Drug interactions
Dexamethasone-tobramycin + Sulindac
Severity: Moderate
Dexamethasone-tobramycin and Sulindac: 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
Combining a corticosteroid with an NSAID increases the risk of gastric and duodenal ulceration and gastrointestinal bleeding. The risk is higher in older patients and with long-term use. Sulindac may also add to the nephrotoxic risk of tobramycin.
What this interaction means in plain words
Dexamethasone-tobramycin and Sulindac 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.
Dexamethasone-tobramycin belongs to Anti Bacterial; Sulindac belongs to Musculoskeletal.
Why it happens
Additive gastric mucosal injury from NSAID prostaglandin inhibition and corticosteroid effects on mucosal defense.
What to do
Avoid combining if possible, or add gastroprotection with a proton pump inhibitor and use the shortest duration. Monitor renal function if tobramycin is given systemically.
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
Other interactions of Sulindac
- Ketorolac intranasal + Sulindac Contraindicated
- Ketorolac + Sulindac Contraindicated
- Aceclofenac + Sulindac Major
- Acetylsalicylic acid + Sulindac Major
- Alteplase + Sulindac Major
- Amiloride + Sulindac Major
Frequently asked questions
Can I take Dexamethasone-tobramycin with Sulindac?
MediHelp rates the interaction as moderate. Dexamethasone-tobramycin and Sulindac 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. Combining a corticosteroid with an NSAID increases the risk of gastric and duodenal ulceration and gastrointestinal bleeding. The risk is higher in older patients and with long-term use. Sulindac may also add to the nephrotoxic risk of tobramycin.
How serious is the interaction between Dexamethasone-tobramycin and Sulindac?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining if possible, or add gastroprotection with a proton pump inhibitor and use the shortest duration. Monitor renal function if tobramycin is given systemically.
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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