Drug interactions
Pentamidine + Tobramycin
Severity: Major
Pentamidine 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
Both drugs can injure the kidney, and their combination raises the risk of acute kidney injury. Renal impairment in turn leads to tobramycin accumulation and a greater chance of ototoxicity.
What this interaction means in plain words
Pentamidine 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.
Pentamidine belongs to Anti Parasitic; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive direct tubular nephrotoxicity of both agents.
What to do
Avoid concurrent use if alternatives exist. Otherwise monitor serum creatinine, electrolytes and tobramycin levels frequently and adjust the 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 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 Pentamidine
- Clomipramine + Pentamidine Contraindicated
- Desipramine + Pentamidine Contraindicated
- Dronedarone + Pentamidine Contraindicated
- Moxifloxacin + Pentamidine Contraindicated
- Nortriptyline + Pentamidine Contraindicated
- Pentamidine + Pimozide Contraindicated
Frequently asked questions
Can I take Pentamidine with Tobramycin?
MediHelp rates the interaction as major. Pentamidine 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. Both drugs can injure the kidney, and their combination raises the risk of acute kidney injury. Renal impairment in turn leads to tobramycin accumulation and a greater chance of ototoxicity.
How serious is the interaction between Pentamidine 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 if alternatives exist. Otherwise monitor serum creatinine, electrolytes and tobramycin levels frequently and adjust the dose.
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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