Amikacin and Ibuprofen: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ibuprofen
Amikacin
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increase amikacin exposure
Interaction Deep Dive
The Cmin and half-life increased and clearance decreased of amikacin when administered with ibuprofen lysine in a retrospective pharmacokinetic analysis of 73 preterm infants administered either ibuprofen lysine or placebo during the first 3 days of life. The dosing interval of amikacin may have to be increased when amikacin is coadministered with ibuprofen lysine1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) The Cmin and half-life increased and clearance decreased of amikacin when administered with ibuprofen lysine in a retrospective pharmacokinetic analysis of 73 preterm infants administered either ibuprofen lysine or placebo during the first 3 days of life. Preterm infants were randomized to intravenous ibuprofen lysine or placebo in a multicenter ibuprofen prophylaxis study. Infants in the ibuprofen group (mean weight 982 +/- 380 grams, mean gestational age (GA) 27.4 +/- 1.7) received a loading dose of 10 mg/kg over 15 minutes within the first 6 hours of life followed by 5 mg/kg at 24 hours and 48 hours later. The corresponding volumes of placebo in the placebo group (mean weight 1,064 +/- 390, p greater than 0.05 compared with ibuprofen; mean GA 27.8 +/- 2, p greater than 0.05 compared with ibuprofen) were 1 mL/kg and 0.5 mL/kg. All infants received empiric treatment with amikacin (20 mg/kg every 36 hours with a GA of less than 30 weeks and 20 mg/kg every 24 hours with a gestational age of 30 weeks or more). The Cmax and Vd of amikacin was not different between the groups. However, the half-life of amikacin was greater in the ibuprofen group (16.4 hours; range, 7.8 to 92.1 hours) compared with the placebo group (12.4 hours; range, 6.7 to 60.3 hours) (p less than 0.02). The Cmin of amikacin was greater in the ibuprofen group (9.9 mg/L; range, 3.5 to 19 mg/L) compared with the placebo group (6.2 mg/L; range, 1 to 19 mg/l) (p less than 0.01). The clearance of amikacin was less in the ibuprofen group (0.36 mL/kg/min; range, 0.14 to 0.84 mL/kg/min) compared with placebo group (0.6 mL/kg/min; range 0.03 to 2.6 mL/kg/min) (p less than 0.005) 1.
Common questions
Can I take Amikacin and Ibuprofen together?
Increase amikacin exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amikacin and Ibuprofen interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amikacin or Ibuprofen need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Allegaert K, Cossey V, Langhendries JP, et al: Effects of co-administration of ibuprofen-lysine on the pharmacokinetics of amikacin in preterm infants during the first days of life. Biol Neonate 2004; 86(3):207-211. PubMed
Keep reading about Ibuprofen
Keep reading about Amikacin
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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