Cisplatin Injection and Tobramycin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cisplatin Injection
Tobramycin
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
Renal dysfunction
Interaction Deep Dive
Concomitant use of CISplatin and aminoglycosides has the potential to increase the incidence of nephrotoxicity compared to either agent alone because both drugs are nephrotoxic. One study documented an increased frequency of nephrotoxicity with concomitant use of these agents, but the overall renal changes were mild and not clinically significant1.
Why it happens (mechanism)
Unknown
Literature reports
2 reports — tap to read
a) Sixty-seven patients receiving CISplatin for esophageal or head and neck cancer were studied for renal changes . Seventeen patients also received an aminoglycoside with a maximum interval of 100 days between exposure to CISplatin and the aminoglycoside. When abnormal renal function was defined as a serum creatinine that exceeded 150% of the pretreatment value, there was a significant increase in the frequency of abnormal renal function with concomitant use of an aminoglycoside and cisplatin as compared to CISplatin alone. However, the overall change in serum creatinine was the same for both groups (0.69 +/- 0.95 mg/dL for the CISplatin group versus 0.84 +/- 0.58 mg/dL for the CISplatin/aminoglycoside group) 1.
b) In a study of CISplatin induced nephrotoxicity, patients receiving other potential nephrotoxins along with CISplatin experienced a greater decrease in creatinine clearance . Out of fifteen patients on CISplatin, three also received gentamicin or tobramycin seven to ten days after CISplatin administration. These patients had a mean decrease in creatinine clearance of 64 mL/min as compared to a decrease of 32 mL/min with CISplatin alone 2.
Common questions
Can I take Cisplatin Injection and Tobramycin together?
Renal dysfunction Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cisplatin Injection and Tobramycin interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Cisplatin Injection or Tobramycin 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 (2)
- Haas A, Anderson L, & Lad T: The influence of aminoglycosides on the nephrotoxicity of cis-diamminedichloroplatinum in cancer patients. J Infect Dis 1983; 147:363. PubMed
- Dentino M, Luft FC, Yum MN, et al: Long term effect of cis-diamminedichloride platinum (CDDP) on renal function and structure in man. Cancer 1978; 41:1274-1281. PubMed
Keep reading about Cisplatin Injection
Keep reading about Tobramycin
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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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