Drug interactions
Streptomycin + Tobramycin
Severity: Major
Streptomycin 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
Using two aminoglycosides together increases the risk of nephrotoxicity, ototoxicity and neuromuscular blockade. The toxicities are additive and the combination offers no usual benefit.
What this interaction means in plain words
Streptomycin 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.
Streptomycin belongs to Anti Bacterial; Tobramycin belongs to Anti Bacterial.
Why it happens
Additive renal tubular accumulation, inner ear toxicity and neuromuscular blockade.
What to do
Avoid concurrent systemic use of both. If unavoidable, monitor renal function, drug levels, hearing and vestibular function.
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 Streptomycin
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 Streptomycin with Tobramycin?
MediHelp rates the interaction as major. Streptomycin 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. Using two aminoglycosides together increases the risk of nephrotoxicity, ototoxicity and neuromuscular blockade. The toxicities are additive and the combination offers no usual benefit.
How serious is the interaction between Streptomycin 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 systemic use of both. If unavoidable, monitor renal function, drug levels, hearing and vestibular function.
What other medicines interact with Streptomycin?
MediHelp also lists interactions of Streptomycin with, for example, Abobotulinumtoxina, Adefovir, Amikacin. The full list is on the Streptomycin page.
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