Drug interactions
Amikacin + Tobramycin inhaled
Severity: Major
Amikacin and Tobramycin inhaled: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Inhaled tobramycin is partly absorbed systemically, especially with impaired lung or renal function. Combined with parenteral amikacin, the total aminoglycoside burden raises the risk of kidney injury and hearing or balance damage.
What this interaction means in plain words
Amikacin and Tobramycin inhaled can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive aminoglycoside nephrotoxicity and ototoxicity from combined systemic exposure.
What to do
Avoid concurrent or sequential use of two aminoglycosides where possible. If both are needed, monitor serum creatinine, drug levels and audiometry.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amikacin
- Amikacin + Cidofovir Contraindicated
- Adefovir + Amikacin Major
- Amikacin + Amphotericin b Major
- Amikacin + Amphotericin b deoxycholate Major
- Amikacin + Atracurium Major
- Amikacin + Bacitracin Major
Frequently asked questions
Can I take Amikacin with Tobramycin inhaled?
MediHelp rates the interaction as major. Amikacin and Tobramycin inhaled can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Inhaled tobramycin is partly absorbed systemically, especially with impaired lung or renal function. Combined with parenteral amikacin, the total aminoglycoside burden raises the risk of kidney injury and hearing or balance damage.
How serious is the interaction between Amikacin and Tobramycin inhaled?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent or sequential use of two aminoglycosides where possible. If both are needed, monitor serum creatinine, drug levels and audiometry.
What other medicines interact with Amikacin?
MediHelp also lists interactions of Amikacin with, for example, Cidofovir, Adefovir, Amphotericin b. The full list is on the Amikacin page.
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