Drug interactions
Meclofenamate + Tobramycin
Severity: Moderate
Meclofenamate 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
NSAIDs such as meclofenamate can reduce renal clearance of aminoglycosides, raising tobramycin serum concentrations. The effect is best documented in preterm neonates, and in other patients it is most relevant with renal impairment or dehydration. Higher exposure increases the risk of nephrotoxicity and ototoxicity.
What this interaction means in plain words
Meclofenamate 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.
Why it happens
NSAID inhibition of renal prostaglandin synthesis reduces renal blood flow and glomerular filtration, decreasing tobramycin elimination.
What to do
Monitor tobramycin trough levels and serum creatinine, particularly in neonates and patients with renal impairment. Adjust the tobramycin dose according to levels or avoid the NSAID where possible.
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 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 Meclofenamate with Tobramycin?
MediHelp rates the interaction as moderate. Meclofenamate 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. NSAIDs such as meclofenamate can reduce renal clearance of aminoglycosides, raising tobramycin serum concentrations. The effect is best documented in preterm neonates, and in other patients it is most relevant with renal impairment or dehydration. Higher exposure increases the risk of nephrotoxicity and ototoxicity.
How serious is the interaction between Meclofenamate 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 levels and serum creatinine, particularly in neonates and patients with renal impairment. Adjust the tobramycin dose according to levels or avoid the NSAID where possible.
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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