Drug interactions
Piroxicam + Tobramycin
Severity: Moderate
Piroxicam 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
NSAIDs can reduce aminoglycoside clearance, as reported mainly in preterm infants, leading to higher tobramycin levels. This may increase nephrotoxicity and ototoxicity risk.
What this interaction means in plain words
Piroxicam 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.
Piroxicam belongs to Musculoskeletal; Tobramycin belongs to Anti Bacterial.
Why it happens
NSAID inhibition of renal prostaglandins reduces glomerular filtration and aminoglycoside elimination.
What to do
Monitor serum creatinine and tobramycin trough levels, and adjust the aminoglycoside dose accordingly. Avoid the NSAID in neonates and patients with renal impairment.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Piroxicam and Tobramycin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Piroxicam
- Ketorolac intranasal + Piroxicam Contraindicated
- Ketorolac + Piroxicam Contraindicated
- Aceclofenac + Piroxicam Major
- Acemetacin + Piroxicam Major
- Acetylsalicylic acid + Piroxicam Major
- Alteplase + Piroxicam Major
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 Piroxicam with Tobramycin?
MediHelp rates the interaction as moderate. Piroxicam 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. NSAIDs can reduce aminoglycoside clearance, as reported mainly in preterm infants, leading to higher tobramycin levels. This may increase nephrotoxicity and ototoxicity risk.
How serious is the interaction between Piroxicam 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 serum creatinine and tobramycin trough levels, and adjust the aminoglycoside dose accordingly. Avoid the NSAID in neonates and patients with renal impairment.
What other medicines interact with Piroxicam?
MediHelp also lists interactions of Piroxicam with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Piroxicam page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
