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Drug Interactions between Principen and tobramycin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

ampicillin tobramycin

Applies to: Principen (ampicillin) and tobramycin

ADJUST DOSING INTERVAL: Ampicillin may inactivate aminoglycosides in vivo and in vitro. The mechanism is complexation with the aminoglycoside. Typically, this effect is significant only in patients with renal failure or if the agents are mixed in the same IV container or line. Lower serum aminoglycoside levels may be seen, and dosage adjustments may be necessary.

MANAGEMENT: Ampicillin and aminoglycosides should be administered separately during combined therapy.

References

  1. Riff LJ, Jackson GG "Laboratory and clinical conditions for gentamicin inactivation by carbenicillin." Arch Intern Med 130 (1972): 887-91
  2. Davies M, Morgan JR, Anand C "Interactions of carbenicillin and ticarcillin with gentamicin." Antimicrob Agents Chemother 7 (1975): 431-4
  3. Thompson MI, Russo ME, Saxon BJ, Atkin-Thor E, Matsen JM "Gentamicin inactivation by piperacillin or carbenicillin in patients with end-stage renal disease." Antimicrob Agents Chemother 21 (1982): 268-72
  4. Halstenson CE, Hirata CA, Heim-Duthoy KL, Abraham PA, Matzke GR "Effect of concomitant administration of piperacillin on the dispositions of netilmicin and tobramycin in patients with end-stage renal disease." Antimicrob Agents Chemother 34 (1990): 128-33
  5. Kradjan WA, Burger R "In vivo inactivation of gentamycin by carbenicillin and ticarcillin." Arch Intern Med 140 (1980): 1668-70
  6. Russo ME, Atkin-Thor E "Gentamicin and ticarcillin in subjects with end-stage renal disease." Clin Nephrol 15 (1981): 175-80
  7. Viollier AF, Standiford HC, Drusano GL, Tatem BA, Moody MR, Schimpff SC "Comparative pharmacokinetics and serum bactericidal activity of mezlocillin, ticarcillin and piperacillin, with and without gentamicin." J Antimicrob Chemother 15 (1985): 597-606
  8. Weibert R, Keane W, Shapiro F "Carbenicillin inactivation of aminoglycosides in patients with severe renal failure." Trans Am Soc Artif Intern Organs 22 (1976): 439-43
  9. Pickering LK, Rutherford I "Effect of concentration and time upon inactivation of tobramycin, gentamicin, netilmicin and amikacin by azlocillin, carbenicillin, mecillinam, mezlocillin and piperacillin." J Pharmacol Exp Ther 217 (1981): 345-9
  10. Henderson JL, Polk RE, Kline BJ "In vitro inactivation of gentamicin, tobramycin, and netilmicin by carbenicillin, azlocillin, or mezlocillin." Am J Hosp Pharm 38 (1981): 1167-70
  11. "Product Information. Arikayce (amikacin liposome)." Insmed Incorporated (2018):
View all 11 references

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Drug and food interactions

Moderate

ampicillin food

Applies to: Principen (ampicillin)

ADJUST DOSING INTERVAL: Certain penicillins may exhibit reduced gastrointestinal absorption in the presence of food. The therapeutic effect of the antimicrobial may be reduced.

MANAGEMENT: The interacting penicillin should be administered one hour before or two hours after meals. Penicillin V and amoxicillin are not affected by food and may be given without regard to meals.

References

  1. Neu HC "Antimicrobial activity and human pharmacology of amoxicillin." J Infect Dis 129 (1974): s123-31
  2. Welling PG, Huang H, Koch PA, Madsen PO "Bioavailability of ampicillin and amoxicillin in fasted and nonfasted subjects." J Pharm Sci 66 (1977): 549-52
  3. McCarthy CG, Finland M "Absorption and excretion of four penicillins." N Engl J Med 263 (1960): 315-26
  4. Cronk GA, Wheatley WB, Fellers GF, Albright H "The relationship of food intake to the absorption of potassium alpha-phenoxyethyl penicillin and potassium phenoxymethyl penicillin from the gastrointestinal tract." Am J Med Sci 240 (1960): 219-25
  5. Klein JO, Sabath LD, Finland M "Laboratory studies on oxacillin. I: in vitro activity against staphylococci and some other bacterial pathogens. II: absorption and urinary excretion in normal young." Am J Med Sci 245 (1963): 399-411
  6. Neuvonen PJ, Elonen E, Pentikainen PJ "Comparative effect of food on absorption of ampicillin and pivampicillin." J Int Med Res 5 (1977): 71-6
View all 6 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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