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Drug Interactions between Diaqua-2 and Septopal

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

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Interactions between your drugs

Major

gentamicin furosemide

Applies to: Septopal (gentamicin) and Diaqua-2 (furosemide)

GENERALLY AVOID: Coadministration of parenteral or inhaled aminoglycoside antibiotics or oral neomycin in combination with loop diuretics may potentiate the risk of oto- or nephrotoxicity due to additive or synergistic pharmacologic effects of these drugs and or altered aminoglycoside serum and tissue levels. Coadministration of aminoglycosides with intravenous mannitol may increase the risk of nephrotoxicity. The risk may be greater with high dosages of either drug, preexisting renal insufficiency, advanced age, dehydration, or the presence of other oto- or nephrotoxic drugs. The onset of ototoxicity may be greatly delayed, and cochlear damage may initially be asymptomatic. Reversible and irreversible hearing losses have been reported with aminoglycosides and loop diuretics.

MANAGEMENT: The use of aminoglycoside antibiotics in combination with loop diuretics or intravenous mannitol should generally be avoided. Renal function tests and serial, vestibular, and audiometric tests should be performed as appropriate for the type of diuretic before and during therapy if coadministration is necessary.

References

  1. Whiting PH, Barber HE, Petersen J (1981) "The effect of frusemide and piretanide on the renal clearance of gentamicin in man." Br J Clin Pharmacol, 12, p. 795-9
  2. Tilstone WJ, Semple PF, Lawson DH, Boyle JA (1977) "Effects of furosemide on glomerular filtration rate and clearance of practolol, digoxin, cephaloridine, and gentamicin." Clin Pharmacol Ther, 22, p. 389-94
  3. Lawson DH, Tilstone WJ, Gray JM, Srivastava PK (1982) "Effect of furosemide on the pharmacokinetics of gentamicin in patients." J Clin Pharmacol, 22, p. 254-8
  4. Smith CR, Lietman PS (1983) "Effect of furosemide on aminoglycoside-induced nephrotoxicity and auditory toxicity in humans." Antimicrob Agents Chemother, 23, p. 133-7
  5. Kaka JS, Lyman C, Kilarski DJ (1984) "Tobramycin-furosemide interaction." Drug Intell Clin Pharm, 18, p. 235-8
  6. Bruun JN, Eng J, Arnesen AR (1981) "Tobramycin therapy of serious infections." Scand J Infect Dis, 13, p. 59-64
  7. 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
  8. Moore RD, Smith CR, Lipsky JJ (1984) "Risk factors for nephrotoxicity in patients treated with aminoglycosides." Ann Intern Med, 100, p. 352-7
  9. Mathog RH, Klein WJ (1969) "Ototoxicity of ethacrynic acid and aminoglycoside antibiotics in uremia." N Engl J Med, 280, p. 1223-4
  10. Athlin L, Domellof L, Holm S (1981) "Gentamicin treatment in severe surgical infections: serum levels, interactions, toxicity and efficacy." Acta Chir Scand, 147, p. 225-30
  11. (2007) "Product Information. Lasix (furosemide)." sanofi-aventis
  12. Quick CA, Hoppe W (1975) "Permanent deafness associated with furosemide administration." Ann Otol Rhinol Laryngol, 84, p. 94-101
  13. Meriwether WD, Mangi RJ, Serpick AA (1971) "Deafness following standard intravenous dose of ethacrynic acid." JAMA, 216, p. 795-8
  14. Lynn AM, Redding GJ, Morray JP, Tyler DC (1985) "Isolated deafness following recovery from neurologic injury and adult respiratory distress syndrome. A sequela of intercurrent aminoglycoside and diuretic use." Am J Dis Child, 139, p. 464-6
  15. Salamy A, Eldredge L, Tooley WH (1989) "Neonatal status and hearing loss in high-risk infants." J Pediatr, 114, p. 847-52
  16. (2022) "Product Information. Tobi (tobramycin)." PathoGenesis
  17. Bates DE, Beaumont SJ, Baylis BW (2002) "Ototoxicity induced by gentamicin and furosemide." Ann Pharmacother, 36, p. 446-51
  18. Leary WP, Reyes AJ (1984) "Drug interactions with diuretics." S Afr Med J, 65, p. 455-61
  19. (2018) "Product Information. Arikayce (amikacin liposome)." Insmed Incorporated
View all 19 references

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Drug and food interactions

Moderate

furosemide food

Applies to: Diaqua-2 (furosemide)

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
  3. Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
  4. Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
  6. Cerner Multum, Inc. "Australian Product Information."
  7. Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
  8. Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
View all 8 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.

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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

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