Drug interactions
Colistin + Tobramycin
Severity: Major
Colistin 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
Colistin and tobramycin are both nephrotoxic and may cause neurotoxicity including neuromuscular blockade. Combined use raises the risk of acute kidney injury and possible ototoxicity.
What this interaction means in plain words
Colistin 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.
Colistin belongs to Anti Bacterial; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive nephrotoxicity, plus additive neuromuscular blocking and ototoxic effects.
What to do
Avoid concurrent systemic use where possible. If needed, monitor serum creatinine and tobramycin levels closely, adjust doses to renal function, and watch for neuromuscular weakness.
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 Colistin
- Colistin + Polymyxin b Contraindicated
- Amikacin + Colistin Major
- Amphotericin b deoxycholate + Colistin Major
- Amphotericin b + Colistin Major
- Atracurium + Colistin Major
- Bacitracin + Colistin Major
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 Colistin with Tobramycin?
MediHelp rates the interaction as major. Colistin 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. Colistin and tobramycin are both nephrotoxic and may cause neurotoxicity including neuromuscular blockade. Combined use raises the risk of acute kidney injury and possible ototoxicity.
How serious is the interaction between Colistin 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 systemic use where possible. If needed, monitor serum creatinine and tobramycin levels closely, adjust doses to renal function, and watch for neuromuscular weakness.
What other medicines interact with Colistin?
MediHelp also lists interactions of Colistin with, for example, Polymyxin b, Amikacin, Amphotericin b deoxycholate. The full list is on the Colistin page.
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