Drug interactions
Tobramycin + Voclosporin
Severity: Major
Tobramycin and Voclosporin: 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
Voclosporin is a calcineurin inhibitor with dose-related nephrotoxicity, and labeling advises caution with other nephrotoxic drugs. Combining it with tobramycin increases the risk of kidney injury and secondary aminoglycoside accumulation and ototoxicity.
What this interaction means in plain words
Tobramycin and Voclosporin 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; Voclosporin belongs to Miscellaneous.
Why it happens
Additive nephrotoxicity from calcineurin-inhibitor renal vasoconstriction and aminoglycoside tubular injury.
What to do
Avoid co-use if possible. If required, monitor eGFR, serum creatinine and tobramycin levels frequently and reduce or hold voclosporin per labeling if renal function declines.
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
Other interactions of Voclosporin
- Clarithromycin + Voclosporin Contraindicated
- Cyclosporin + Voclosporin Contraindicated
- Ensitrelvir + Voclosporin Contraindicated
- Itraconazole + Voclosporin Contraindicated
- Ketoconazole + Voclosporin Contraindicated
- Posaconazole + Voclosporin Contraindicated
Frequently asked questions
Can I take Tobramycin with Voclosporin?
MediHelp rates the interaction as major. Tobramycin and Voclosporin 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. Voclosporin is a calcineurin inhibitor with dose-related nephrotoxicity, and labeling advises caution with other nephrotoxic drugs. Combining it with tobramycin increases the risk of kidney injury and secondary aminoglycoside accumulation and ototoxicity.
How serious is the interaction between Tobramycin and Voclosporin?
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 co-use if possible. If required, monitor eGFR, serum creatinine and tobramycin levels frequently and reduce or hold voclosporin per labeling if renal function declines.
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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