Drug interactions
Indomethacin + Tobramycin
Severity: Moderate
Indomethacin and Tobramycin: 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
In preterm infants treated with indomethacin, tobramycin clearance falls and serum concentrations can rise. This raises the risk of aminoglycoside nephrotoxicity and ototoxicity.
What this interaction means in plain words
Indomethacin and Tobramycin 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.
Indomethacin belongs to Musculoskeletal; Tobramycin belongs to Anti Bacterial.
Why it happens
Indomethacin-induced reduction in renal blood flow and glomerular filtration decreases aminoglycoside elimination.
What to do
Monitor tobramycin trough and peak levels and renal function in neonates, adjusting dose or interval as needed.
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 Indomethacin
- Indomethacin + Ketorolac Contraindicated
- Indomethacin + Ketorolac intranasal Contraindicated
- Aceclofenac + Indomethacin Major
- Acemetacin + Indomethacin Major
- Acetylsalicylic acid + Indomethacin Major
- Alteplase + Indomethacin Major
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
Frequently asked questions
Can I take Indomethacin with Tobramycin?
MediHelp rates the interaction as moderate. Indomethacin and Tobramycin 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. In preterm infants treated with indomethacin, tobramycin clearance falls and serum concentrations can rise. This raises the risk of aminoglycoside nephrotoxicity and ototoxicity.
How serious is the interaction between Indomethacin and Tobramycin?
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 tobramycin trough and peak levels and renal function in neonates, adjusting dose or interval as needed.
What other medicines interact with Indomethacin?
MediHelp also lists interactions of Indomethacin with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Indomethacin page.
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