Drug interactions
Cefepime + Tobramycin
Severity: Moderate
Cefepime 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
Tobramycin can injure the kidneys and inner ear, and use alongside a cephalosporin has been linked in some reports to further renal impairment. Cefepime has limited intrinsic nephrotoxicity, so the added risk is generally modest but greater in renal impairment, older patients and prolonged courses.
What this interaction means in plain words
Cefepime 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.
Cefepime belongs to Anti Bacterial; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive renal tubular stress; reduced renal function increases aminoglycoside accumulation and thus toxicity.
What to do
Monitor serum creatinine and tobramycin trough levels, and adjust doses to renal function. Keep the combination as short as possible and ask about hearing or balance changes.
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 Cefepime
- Amikacin + Cefepime Moderate
- Cefepime + Cholera vaccine Moderate
- Cefepime + Dexamethasone-tobramycin Moderate
- Cefepime + Gentamicin Moderate
- Cefepime + Kanamycin Moderate
- Cefepime + Microbiota 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 Cefepime with Tobramycin?
MediHelp rates the interaction as moderate. Cefepime 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. Tobramycin can injure the kidneys and inner ear, and use alongside a cephalosporin has been linked in some reports to further renal impairment. Cefepime has limited intrinsic nephrotoxicity, so the added risk is generally modest but greater in renal impairment, older patients and prolonged courses.
How serious is the interaction between Cefepime 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, and adjust doses to renal function. Keep the combination as short as possible and ask about hearing or balance changes.
What other medicines interact with Cefepime?
MediHelp also lists interactions of Cefepime with, for example, Amikacin, Cholera vaccine, Dexamethasone-tobramycin. The full list is on the Cefepime page.
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