Drug interactions
Parecoxib + Tobramycin
Severity: Moderate
Parecoxib 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
Parecoxib, through its active metabolite valdecoxib, can reduce renal perfusion and thereby slow elimination of tobramycin. Serum aminoglycoside concentrations may rise, increasing the risk of kidney injury and ototoxicity, especially in neonates, dehydrated patients or those with renal impairment.
What this interaction means in plain words
Parecoxib 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
Inhibition of renal prostaglandin synthesis reduces glomerular filtration and tobramycin clearance.
What to do
Monitor renal function and tobramycin concentrations during co-therapy and keep the patient well hydrated. Reduce the aminoglycoside dose if levels or creatinine rise.
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 Parecoxib with Tobramycin?
MediHelp rates the interaction as moderate. Parecoxib 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. Parecoxib, through its active metabolite valdecoxib, can reduce renal perfusion and thereby slow elimination of tobramycin. Serum aminoglycoside concentrations may rise, increasing the risk of kidney injury and ototoxicity, especially in neonates, dehydrated patients or those with renal impairment.
How serious is the interaction between Parecoxib 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 renal function and tobramycin concentrations during co-therapy and keep the patient well hydrated. Reduce the aminoglycoside dose if levels or creatinine rise.
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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