Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction

Concurrent and/or sequential use of Bramitob with other medicinal products with nephrotoxic or ototoxic potential should be avoided. Some diuretics can enhance aminoglycoside toxicity by 
altering antibiotic concentrations in serum and tissue. Bramitob should not be administered concomitantly with furosemide, ethacrynic acid, urea or intravenous and oral mannitol.

Other medicinal products that have been reported to increase the potential toxicity of parenterally administered aminoglycosides include:

Amphotericin B, cephalotin, ciclosporin, tacrolimus, polymyxins (risk of increased nephrotoxicity); platinum compounds (risk increased nephrotoxicity and ototoxicity).

Anticholinesterases, botulinum toxin: Due to their neuromuscular effects, the combination with tobramycin should be avoided.


Others:
In clinical studies, patients taking nebulised tobramycin concomitantly with dornase alfa, mucolytic, B agonists, inhaled corticosteroids, and other oral or parenteral anti-pseudomonal antibiotics, showed adverse events similar to the patients of the control group.