Furosemide Injection and Neomycin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Furosemide Injection
Neomycin
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
Increased neomycin exposure, an increased risk of neomycin toxicity and additive ototoxicity and/or nephrotoxicity
Interaction Deep Dive
Avoid concomitant use of furosemide and neomycin due to potential additive nephrotoxicity and ototoxicity4 except in life-threatening situations. Coadministration of neomycin and furosemide may increase the risk of ototoxicity, especially in the presence of impaired renal function 21. If the physician elects to use high-dose parenteral therapy, controlled intravenous infusion is advisable (for adults, an infusion rate not exceeding 4 mg furosemide per minute has been used) 1. Concurrent use of intravenous furosemide may increase neomycin toxicity by altering neomycin exposure and may potentiate neuromuscular blocking effects of neomycin 4.
Why it happens (mechanism)
Additive or synergistic toxicity
Literature reports
2 reports — tap to read
a) A study was conducted to research the effects of furosemide-aminoglycoside combination therapy on ototoxicity. As measured by audiograms, toxicity developed in 5 out of 23 patients (21.7%) receiving furosemide and aminoglycosides and in 28 out of 119 patients (23.5%) who received only an aminoglycoside. However, only a small number of patients received combination therapy, as opposed to single agent furosemide therapy. Significant differences may have been detected with larger numbers of patients receiving the combination. The same authors also conducted a retrospective study of the influence of furosemide on aminoglycoside-induced nephrotoxicity. Nephrotoxicity was defined as a rise in serum creatinine of greater than or equal to 0.5 mg/dL (40 mcmol/L) if the original concentration was less than 3 mg/dL (300 mcmol/L) or a rise of greater than or equal to 1 mg/dL (90 mcmol/L) if the original concentration was 3 mg/dL (300 mcmol/L) or greater. Results demonstrated nephrotoxicity in 10 out of 50 patients (20%) given furosemide and aminoglycoside and in 38 out of 222 patients (17.1%) given only an aminoglycoside. The authors concluded that the coadministration of furosemide with aminoglycosides should not be considered a major risk factor for the development of aminoglycoside-induced nephrotoxicity or auditory toxicity 3.
b) Cases of tinnitus and reversible or irreversible hearing impairment and deafness have been reported with furosemide. Reports usually indicate that furosemide ototoxicity is associated with rapid injection, severe renal impairment, the use of higher than recommended doses, hypoproteinemia or concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs 21.
Common questions
Can I take Furosemide Injection and Neomycin together?
Increased neomycin exposure, an increased risk of neomycin toxicity and additive ototoxicity and/or nephrotoxicity Always confirm with your pharmacist or prescriber before making any change.
How serious is the Furosemide Injection and Neomycin interaction?
It is rated major. Potentially serious — often needs a change or close 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Furosemide Injection or Neomycin 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 a safer alternative to one of these medications for me?
References (4)
- Product Information: LASIX® ONYU subcutaneous injection, furosemide subcutaneous injection. SQ Innovation, Inc (per manufacturer), Burlington, MA, 2025. DailyMed
- Product Information: FUROSCIX(R) subcutaneous injection, furosemide subcutaneous injection. scPharmaceuticals Inc (per FDA), Burlington, MA, 2025. DailyMed
- Smith CR & Lietman PS: Effect of furosemide on aminoglycoside-induced nephrotoxicity and auditory toxicity in humans. Antimicrob Agents Chemother 1983; 23:133-137. DOI
- Product Information: neomycin sulfate oral tablets, neomycin sulfate oral tablets. X-Gen Pharmaceticals Inc, Big Flats, NY, 2009. DailyMed
Keep reading about Furosemide Injection
Keep reading about Neomycin
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist