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Acunivive 60 Injection System and Tobramycin Sulfate

Determining the interaction of Acunivive 60 Injection System and Tobramycin Sulfate and the possibility of their joint administration.

Check result:

Acunivive 60 Injection System <> Tobramycin Sulfate

Relevance: 19.08.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Tobramycin can sometimes cause kidney damage, and using it with ketorolac may increase that risk, particularly if the latter is used chronically for prolonged periods. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. Signs and symptoms of kidney damage may include nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm. Let your doctor know if you experience some or all of these problems during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: The nephrotoxic effect of aminoglycosides may be potentiated by nonsteroidal anti-inflammatory drugs (NSAIDs), particularly if the latter had been given in high dosages for prolonged periods. Four children with cystic fibrosis who had been receiving chronic ibuprofen developed acute renal insufficiency shortly after initiation of IV aminoglycoside therapy for pulmonary exacerbations. An adolescent with CF who received intermittent, standard-dose ibuprofen during treatment with IV gentamicin also developed renal failure in addition to severe vestibular toxicity. Animal models suggest that renal prostaglandins may play a role in maintaining normal renal blood flow and glomerular filtration rate during the development of aminoglycoside nephrotoxicity, thus inhibition of their production by NSAIDs may worsen the renal damage.

MANAGEMENT: Whenever feasible, NSAID use should preferably be discontinued prior to initiating IV aminoglycoside therapy. If concomitant administration is necessary, hydration status as well as renal and vestibular functions should be closely monitored.

MONITOR: In premature infants, NSAIDs may increase the plasma concentrations of aminoglycosides. The proposed mechanism is decreased aminoglycoside clearance due to NSAID reduction of glomerular filtration rate, which is already low in premature infants. In a study of 20 preterm infants who had been given at least three days of amikacin or gentamicin therapy, mean peak plasma concentration increased by 17% and 33%, and mean trough concentration increased by 29% and 48%, respectively, on day 1 following administration of IV indomethacin for patent ductus arteriosus. Serum creatinine increased by 17%, while urine output and serum sodium decreased. Six patients developed hyponatremia.

MANAGEMENT: It may be advisable to consider reducing the dosage of aminoglycoside prior to initiation of NSAID therapy in infants. During coadministration, plasma antibiotic concentrations and renal function should be closely monitored, and the antibiotic dosage further adjusted as necessary.

References

Gagliardi L "Possible indomethacin-aminoglycoside interaction in preterm infants." J Pediatr 107 (1985): 991-2
Zarfin Y, Koren G, Maresky D, et al "Clinical and laboratory observations: possible indomethacin-aminoglycoside interaction in preterm infants." J Pediatr 106 (1985): 511-3
Farag MM, Mikhail MR, Abdel-Meguid E, Abdel-Tawab S "Assessment of gentamicin-induced nephrotoxicity in rats treated with low doses of ibuprofen and diclofenac sodium." Clin Sci 91 (1996): 187-91
Assael BM, Chiabrando C, Gagliardi L, Noseda A, Bamonte F, Salmona M "Prostaglandins and aminoglycoside nephrotoxicity." Toxicol Appl Pharmacol 78 (1985): 386-94
Scott CS, RetschBogart GZ, Henry MM "Renal failure and vestibular toxicity in an adolescent with cystic fibrosis receiving gentamicin and standard-dose ibuprofen." Pediat Pulm 31 (2001): 314-6
Kovesi TA, Swartz R, MacDonald N "Transient renal failure due to simultaneous ibuprofen and aminoglycoside therapy in children with cystic fibrosis." N Engl J Med 338 (1998): 65-6

Acunivive 60 Injection System

Generic Name: ketorolac

Brand name: Sprix, Toradol

Synonyms: Ketorolac (nasal), Ketorolac (Nasal)

What is Acunivive 60 Injection System?

Tobramycin Sulfate

Generic Name: tobramycin

Brand name: Bethkis, Kitabis Pak, Tobi, TOBI Podhaler

Synonyms: Tobramycin (inhalation), Tobramycin (Oral Inhalation)

What is Tobramycin Sulfate?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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