Drug interactions
Neomycin + Tobramycin
Severity: Major
Neomycin and Tobramycin: 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
Two aminoglycosides together add to the risk of kidney injury, hearing loss and vestibular damage, and absorbed neomycin can add to systemic exposure. The risk is greater with renal impairment, high doses or long courses.
What this interaction means in plain words
Neomycin 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.
Neomycin belongs to Anti Bacterial; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive nephrotoxicity, ototoxicity and neuromuscular effects from two aminoglycosides.
What to do
Avoid concurrent use where possible. If unavoidable, monitor renal function, tobramycin levels and hearing.
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 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 Neomycin with Tobramycin?
MediHelp rates the interaction as major. Neomycin 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. Two aminoglycosides together add to the risk of kidney injury, hearing loss and vestibular damage, and absorbed neomycin can add to systemic exposure. The risk is greater with renal impairment, high doses or long courses.
How serious is the interaction between Neomycin 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: Avoid concurrent use where possible. If unavoidable, monitor renal function, tobramycin levels and hearing.
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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