Drug interactions
Gentamicin + Tacrolimus
Severity: Major
Gentamicin and Tacrolimus: major 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
Both drugs are nephrotoxic, and combined use increases the risk of acute kidney injury. Aminoglycoside ototoxicity and vestibular toxicity may also be more likely when renal function declines. Tacrolimus exposure may rise if kidney function deteriorates.
What this interaction means in plain words
Gentamicin and Tacrolimus 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.
Gentamicin belongs to Anti Bacterial; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive nephrotoxicity: tacrolimus causes afferent arteriolar vasoconstriction while gentamicin causes proximal tubular injury.
What to do
Avoid the combination where an alternative antibiotic is possible; otherwise monitor serum creatinine, tacrolimus trough levels and gentamicin levels closely. Use the shortest course and adjust doses to renal function.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Gentamicin and Tacrolimus, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Gentamicin
- Cidofovir + Gentamicin Contraindicated
- Adefovir + Gentamicin Major
- Amikacin + Gentamicin Major
- Amlodipine-hydrochlorothiazide-valsartan + Gentamicin Major
- Amphotericin b deoxycholate + Gentamicin Major
- Amphotericin b + Gentamicin Major
Other interactions of Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Gentamicin with Tacrolimus?
MediHelp rates the interaction as major. Gentamicin and Tacrolimus 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. Both drugs are nephrotoxic, and combined use increases the risk of acute kidney injury. Aminoglycoside ototoxicity and vestibular toxicity may also be more likely when renal function declines. Tacrolimus exposure may rise if kidney function deteriorates.
How serious is the interaction between Gentamicin and Tacrolimus?
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 the combination where an alternative antibiotic is possible; otherwise monitor serum creatinine, tacrolimus trough levels and gentamicin levels closely. Use the shortest course and adjust doses to renal function.
What other medicines interact with Gentamicin?
MediHelp also lists interactions of Gentamicin with, for example, Cidofovir, Adefovir, Amikacin. The full list is on the Gentamicin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
