Skip to content

Drug interactions

Cefotaxime + Tobramycin

Severity: Moderate

Cefotaxime 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

Combining a cephalosporin with an aminoglycoside may raise the risk of kidney injury, and tobramycin itself can damage the kidneys and inner ear. The additive risk with cefotaxime is modest and mainly relevant in patients with renal impairment, older age or dehydration.

What this interaction means in plain words

Cefotaxime 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.

Cefotaxime belongs to Anti Bacterial; Tobramycin belongs to Anti Bacterial.

Evidence level: Low

Why it happens

Possible additive nephrotoxicity, with reduced renal function leading to higher aminoglycoside exposure and greater ototoxic potential.

What to do

Monitor serum creatinine and tobramycin trough levels, and adjust the dose to renal function. Keep the patient hydrated and assess hearing and balance if therapy is prolonged.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

Pro+ members

Unlock the full page

Create an account and start a Pro+ trial to unlock the full management advice for Cefotaxime and Tobramycin, the additional notes, the evidence detail and the whole-prescription interaction checker.

  • Full clinical management advice
  • Additional notes
  • Evidence detail
  • Interaction checker for a whole prescription

Try Pro+ free for 14 days on the web. No card needed.

Frequently asked questions

Can I take Cefotaxime with Tobramycin?

MediHelp rates the interaction as moderate. Cefotaxime 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. Combining a cephalosporin with an aminoglycoside may raise the risk of kidney injury, and tobramycin itself can damage the kidneys and inner ear. The additive risk with cefotaxime is modest and mainly relevant in patients with renal impairment, older age or dehydration.

How serious is the interaction between Cefotaxime 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 the dose to renal function. Keep the patient hydrated and assess hearing and balance if therapy is prolonged.

What other medicines interact with Cefotaxime?

MediHelp also lists interactions of Cefotaxime with, for example, Typhoid vaccine live, Amikacin, Cholera vaccine. The full list is on the Cefotaxime page.

Full monographs, dosing and an interaction checker in the MediHelp app

Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.

Browse A–Z · Drug interactions

Get the app Sign in