Drug interactions
Tobramycin + Vancomycin
Severity: Major
Tobramycin 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
Concurrent vancomycin and tobramycin increases the risk of acute kidney injury and may add to ototoxicity. Declining renal function then raises levels of both drugs.
What this interaction means in plain words
Tobramycin 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.
Tobramycin belongs to Anti Bacterial; Vancomycin belongs to Anti Bacterial.
Why it happens
Additive nephrotoxicity and ototoxicity.
What to do
Monitor serum creatinine and trough or AUC levels of both agents, and screen for hearing or balance changes. Limit aminoglycoside duration and ensure adequate hydration.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Tobramycin and Vancomycin, 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 14 days on the web. No card needed.
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 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 Vancomycin?
MediHelp rates the interaction as major. Tobramycin 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. Concurrent vancomycin and tobramycin increases the risk of acute kidney injury and may add to ototoxicity. Declining renal function then raises levels of both drugs.
How serious is the interaction between Tobramycin 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: Monitor serum creatinine and trough or AUC levels of both agents, and screen for hearing or balance changes. Limit aminoglycoside duration and ensure adequate hydration.
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.
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.
