Drug interactions
Cyclosporine + Dexamethasone-tobramycin
Severity: Moderate
Cyclosporine and Dexamethasone-tobramycin: moderate 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
Cyclosporine and systemically absorbed tobramycin both injure the kidney and inner ear, so toxicity can be additive. Cyclosporine and corticosteroids can also affect each other's concentrations. With topical or ophthalmic tobramycin/dexamethasone the systemic exposure is small, so the concern is mainly with significant absorption.
What this interaction means in plain words
Cyclosporine and Dexamethasone-tobramycin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive nephrotoxicity and ototoxicity, plus P-glycoprotein and CYP3A4 effects altering corticosteroid and cyclosporine exposure.
What to do
Monitor serum creatinine and cyclosporine trough levels if systemic tobramycin or substantial absorption is involved. Watch for corticosteroid adverse effects and adjust doses as needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Dexamethasone-tobramycin
Frequently asked questions
Can I take Cyclosporine with Dexamethasone-tobramycin?
MediHelp rates the interaction as moderate. Cyclosporine and Dexamethasone-tobramycin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cyclosporine and systemically absorbed tobramycin both injure the kidney and inner ear, so toxicity can be additive. Cyclosporine and corticosteroids can also affect each other's concentrations. With topical or ophthalmic tobramycin/dexamethasone the systemic exposure is small, so the concern is mainly with significant absorption.
How serious is the interaction between Cyclosporine and Dexamethasone-tobramycin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum creatinine and cyclosporine trough levels if systemic tobramycin or substantial absorption is involved. Watch for corticosteroid adverse effects and adjust doses as needed.
What other medicines interact with Dexamethasone-tobramycin?
MediHelp also lists interactions of Dexamethasone-tobramycin with, for example, Capreomycin, Carboplatin, Ciprofloxacin. The full list is on the Dexamethasone-tobramycin page.
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