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)

  • 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)

  • 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)

  • Furosemideloop diureticMajor

    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)

  • Torsemideloop diureticMajor

    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)

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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.