Drug interactions
Neomycin po + Tobramycin
Severity: Major
Neomycin po 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
Oral neomycin can be absorbed in renal impairment or damaged bowel, and then adds to tobramycin nephrotoxicity, ototoxicity and neuromuscular blockade.
What this interaction means in plain words
Neomycin po 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 aminoglycoside toxicity to kidney and cochlea.
What to do
Avoid combining where possible. If needed, monitor renal function, tobramycin levels and hearing, especially with renal impairment or inflamed bowel.
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 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 po with Tobramycin?
MediHelp rates the interaction as major. Neomycin po 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. Oral neomycin can be absorbed in renal impairment or damaged bowel, and then adds to tobramycin nephrotoxicity, ototoxicity and neuromuscular blockade.
How serious is the interaction between Neomycin po 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 combining where possible. If needed, monitor renal function, tobramycin levels and hearing, especially with renal impairment or inflamed bowel.
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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