Drug interactions
Amphotericin b + Tobramycin
Severity: Major
Amphotericin b and Tobramycin: 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
Both drugs are nephrotoxic, and tobramycin is also ototoxic and vestibulotoxic. Combined use raises the risk of acute kidney injury, which in turn increases aminoglycoside accumulation and the risk of permanent hearing or balance damage.
What this interaction means in plain words
Amphotericin b and Tobramycin 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.
Amphotericin b belongs to Anti Fungals; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive nephrotoxicity from renal tubular injury, with reduced aminoglycoside clearance amplifying ototoxicity.
What to do
Avoid the combination if an alternative exists. If it is necessary, monitor serum creatinine, electrolytes and tobramycin levels frequently, ensure hydration, and consider a lipid-based amphotericin formulation.
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 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
Other interactions of Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Atracurium + Tobramycin Major
- Bacitracin + Tobramycin Major
Frequently asked questions
Can I take Amphotericin b with Tobramycin?
MediHelp rates the interaction as major. Amphotericin b and Tobramycin 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. Both drugs are nephrotoxic, and tobramycin is also ototoxic and vestibulotoxic. Combined use raises the risk of acute kidney injury, which in turn increases aminoglycoside accumulation and the risk of permanent hearing or balance damage.
How serious is the interaction between Amphotericin b and Tobramycin?
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 the combination if an alternative exists. If it is necessary, monitor serum creatinine, electrolytes and tobramycin levels frequently, ensure hydration, and consider a lipid-based amphotericin formulation.
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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