Drug interactions
Capreomycin + Tobramycin
Severity: Major
Capreomycin 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 toxic to the kidney and the inner ear, and giving them together adds to the risk of acute kidney injury, hearing loss and vestibular damage. Capreomycin also carries neuromuscular blocking potential, which adds to the risk. The damage can be permanent.
What this interaction means in plain words
Capreomycin 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.
Why it happens
Additive nephrotoxicity, ototoxicity and neuromuscular blockade through overlapping toxicities.
What to do
Avoid concurrent use when alternatives exist. If unavoidable, monitor serum creatinine, tobramycin levels and hearing or vestibular function, and adjust doses to renal function.
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 Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Amphotericin b + Tobramycin Major
- Atracurium + Tobramycin Major
Frequently asked questions
Can I take Capreomycin with Tobramycin?
MediHelp rates the interaction as major. Capreomycin 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 toxic to the kidney and the inner ear, and giving them together adds to the risk of acute kidney injury, hearing loss and vestibular damage. Capreomycin also carries neuromuscular blocking potential, which adds to the risk. The damage can be permanent.
How serious is the interaction between Capreomycin 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 concurrent use when alternatives exist. If unavoidable, monitor serum creatinine, tobramycin levels and hearing or vestibular function, and adjust doses to renal function.
What other medicines interact with Tobramycin?
MediHelp also lists interactions of Tobramycin with, for example, Cidofovir, Adefovir, Amikacin. The full list is on the Tobramycin page.
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