Tobramycin interactions
Tobramycin (Tobrex, Tobi), an aminoglycoside has 66 documented interactions across the FDA labels and fact sheets we index: 7 major, 22 moderate, 37 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.
Major interactions (7)
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)
- 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)
- Ethacrynic acidloop diureticMajor
TOBI Podhaler should not be administered concomitantly with ethacrynic acid, furosemide, urea, or intravenous mannitol. (Tobramycin label, Drug interactions)
TOBI Podhaler should not be administered concomitantly with ethacrynic acid, furosemide, urea, or intravenous mannitol. (Tobramycin label, Drug interactions)
- GentamicinaminoglycosideMajor
Concurrent and/or sequential systemic or topical use of other potentially neurotoxic and/or nephrotoxic drugs, such as cisplatin, cephaloridine, kanamycin, amikacin, neomycin, polymyxin B, colistin, paromomycin, streptomycin, tobramycin, vancomycin, and viomycin, should be avoided (see PRECAUTIONS, Drug Interactions section). (Gentamicin 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)
Avoid concomitant use of torsemide and aminoglycoside antibiotics, if possible. (Torsemide label, Drug interactions)
Moderate interactions (22)
- Acetazolamidecarbonic anhydrase inhibitorModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Amiloridepotassium-sparing diureticModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Bisoprolol and hydrochlorothiazidebeta blockerModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Chlorthalidonethiazide diureticModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- CyclosporineimmunosuppressantModerate
…ciprofloxacin melphalan amphotericin B azapropazon cimetidine tacrolimus fibric acid derivatives (e.g., bezafibrate, fenofibrate) gentamicin ketoconazole colchicine ranitidine methotrexate tobramycin diclofenac trimethoprim with sulfamethoxazole naproxen vancomycin sulindac During the concomitant use of a drug that may exhibit additive or synergistic renal impairment… (Cyclosporine 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)
- Eplerenonealdosterone antagonistModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Hydrochlorothiazidethiazide diureticModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Indapamidethiazide diureticModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Lisinopril and hydrochlorothiazideACE inhibitorModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Metolazonethiazide diureticModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- 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 MYHIBBIN… (Mycophenolate label, Drug interactions)
- OnabotulinumtoxinAneuromuscular blockerModerate
Patients receiving concomitant treatment of BOTOX and aminoglycosides or other agents interfering with neuromuscular transmission (e.g., curare-like agents), or muscle relaxants, should be observed closely because the effect of BOTOX may be potentiated ( 7.1 , 7.4 ) (OnabotulinumtoxinA 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)
- Spironolactonealdosterone antagonistModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Spironolactone and hydrochlorothiazidealdosterone antagonistModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- 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)
- Triamterenepotassium-sparing diureticModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)
- Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin 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)
Minor mentions (37)
- AclidiniumanticholinergicMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Albuterolbeta-adrenergic agonistMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Azithromycinmacrolide antibioticMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- BeclomethasonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- BetamethasonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- BudesonidecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Budesonide and formoterolcorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Clarithromycinmacrolide antibioticMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- ClobetasolcorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- DesonidecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- DexamethasonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Dornase alfaMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- EpinephrinesympathomimeticMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Erythromycinmacrolide antibioticMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Fidaxomicinmacrolide antibioticMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- FludrocortisonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- FluocinonidecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- FluticasonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Fluticasone and salmeterolcorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Formoterolbeta-adrenergic agonistMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- HalobetasolcorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- HydrocortisonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- IpratropiumanticholinergicMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Levalbuterolbeta-adrenergic agonistMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- MethylprednisolonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Mirabegronbeta-adrenergic agonistMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- MometasonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- PrednisolonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- PrednisonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- 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)
- Salmeterolbeta-adrenergic agonistMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Terbutalinebeta-adrenergic agonistMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- TheophyllinemethylxanthineMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- TiotropiumanticholinergicMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- TriamcinolonecorticosteroidMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Umeclidinium and vilanterolanticholinergicMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- Vibegronbeta-adrenergic agonistMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
Check Tobramycin against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot 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.