Drug interactions
Piperacillin-tazobactam + Tobramycin
Severity: Moderate
Piperacillin-tazobactam 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
The pair is used for synergy against Pseudomonas, but piperacillin can inactivate tobramycin in vitro and in patients with renal failure, lowering levels. Nephrotoxicity may also be additive.
What this interaction means in plain words
Piperacillin-tazobactam 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.
Piperacillin-tazobactam belongs to Anti Bacterial; Tobramycin belongs to Anti Bacterial.
Why it happens
Pharmacodynamic synergy, plus chemical inactivation of the aminoglycoside by the penicillin, particularly when renal clearance is reduced.
What to do
Give the drugs separately and never mix them in the same infusion. Monitor tobramycin concentrations and serum creatinine.
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 Piperacillin-tazobactam
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 Piperacillin-tazobactam with Tobramycin?
MediHelp rates the interaction as moderate. Piperacillin-tazobactam 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. The pair is used for synergy against Pseudomonas, but piperacillin can inactivate tobramycin in vitro and in patients with renal failure, lowering levels. Nephrotoxicity may also be additive.
How serious is the interaction between Piperacillin-tazobactam 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: Give the drugs separately and never mix them in the same infusion. Monitor tobramycin concentrations and serum creatinine.
What other medicines interact with Piperacillin-tazobactam?
MediHelp also lists interactions of Piperacillin-tazobactam with, for example, Vancomycin, Amikacin, Antithrombin alfa. The full list is on the Piperacillin-tazobactam page.
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