Drug interactions
Tenofovir disoproxil + Tobramycin
Severity: Major
Tenofovir disoproxil 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
Tobramycin is a nephrotoxic and ototoxic aminoglycoside eliminated by the kidneys. Together with tenofovir, the risk of renal damage rises, and falling renal function may then increase exposure to both drugs.
What this interaction means in plain words
Tenofovir disoproxil 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.
Why it happens
Additive nephrotoxicity with reduced renal elimination of both drugs.
What to do
Monitor serum creatinine, phosphate and tobramycin levels, and watch for hearing or balance changes. Consider an alternative antiretroviral during aminoglycoside courses.
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
Frequently asked questions
Can I take Tenofovir disoproxil with Tobramycin?
MediHelp rates the interaction as major. Tenofovir disoproxil 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. Tobramycin is a nephrotoxic and ototoxic aminoglycoside eliminated by the kidneys. Together with tenofovir, the risk of renal damage rises, and falling renal function may then increase exposure to both drugs.
How serious is the interaction between Tenofovir disoproxil 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: Monitor serum creatinine, phosphate and tobramycin levels, and watch for hearing or balance changes. Consider an alternative antiretroviral during aminoglycoside courses.
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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