Drug interactions
Diflunisal + Tobramycin inhaled
Severity: Moderate
Diflunisal and Tobramycin inhaled: 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
Systemic absorption of inhaled tobramycin is low, but it can be higher in renal impairment or with damaged airways. NSAIDs can reduce renal function and may increase aminoglycoside accumulation, adding to nephrotoxic and ototoxic risk.
What this interaction means in plain words
Diflunisal and Tobramycin inhaled 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 through NSAID-induced renal hemodynamic changes and reduced aminoglycoside clearance.
What to do
Monitor serum creatinine and, in at-risk patients, serum tobramycin concentrations. Avoid the NSAID in patients with existing renal impairment.
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 Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
Frequently asked questions
Can I take Diflunisal with Tobramycin inhaled?
MediHelp rates the interaction as moderate. Diflunisal and Tobramycin inhaled 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. Systemic absorption of inhaled tobramycin is low, but it can be higher in renal impairment or with damaged airways. NSAIDs can reduce renal function and may increase aminoglycoside accumulation, adding to nephrotoxic and ototoxic risk.
How serious is the interaction between Diflunisal and Tobramycin inhaled?
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, in at-risk patients, serum tobramycin concentrations. Avoid the NSAID in patients with existing renal impairment.
What other medicines interact with Diflunisal?
MediHelp also lists interactions of Diflunisal with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Diflunisal page.
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