Furosemide with Neomycin Interaction Details
Brand Names Associated with Furosemide
- Furosemide
- Lasix®
Brand Names Associated with Neomycin
- Myciguent®
- Neo-Cortef® (as a combination product containing Hydrocortisone, Neomycin)
- Neo-Decadron® (as a combination product containing Dexamethasone, Neomycin)
- Neo-Medrol® (as a combination product containing Methylprednisolone, Neomycin)
- Neomycin Topical
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 10, 2023
Interaction Effect
Increased neomycin exposure, increased risk of neomycin toxicity and additive ototoxicity and/or nephrotoxicity
Interaction Summary
Concomitant use of furosemide and neomycin should be avoided due to potential additive nephrotoxicity and ototoxicity except in life-threatening situations . Concurrent administration of intravenous furosemide may increase neomycin toxicity by altering neomycin serum and tissue concentrations and may potentiate neuromuscular blocking effects of neomycin . Coadministration of neomycin and furosemide may increase the risk of ototoxicity, especially in the presence of impaired renal function .
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
The concomitant use of furosemide and neomycin should be avoided due to potential additive nephrotoxicity and ototoxicity except in life-threatening situations . Concurrent administration of intravenous furosemide may increase neomycin toxicity by altering neomycin serum and tissue concentrations and may potentiate neuromuscular blocking effects of neomycin . Coadministration of neomycin and furosemide may increase the risk of ototoxicity, especially in the presence of impaired renal function .
Mechanism Of Interaction
Additive or synergistic toxicity
Literature Reports
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 .
Furosemide Overview
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Furosemide is used alone or in combination with other medications to treat high blood pressure. Furosemide is used to treat edema (fluid retention; excess fluid held in body tissues) caused by various medical problems, including heart, kidney, and liver disease. Furosemide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.
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High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
Neomycin Overview
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Neomycin, an antibiotic, is used to prevent or treat skin infections caused by bacteria. It is not effective against fungal or viral infections.
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This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.