Drug interactions
Cephaloridine + Tobramycin
Severity: Major
Cephaloridine 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
Cephaloridine is itself markedly nephrotoxic and was withdrawn from use for that reason. Combined with tobramycin, the risk of tubular necrosis and kidney failure is substantially increased, and ototoxicity from the aminoglycoside may become more likely as renal clearance falls.
What this interaction means in plain words
Cephaloridine 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 proximal tubular toxicity, with reduced renal clearance of tobramycin raising its exposure.
What to do
Avoid the combination; cephaloridine is obsolete and a safer cephalosporin should be chosen. If it cannot be avoided, monitor creatinine and tobramycin levels closely.
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 Cephaloridine with Tobramycin?
MediHelp rates the interaction as major. Cephaloridine 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. Cephaloridine is itself markedly nephrotoxic and was withdrawn from use for that reason. Combined with tobramycin, the risk of tubular necrosis and kidney failure is substantially increased, and ototoxicity from the aminoglycoside may become more likely as renal clearance falls.
How serious is the interaction between Cephaloridine 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; cephaloridine is obsolete and a safer cephalosporin should be chosen. If it cannot be avoided, monitor creatinine and tobramycin levels closely.
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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