Drug interactions
Ioversol + Tobramycin
Severity: Major
Ioversol 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
Ioversol is an iodinated contrast agent that can cause acute kidney injury, and tobramycin adds nephrotoxic risk. Impaired renal function leads to accumulation of tobramycin and a greater risk of ototoxicity.
What this interaction means in plain words
Ioversol 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.
Why it happens
Additive tubular toxicity and renal hemodynamic effects, with reduced tobramycin clearance as renal function falls.
What to do
Hydrate adequately and check renal function before and after contrast. Monitor serum creatinine and tobramycin levels and adjust the dose if renal function worsens.
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
Frequently asked questions
Can I take Ioversol with Tobramycin?
MediHelp rates the interaction as major. Ioversol 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. Ioversol is an iodinated contrast agent that can cause acute kidney injury, and tobramycin adds nephrotoxic risk. Impaired renal function leads to accumulation of tobramycin and a greater risk of ototoxicity.
How serious is the interaction between Ioversol 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: Hydrate adequately and check renal function before and after contrast. Monitor serum creatinine and tobramycin levels and adjust the dose if renal function worsens.
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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