Drug interactions
Polymyxin b + Vancomycin
Severity: Major
Polymyxin b and Vancomycin: 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 are nephrotoxic, and parenteral polymyxin B also carries neurotoxicity and potentially ototoxicity. Concurrent use increases the risk of acute kidney injury.
What this interaction means in plain words
Polymyxin b and Vancomycin 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.
Polymyxin b belongs to Anti Bacterial; Vancomycin belongs to Anti Bacterial.
Why it happens
Additive nephrotoxicity, with polymyxin B causing direct tubular cell injury.
What to do
Avoid if alternatives exist; otherwise monitor serum creatinine and vancomycin trough levels frequently and adjust doses.
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 Vancomycin
- Amikacin + Vancomycin Major
- Bacitracin + Vancomycin Major
- Capreomycin + Vancomycin Major
- Cephaloridine + Vancomycin Major
- Cidofovir + Vancomycin Major
- Cisplatin + Vancomycin Major
Other interactions of Polymyxin b
- Cidofovir + Polymyxin b Contraindicated
- Colistin + Polymyxin b Contraindicated
- Acyclovir + Polymyxin b Major
- Adefovir + Polymyxin b Major
- Amikacin + Polymyxin b Major
- Amphotericin b + Polymyxin b Major
Frequently asked questions
Can I take Polymyxin b with Vancomycin?
MediHelp rates the interaction as major. Polymyxin b and Vancomycin 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 are nephrotoxic, and parenteral polymyxin B also carries neurotoxicity and potentially ototoxicity. Concurrent use increases the risk of acute kidney injury.
How serious is the interaction between Polymyxin b and Vancomycin?
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 if alternatives exist; otherwise monitor serum creatinine and vancomycin trough levels frequently and adjust doses.
What other medicines interact with Vancomycin?
MediHelp also lists interactions of Vancomycin with, for example, Amikacin, Bacitracin, Capreomycin. The full list is on the Vancomycin page.
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