Drug interactions
Amikacin + Tolmetin
Severity: Moderate
Amikacin and Tolmetin: moderate 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
NSAIDs can reduce renal prostaglandin-dependent perfusion and glomerular filtration, which may slow aminoglycoside elimination and raise serum amikacin concentrations. This has been described mainly in preterm infants, with a higher risk of nephrotoxicity and ototoxicity.
What this interaction means in plain words
Amikacin and Tolmetin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amikacin belongs to Anti Bacterial; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID-mediated reduction in renal prostaglandin synthesis and glomerular filtration decreases aminoglycoside clearance.
What to do
Monitor serum amikacin concentrations and renal function when tolmetin is given, particularly in neonates, and adjust the aminoglycoside dose accordingly. Avoid the combination in patients with renal impairment where possible.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin Major
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 Tolmetin?
MediHelp rates the interaction as moderate. Amikacin and Tolmetin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. NSAIDs can reduce renal prostaglandin-dependent perfusion and glomerular filtration, which may slow aminoglycoside elimination and raise serum amikacin concentrations. This has been described mainly in preterm infants, with a higher risk of nephrotoxicity and ototoxicity.
How serious is the interaction between Amikacin and Tolmetin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum amikacin concentrations and renal function when tolmetin is given, particularly in neonates, and adjust the aminoglycoside dose accordingly. Avoid the combination in patients with renal impairment where possible.
What other medicines interact with Tolmetin?
MediHelp also lists interactions of Tolmetin with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Tolmetin page.
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