Drug interactions
Furosemide + Vancomycin
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.
Overview
Additive risk of ototoxicity and potential increase in vancomycin-associated nephrotoxicity, especially with high vancomycin exposure, rapid/high-dose IV furosemide, renal impairment, or concurrent ototoxic/nephrotoxic agents.
Mechanism of action
Pharmacodynamic additive ototoxic effects; possible increased nephrotoxicity from diuretic-induced volume depletion and reduced renal perfusion. No consistent pharmacokinetic interaction.
Clinical management
Avoid rapid/high-dose IV furosemide; maintain euvolemia. Monitor serum creatinine/urine output and vancomycin AUC/trough; assess for tinnitus or hearing changes. Consider alternatives or dose adjustments if renal function worsens or ototoxic symptoms occur.
Drug reference
References
- Vancomycin Injection, USP – Prescribing Information — FDA Label
- Furosemide (Lasix) – Prescribing Information — FDA Label
- Vancomycin: Drug information — UpToDate
- Vancomycin – Interactions (Vancomycin + Loop Diuretics) — Lexicomp
Frequently asked questions
Can I take Furosemide with Vancomycin?
The interaction is rated: Moderate. Additive risk of ototoxicity and potential increase in vancomycin-associated nephrotoxicity, especially with high vancomycin exposure, rapid/high-dose IV furosemide, renal impairment, or concurrent ototoxic/nephrotoxic agents.
How serious is the interaction between Furosemide and Vancomycin?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between Furosemide and Vancomycin managed?
Avoid rapid/high-dose IV furosemide; maintain euvolemia. Monitor serum creatinine/urine output and vancomycin AUC/trough; assess for tinnitus or hearing changes. Consider alternatives or dose adjustments if renal function worsens or ototoxic symptoms occur.
Why do Furosemide and Vancomycin interact?
Pharmacodynamic additive ototoxic effects; possible increased nephrotoxicity from diuretic-induced volume depletion and reduced renal perfusion. No consistent pharmacokinetic interaction.
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