Drug interactions
Amphotericin b + Tobramycin inhaled
Severity: Moderate
Amphotericin b and Tobramycin inhaled: 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
Amphotericin B is nephrotoxic and aminoglycosides can cause kidney injury and ototoxicity. Inhaled tobramycin has low systemic absorption, but absorption can increase with renal impairment, so the combination may add to renal and cochleovestibular toxicity.
What this interaction means in plain words
Amphotericin b and Tobramycin inhaled 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.
Why it happens
Additive nephrotoxicity from amphotericin tubular injury and aminoglycoside accumulation in renal tubular and inner ear cells.
What to do
Monitor serum creatinine and electrolytes regularly, and consider tobramycin serum levels if renal function declines. Ask about hearing changes or tinnitus and consider audiometry.
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 Amphotericin b
- Amphotericin b + Cidofovir Contraindicated
- Adefovir + Amphotericin b Major
- Amikacin + Amphotericin b Major
- Amphotericin b + Arsenic trioxide Major
- Amphotericin b + Capreomycin Major
- Amphotericin b + Cephaloridine Major
Frequently asked questions
Can I take Amphotericin b with Tobramycin inhaled?
MediHelp rates the interaction as moderate. Amphotericin b and Tobramycin inhaled 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. Amphotericin B is nephrotoxic and aminoglycosides can cause kidney injury and ototoxicity. Inhaled tobramycin has low systemic absorption, but absorption can increase with renal impairment, so the combination may add to renal and cochleovestibular toxicity.
How serious is the interaction between Amphotericin b and Tobramycin inhaled?
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 creatinine and electrolytes regularly, and consider tobramycin serum levels if renal function declines. Ask about hearing changes or tinnitus and consider audiometry.
What other medicines interact with Amphotericin b?
MediHelp also lists interactions of Amphotericin b with, for example, Cidofovir, Adefovir, Amikacin. The full list is on the Amphotericin b page.
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