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Drug Interactions between Ancef and gentamicin

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

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Moderate

ceFAZolin gentamicin

Applies to: Ancef (cefazolin) and gentamicin

MONITOR: Coadministration of aminoglycosides and cephalosporins may increase the risk of nephrotoxicity. An increased incidence of nephrotoxicity has been reported during concomitant use of aminoglycosides and some, mostly older cephalosporins (e.g., cefaloridine, cefamandole, cefazolin, cefotaxime, cefoxitin, ceftazidime, cefuroxime, cephalothin, ceftriaxone). The risk may be greatest in the elderly or patients with preexisting renal impairment, when large doses are used, and during prolonged treatment. However, some studies have reported no adverse interaction between certain combinations of these agents.

MANAGEMENT: The lowest effective dosages of aminoglycosides and cephalosporins should be used when they are prescribed in combination. Renal function should be monitored closely. The same precaution may be applicable when aminoglycosides are administered via irrigation, intrapleurally, intraperitoneally or orally, since aminoglycosides can be systemically absorbed via these routes; however, clinical data are lacking.

References

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  2. Aronoff GR, Brier RA, Sloan RS, Brier ME (1990) "Interactions of ceftazidime and tobramycin in patients with normal and impaired renal function." Antimicrob Agents Chemother, 34, p. 1139-42
  3. Wade J, Smith C, Petty B, et al. (1978) "Nephrotoxicity of gentamicin or tobramycin with methicillin or cephalothin." Curr Chem, 2, p. 971-2
  4. Plager JE (1976) "Association of renal injury with combined cephalothin-gentamicin therapy among patients severely ill with malignant disease." Cancer, 37, p. 1937-43
  5. Schultze RG, Winters RE, Kauffman H (1971) "Possible nephrotoxicity of gentamicin." J Infect Dis, 124, s145-7
  6. Kleinknecht D, Ganeval D, Droz D (1973) "Acute renal failure after high doses of gentamicin and cephalothin." Lancet, 1, p. 1129
  7. Dellinger P, Murphy T, Barza M, et al. (1976) "Effect of cephalothin on renal cortical concentrations of gentamicin in rats." Antimicrob Agents Chemother, 9, p. 587-8
  8. Fanning WL, Gump D, Jick H (1976) "Gentamicin and cephalothin-associated rises in blood urea nitrogen." Antimicrob Agents Chemother, 10, p. 80-2
  9. Yasuhara H, Kobayashi S, Sakamoto K, Kamijo K (1982) "Pharmacokinetics of amikacin and cephalothin in bedridden elderly patients." J Clin Pharmacol, 22, p. 403-9
  10. Barbhaiya RH, Knupp CA, Pfeffer M, Pittman KA (1992) "Lack of pharmacokinetic interaction between cefepime and amikacin in humans." Antimicrob Agents Chemother, 36, p. 1382-6
  11. Schentag JJ, Cerra FB, Plaut ME (1982) "Clinical and pharmacokinetic characteristics of aminoglycoside nephrotoxicity in 201 critically ill patients." Antimicrob Agents Chemother, 21, p. 721-6
  12. Krcmery V, Fuchsberger P, Gocar M, et al. (1991) "Nephrotoxicity of aminoglycosides, polypeptides and cephalosporins in cancer patients." Chemotherapy, 37, p. 287-91
  13. Kabins SA, Cohen S (1964) "Cephalothin serum levels in the azotemic patient." Antimicrob Agents Chemother, 10, p. 207-14
  14. Klastersky J, Hensgens C, Debusscher L (1975) "Empiric therapy for cancer patients: comparative study of ticarcillin-tobramycin, ticarcillin-cephalothin, and cephalothin-tobramycin." Antimicrob Agents Chemother, 7, p. 640-5
  15. Pasternak DP, Stephens BG (1975) "Reversible nephrotoxicity associated with cephalothin therapy." Arch Intern Med, 135, p. 599-602
  16. Fanning WL, Gump D, Jick H (1976) "Gentamicin- and cephalothin-associated rises in blood urea nitrogen." Antimicrob Agents Chemother, 10, p. 80-2
  17. Gonzalez-Vitale JC, hayes DM, Cvitkovic E, Sternberg SS (1978) "Acute renal failure after cis-Dichlorodiammineplatinum (II) and gentamicin-cephalothin therapies." Cancer Treat Rep, 62, p. 693-8
  18. Kleinknecht D, Ganeval D, Droz D (1973) "Acute renal failure after high doses of gentamicin and cephalothin." Lancet, 05/19/73, p. 1129
  19. Cockram CS, Richards P, Bax RP (1980) "The safety of cefuroxime and gentamicin in patients with reduced renal function." Curr Med Res Opin, 6, p. 398-403
  20. Sanders WE, Jr Johnson JE, 3d Taggart JG (1974) "Adverse reactions to cephalothin and cephapirin. Uniform occurrence on prolonged intravenous administration of high doses." N Engl J Med, 290, p. 424-9
  21. Hansen MM, Kaaber K (1977) "Nephrotoxicity in combined cephalothin and gentamicin therapy." Acta Med Scand, 201, p. 463-7
  22. Engle JE, Drago J, Carlin B, Schoolwerth AC (1975) "Letter: Reversible acute renal failure after cephalothin." Ann Intern Med, 83, p. 232-3
  23. Cabanillas F, Burgos RC, Rodriguez C, Baldizon C (1975) "Nephrotoxicity of combined cephalothin-gentamicin regimen." Arch Intern Med, 135, p. 850-2
  24. Carling PC, Idelson BA, Casano AA, Alexander EA, McCabe WR (1975) "Nephrotoxicity associated with cephalothin administration." Arch Intern Med, 135, p. 797-801
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  32. Foord RD (1975) "Cephaloridine, cephalothin and the kidney." J Antimicrob Chemother, 1, p. 119-33
  33. Wade JC, Smith CR, Petty BG, et al. (1978) "Cephalothin plus an aminoglycoside is more nephrotoxic than methicillin plus an aminoglycoside." Lancet, 2, p. 604-6
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  39. (2018) "Product Information. Arikayce (amikacin liposome)." Insmed Incorporated
View all 39 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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.

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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.

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