Drug interactions
Furosemide + Tobramycin
Severity: Major
Furosemide 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
Furosemide with tobramycin increases the risk of ototoxicity and nephrotoxicity, especially at high doses, with rapid intravenous injection or in renal impairment. Hearing loss can be permanent.
What this interaction means in plain words
Furosemide 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.
Furosemide belongs to Cardiovascular; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive ototoxicity and nephrotoxicity, with diuretic volume depletion increasing aminoglycoside exposure.
What to do
Avoid if an alternative exists; otherwise ensure hydration, give furosemide slowly, and monitor renal function, tobramycin levels and hearing.
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 Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Amphotericin b + Tobramycin Major
- Atracurium + Tobramycin Major
Other interactions of Furosemide
- Amifostine + Furosemide Major
- Amikacin + Furosemide Major
- Carbenoxolone + Furosemide Major
- Cephaloridine + Furosemide Major
- Cisplatin + Furosemide Major
- Digoxin + Furosemide Major
Frequently asked questions
Can I take Furosemide with Tobramycin?
MediHelp rates the interaction as major. Furosemide 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. Furosemide with tobramycin increases the risk of ototoxicity and nephrotoxicity, especially at high doses, with rapid intravenous injection or in renal impairment. Hearing loss can be permanent.
How serious is the interaction between Furosemide 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 if an alternative exists; otherwise ensure hydration, give furosemide slowly, and monitor renal function, tobramycin levels and hearing.
What other medicines interact with Tobramycin?
MediHelp also lists interactions of Tobramycin with, for example, Cidofovir, Adefovir, Amikacin. The full list is on the Tobramycin page.
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