Drug interactions
Mefenamic acid + Tobramycin
Severity: Moderate
Mefenamic acid 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 can reduce renal clearance of aminoglycosides, notably in premature infants, leading to higher drug levels. This adds to the intrinsic nephrotoxicity and ototoxicity of tobramycin. Adult data with mefenamic acid are sparse.
What this interaction means in plain words
Mefenamic acid 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.
Mefenamic acid belongs to Musculoskeletal; Tobramycin belongs to Anti Bacterial.
Why it happens
NSAID-induced reduction of renal prostaglandins lowers glomerular filtration and tobramycin clearance.
What to do
Monitor tobramycin trough levels and serum creatinine during co-therapy. Avoid the combination in neonates and patients with renal impairment 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 Mefenamic acid
- Ketorolac intranasal + Mefenamic acid Contraindicated
- Ketorolac + Mefenamic acid Contraindicated
- Aceclofenac + Mefenamic acid Major
- Acemetacin + Mefenamic acid Major
- Acetylsalicylic acid + Mefenamic acid Major
- Alteplase + Mefenamic acid 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 Mefenamic acid with Tobramycin?
MediHelp rates the interaction as moderate. Mefenamic acid 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 can reduce renal clearance of aminoglycosides, notably in premature infants, leading to higher drug levels. This adds to the intrinsic nephrotoxicity and ototoxicity of tobramycin. Adult data with mefenamic acid are sparse.
How serious is the interaction between Mefenamic acid 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 during co-therapy. Avoid the combination in neonates and patients with renal impairment where possible.
What other medicines interact with Mefenamic acid?
MediHelp also lists interactions of Mefenamic acid with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Mefenamic acid page.
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