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kanamycin (bulk)

Aminoglycosides/Loop Diuretics

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, you may experience an increased chance for hearing or kidney problems caused by one or both medicines. You may be at greater risk for hearing problems if you also have kidney problems.

What might happen:

Hearing loss may be permanent because of nerve damage caused by these medicines. Your kidney may not work as well.

What you should do about this interaction:

Tell you doctor if you notice any change in your hearing or balance. Make sure that your doctor knows all of the medicines that you are taking.Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Gentamicin Sulfate in 0.9% Sodium Chloride Injection. Baxter Healthcare Corporation June 2011.
2.Lasix (furosemide) US prescribing information. Sanofi-Aventis U.S. LLC March, 2012.
3.Ahmed RM, Hannigan IP, Macdougall HG, Chan RC, Halmagyi GM. Gentamicin ototoxicity: a 23-year selected case series of 103 patients. Med J Aust 2012 Apr 2;196(10):.
4.Nicolau DP, Freeman CD, Belliveau PP, Nightingale CH, Ross JW, Quintiliani R. Experience with a once-daily aminoglycoside program administered to 2,184 adult patients. Antimicrob Agents Chemother 1995 Mar;39(3):650-5.
5.Rybak MJ, Abate BJ, Kang SL, Ruffing MJ, Lerner SA, Drusano GL. Prospective evaluation of the effect of an aminoglycoside dosing regimen on rates of observed nephrotoxicity and ototoxicity. Antimicrob Agents Chemother 1999 Jul;43(7):1549-55.
6.Gerlach AT, Stawicki SP, Cook CH, Murphy C. Risk factors for aminoglycoside-associated nephrotoxicity in surgical intensive care unit patients. Int J Crit Illn Inj Sci 2011 Jan;1(1):17-21.
7.Mathog RH, Klein WJ Jr. Ototoxicity of ethacrynic acid and aminoglycoside antibiotics in uremia. N Engl J Med 1969 May 29;280(22):1223-4.
8.Tobramycin US prescribing information. X-GEN Pharmaceuticals, Inc. September, 2006.
9.Meriwether WD, Mangi RJ, Serpick AA. Deafness following standard intravenous dose of ethacrynic acid. JAMA 1971 May 3;216(5):795-8.
10.Bates DE, Beaumont SJ, Baylis BW. Ototoxicity induced by gentamicin and furosemide. Ann Pharmacother 2002 Mar;36(3):446-51.
11.Kaka JS, Lyman C, Kilarski DJ. Tobramycin-furosemide interaction. Drug Intell Clin Pharm 1984 Mar;18(3):235-8.
12.Noel P, Levy VG. Renal toxicity of the association: gentamicin/furosemide. One case (author's transl). Nouv Presse Med 1978 Feb 4;7(5):351-3.
13.Lawson DH, Tilstone WJ, Gray JM, Srivastava PK. Effect of furosemide on the pharmacokinetics of gentamicin in patients. J Clin Pharmacol 1982 May-Jun;22(5-6):254-8.
14.Bendush CL. Chapter 19 Ototoxicity: Clinical Considerations and Comparative Information. The Aminoglycosides: Microbiology, Clinical Use, and Toxicology 1982;453-486.

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