Drug interactions
Cisplatin + Tobramycin
Severity: Major
Cisplatin and Tobramycin: major interaction.
Last updated Sources: US FDA label
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 nephrotoxic and ototoxic, and combined use markedly raises the risk of acute kidney injury, permanent hearing loss and electrolyte wasting such as hypomagnesemia. Renal impairment further reduces tobramycin clearance.
What this interaction means in plain words
Cisplatin 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.
Cisplatin belongs to Oncology; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive proximal tubular injury and cochlear hair cell toxicity from cisplatin and aminoglycosides.
What to do
Avoid concurrent use if an alternative antibiotic exists. If unavoidable, monitor renal function, magnesium, potassium and tobramycin levels, and assess hearing.
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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References
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
Other interactions of Cisplatin
- Cidofovir + Cisplatin Contraindicated
- Adefovir + Cisplatin Major
- Adenovirus types 4 and 7 live + Cisplatin Major
- Amikacin + Cisplatin Major
- Amphotericin b deoxycholate + Cisplatin Major
- Amphotericin b + Cisplatin Major
Frequently asked questions
Can I take Cisplatin with Tobramycin?
MediHelp rates the interaction as major. Cisplatin 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 nephrotoxic and ototoxic, and combined use markedly raises the risk of acute kidney injury, permanent hearing loss and electrolyte wasting such as hypomagnesemia. Renal impairment further reduces tobramycin clearance.
How serious is the interaction between Cisplatin 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 if an alternative antibiotic exists. If unavoidable, monitor renal function, magnesium, potassium and tobramycin levels, and assess hearing.
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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