Drug interactions
Neomycin + Tacrolimus
Severity: Major
Neomycin 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
Tacrolimus is nephrotoxic and neomycin can be nephrotoxic and ototoxic, mainly if absorbed, for example with impaired gut mucosa or renal impairment. Together renal injury risk is increased, and tacrolimus levels may be affected by renal changes.
What this interaction means in plain words
Neomycin 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.
Neomycin belongs to Anti Bacterial; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive nephrotoxicity (and possible ototoxicity) from two agents with renal tubular toxicity.
What to do
Avoid if possible; if oral neomycin is needed, monitor serum creatinine and tacrolimus trough levels and adjust the tacrolimus dose.
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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Other interactions of Neomycin
- Amikacin + Neomycin Major
- Amphotericin b deoxycholate + Neomycin Major
- Capreomycin + Neomycin Major
- Cidofovir + Neomycin Major
- Colistin + Neomycin Major
- Ethacrynic acid + Neomycin 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 Neomycin with Tacrolimus?
MediHelp rates the interaction as major. Neomycin 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. Tacrolimus is nephrotoxic and neomycin can be nephrotoxic and ototoxic, mainly if absorbed, for example with impaired gut mucosa or renal impairment. Together renal injury risk is increased, and tacrolimus levels may be affected by renal changes.
How serious is the interaction between Neomycin 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 if possible; if oral neomycin is needed, monitor serum creatinine and tacrolimus trough levels and adjust the tacrolimus dose.
What other medicines interact with Neomycin?
MediHelp also lists interactions of Neomycin with, for example, Amikacin, Amphotericin b deoxycholate, Capreomycin. The full list is on the Neomycin page.
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