Drug interactions
Paromomycin + Tobramycin
Severity: Moderate
Paromomycin 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
Paromomycin is an aminoglycoside that is poorly absorbed orally, but absorption can increase with inflamed gut mucosa or renal impairment. When combined with parenteral tobramycin, additive nephrotoxicity and ototoxicity are possible.
What this interaction means in plain words
Paromomycin 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.
Paromomycin belongs to Anti Bacterial; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive aminoglycoside toxicity to renal proximal tubular cells and cochlear hair cells.
What to do
Avoid concurrent use where an alternative exists. If needed, monitor renal function, tobramycin levels and auditory symptoms, especially with renal impairment or bowel disease.
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
Other interactions of Paromomycin
- Cidofovir + Paromomycin Major
- Adefovir + Paromomycin Moderate
- Amikacin + Paromomycin Moderate
- Amphotericin b + Paromomycin Moderate
- Atracurium + Paromomycin Moderate
- Bacitracin-neomycin-polymyxin + Paromomycin Moderate
Frequently asked questions
Can I take Paromomycin with Tobramycin?
MediHelp rates the interaction as moderate. Paromomycin 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. Paromomycin is an aminoglycoside that is poorly absorbed orally, but absorption can increase with inflamed gut mucosa or renal impairment. When combined with parenteral tobramycin, additive nephrotoxicity and ototoxicity are possible.
How serious is the interaction between Paromomycin 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: Avoid concurrent use where an alternative exists. If needed, monitor renal function, tobramycin levels and auditory symptoms, especially with renal impairment or bowel disease.
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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