Drug interactions
Cefazolin + Tobramycin
Severity: Moderate
Cefazolin and Tobramycin: 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
Concurrent cefazolin and tobramycin may increase the risk of nephrotoxicity, especially in older patients, those who are dehydrated or those with existing kidney disease. Tobramycin is the main contributor to renal and inner-ear toxicity, and impaired kidney function raises its exposure.
What this interaction means in plain words
Cefazolin and Tobramycin 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.
Cefazolin belongs to Anti Bacterial; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive nephrotoxic potential; cephalosporins may modestly add to aminoglycoside tubular injury.
What to do
Monitor serum creatinine and tobramycin trough levels, keep the patient hydrated and use the shortest effective aminoglycoside course. Adjust the dose for renal function.
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 Cefazolin
- Amikacin + Cefazolin Moderate
- Bcg vaccine live + Cefazolin Moderate
- Cefazolin + Cholera vaccine Moderate
- Cefazolin + Dexamethasone-tobramycin Moderate
- Cefazolin + Gentamicin Moderate
- Cefazolin + Kanamycin Moderate
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 Cefazolin with Tobramycin?
MediHelp rates the interaction as moderate. Cefazolin and Tobramycin 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. Concurrent cefazolin and tobramycin may increase the risk of nephrotoxicity, especially in older patients, those who are dehydrated or those with existing kidney disease. Tobramycin is the main contributor to renal and inner-ear toxicity, and impaired kidney function raises its exposure.
How serious is the interaction between Cefazolin and Tobramycin?
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 tobramycin trough levels, keep the patient hydrated and use the shortest effective aminoglycoside course. Adjust the dose for renal function.
What other medicines interact with Cefazolin?
MediHelp also lists interactions of Cefazolin with, for example, Amikacin, Bcg vaccine live, Cholera vaccine. The full list is on the Cefazolin page.
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