Drug interactions
Tobramycin + Tolmetin
Severity: Moderate
Tobramycin and Tolmetin: 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 renal clearance of tobramycin, increasing serum levels and the risk of nephrotoxicity and ototoxicity. Documented mainly in preterm infants but plausible in other patients with reduced renal function.
What this interaction means in plain words
Tobramycin and Tolmetin 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.
Tobramycin belongs to Anti Bacterial; Tolmetin belongs to Musculoskeletal.
Why it happens
NSAID-mediated reduction in renal prostaglandins and glomerular filtration decreases aminoglycoside clearance.
What to do
Monitor tobramycin trough levels and serum creatinine, and adjust the dose as required. Consider a non-NSAID analgesic in high-risk patients.
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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin 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 Tobramycin with Tolmetin?
MediHelp rates the interaction as moderate. Tobramycin and Tolmetin 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 renal clearance of tobramycin, increasing serum levels and the risk of nephrotoxicity and ototoxicity. Documented mainly in preterm infants but plausible in other patients with reduced renal function.
How serious is the interaction between Tobramycin and Tolmetin?
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 tobramycin trough levels and serum creatinine, and adjust the dose as required. Consider a non-NSAID analgesic in high-risk patients.
What other medicines interact with Tolmetin?
MediHelp also lists interactions of Tolmetin with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Tolmetin page.
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