Ibuprofen with Amikacin Interaction Details

Brand Names Associated with Ibuprofen

Brand Names Associated with Amikacin

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Nov 12, 2023

Interaction Effect

Increase amikacin exposure

Interaction Summary

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 lysine.

Severity

Moderate

Onset

Unspecified

Evidence

Probable

How To Manage Interaction

Concurrent use of amikacin and ibuprofen may result in increased amikacin half-life and decreased amikacin clearance. The dosing interval of amikacin may have to be increased when amikacin is coadministered with ibuprofen lysine.

Mechanism Of Interaction

Unknown

Literature Reports

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) .

Ibuprofen Overview

• Prescription ibuprofen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). It is also used to relieve mild to moderate pain, including menstrual pain (pain that happens before or during a menstrual period). Nonprescription ibuprofen is used to reduce fever and to relieve minor aches and pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Ibuprofen is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

Amikacin Overview

• Amikacin injection is used to treat certain serious infections that are caused by bacteria such as meningitis (infection of the membranes that surround the brain and spinal cord) and infections of the blood, abdomen (stomach area), lungs, skin, bones, joints, and urinary tract. Amikacin injection is in a class of medications called aminoglycoside antibiotics. It works by killing bacteria.

• Antibiotics such as amikacin injection will not work for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

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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:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

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.