Drug interactions
Colistin + Vancomycin
Severity: Major
Colistin and Vancomycin: 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
Both vancomycin and colistin are nephrotoxic, and combination therapy has been associated with a higher incidence of acute kidney injury than either drug alone. Colistin also carries neurotoxicity risk.
What this interaction means in plain words
Colistin and Vancomycin 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; Vancomycin belongs to Anti Bacterial.
Why it happens
Additive tubular nephrotoxicity from both drugs.
What to do
Monitor serum creatinine and urine output daily and use vancomycin level-guided dosing. Consider alternatives to vancomycin if gram-positive coverage is not essential.
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 Vancomycin
- Amikacin + Vancomycin Major
- Bacitracin + Vancomycin Major
- Capreomycin + Vancomycin Major
- Cephaloridine + Vancomycin Major
- Cidofovir + Vancomycin Major
- Cisplatin + Vancomycin Major
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 Vancomycin?
MediHelp rates the interaction as major. Colistin and Vancomycin 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 vancomycin and colistin are nephrotoxic, and combination therapy has been associated with a higher incidence of acute kidney injury than either drug alone. Colistin also carries neurotoxicity risk.
How serious is the interaction between Colistin and Vancomycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum creatinine and urine output daily and use vancomycin level-guided dosing. Consider alternatives to vancomycin if gram-positive coverage is not essential.
What other medicines interact with Vancomycin?
MediHelp also lists interactions of Vancomycin with, for example, Amikacin, Bacitracin, Capreomycin. The full list is on the Vancomycin page.
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