patients who are receiving higher doses, who have an underlying hearing loss, who are receiving concomitant therapy with another ototoxic agent, such as an aminoglycoside or who have underlying renal impairment. (Vancomycin label, Warnings and precautions)

  • Zoledronic acidbisphosphonateModerate

    • Aminoglycosides: May lower serum calcium for prolonged periods ( 7.1 ) (Zoledronic acid label, Drug interactions)

Minor mentions (8)

  • AmikacinaminoglycosideMinor

    Before therapy with ZEMDRI is instituted, careful inquiry about previous hypersensitivity reactions to other aminoglycosides should be made. (Plazomicin label, Warnings and precautions)

  • Ampicillin and sulbactampenicillin antibioticMinor

    UNASYN and aminoglycosides should not be reconstituted together due to the in vitro inactivation of aminoglycosides by the ampicillin component of UNASYN. (Ampicillin and sulbactam label, Drug interactions)

  • Closely evaluate the renal function of patients Examples: Aminoglycosides, amphotericin B, systemic bacitracin, cisplatin, cyclosporine, foscarnet, or parenteral vancomycin Angiotensin Converting Enzyme (ACE) Inhibitors Clinical Impact: The hyponatremic and hypotensive effects of ACE inhibitors may be diminished by the concomitant administration of aspirin due… (Butalbital, aspirin, caffeine, and codeine label, Drug interactions)

  • ColistimethateantibioticMinor

    Drug Interactions Certain other antibiotics (aminoglycosides and polymyxin) have also been reported to interfere with the nerve transmission at the neuromuscular junction. (Colistimethate label, Drug interactions)

  • LevofloxacinfluoroquinoloneMinor

    In Trial 2, one case each of irreversible tinnitus and reversible vertigo was reported in ZEMDRI-treated patients, and one case of an abnormal audiogram occurred in a levofloxacin-treated patient [see Adverse Reactions (6.1) ] . (Plazomicin label, Warnings and precautions)

  • Pyridostigminecholinesterase inhibitorMinor

    Aminoglycoside antibiotics, local and some general anesthetics, antiarrhythmic agents, and other drugs that interfere with neuromuscular transmission should be used cautiously, if at all. (Pyridostigmine label, Drug interactions)

  • Spironolactonealdosterone antagonistMinor

    Worsening of renal function can also occur with concomitant use of nephrotoxic drugs (e.g., aminoglycosides, cisplatin, and NSAIDs). (Spironolactone label, Warnings and precautions)

  • TobramycinaminoglycosideMinor

    Before therapy with ZEMDRI is instituted, careful inquiry about previous hypersensitivity reactions to other aminoglycosides should be made. (Plazomicin label, Warnings and precautions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.