Drug interactions
Colistin + Neomycin
Severity: Major
Colistin and Neomycin: 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
Colistin is nephrotoxic and neurotoxic, and neomycin can add to renal and auditory toxicity if systemically absorbed. Oral neomycin absorption is usually low, so risk is greatest in renal impairment, long-term use or damaged bowel mucosa.
What this interaction means in plain words
Colistin and Neomycin 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.
Colistin belongs to Anti Bacterial; Neomycin belongs to Anti Bacterial.
Why it happens
Additive nephrotoxicity and neurotoxicity from two agents with overlapping toxic profiles.
What to do
Avoid the combination if alternatives exist. If both are required, monitor serum creatinine and hearing and limit neomycin duration.
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 Neomycin
Other interactions of Colistin
- Colistin + Polymyxin b Contraindicated
- Amikacin + Colistin Major
- Amphotericin b deoxycholate + Colistin Major
- Amphotericin b + Colistin Major
- Atracurium + Colistin Major
- Bacitracin + Colistin Major
Frequently asked questions
Can I take Colistin with Neomycin?
MediHelp rates the interaction as major. Colistin and Neomycin 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. Colistin is nephrotoxic and neurotoxic, and neomycin can add to renal and auditory toxicity if systemically absorbed. Oral neomycin absorption is usually low, so risk is greatest in renal impairment, long-term use or damaged bowel mucosa.
How serious is the interaction between Colistin and Neomycin?
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 if alternatives exist. If both are required, monitor serum creatinine and hearing and limit neomycin duration.
What other medicines interact with Neomycin?
MediHelp also lists interactions of Neomycin with, for example, Amikacin, Amphotericin b deoxycholate, Capreomycin. The full list is on the Neomycin page.
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