Drug & supplement interaction

Mountain Ash + Tobramycin

Tobramycin brand names: Nebcin, Tobi Podhaler, Bethkis, Kitabis PAK.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Mountain Ash has a moderate interaction with Tobramycin. Taking large amounts of fresh mountain ash berries may cause kidney damage due to its parasorbic acid constituent.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Mountain Ash and Tobramycin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

NEPHROTOXIC DRUGS

Why this applies to Tobramycin

Tobramycin falls under NEPHROTOXIC DRUGS — the group Mountain Ash interacts with.

Taking large amounts of fresh mountain ash berries may cause kidney damage due to its parasorbic acid constituent. Theoretically, taking mountain ash berries with nephrotoxic drugs might increase the risk for kidney damage. Until more is known, advise patients to avoid taking mountain ash berries if they are taking other potentially nephrotoxic drugs.
Some potentially nephrotoxic drugs include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing mountain ash berries and tobramycin. Tobramycin is an aminoglycoside antibiotic that is already known to be tough on the kidneys, especially with longer courses or higher doses. Fresh mountain ash berries contain parasorbic acid, which in large amounts is also thought to stress the kidneys. Put the two together and, at least in theory, you could be doubling up on that kidney strain.

I want to be honest about the strength of this: it's theoretical, based on how these compounds behave rather than real patient studies. A little cooked rowan jam is unlikely to be the problem. Large amounts of raw or concentrated berry supplements are where I'd be cautious. While you're on tobramycin, your kidneys are usually being monitored anyway, so check with your pharmacist or doctor before adding mountain ash.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Mountain Ash Also Interacts With Other Medications

Mountain Ash has 354 moderate known drug interactions in our database — the Tobramycin one above is one of them. If you take anything else, check it against the full list below.

Moderate 354 No known interaction 2,476 (incl. Tobramycin)
Taking anything else?

Check Another of Your Medications Against Mountain Ash

Covers the 2,830 medications we’ve checked against Mountain Ash. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Tobramycin

This page covers Mountain Ash only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tobramycin page lists 52 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), Aristolochia (moderate) and Bacillus Coagulans (moderate).

By severity: 3 major · 38 moderate · 11 minor.

From our pharmacist’s overview on the Tobramycin page

“Kidney protection is the first thing to understand with tobramycin (Nebcin, Tobi Podhaler, Bethkis, Kitabis PAK), an aminoglycoside antibiotic that can stress the kidneys even on its own, so this list warrants genuine care rather than a quick glance. The worst pairings, Siberian cocklebur and asarabacca, can injure the kidneys themselv…”

Reviewed by 2 · Jul 18, 2026

Open the Tobramycin interaction page

One more smart check

Taking Mountain Ash as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1 real supplement products containing Mountain Ash, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Mountain Ash. Your product may carry other ingredients that interact with Tobramycin too, on top of Mountain Ash — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Mountain Ash and Tobramycin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Mountain Ash
Steady interest

#729 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tobramycin
Steady interest

#2,651 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Mountain Ash

What is Mountain Ash?

Mountain Ash
  • Sore throat and hoarseness
  • Digestive upset and constipation
  • Cough and chest congestion
  • Mild urinary complaints
  • Source of vitamin C in folk medicine

Mountain ash (rowan) is a northern-hemisphere tree whose bright red berries are traditionally cooked into jams, syrups, and teas. There is very little reliable human research to support any medical use, and raw berries contain compounds that can cause stomach upset, so cooking is important. If you want to try it, talk with your pharmacist or doctor first.

Read the full Mountain Ash monograph & all interactions
Medication

About Tobramycin Injection

What Is Tobramycin Injection Used For?

Brand names: Nebcin, Tobi Podhaler, Bethkis, Kitabis PAK

Tobramycin Injection is used to treat serious and life-threatening bacterial infections caused by susceptible bacteria. It is approved for adults and children for infections of the blood (septicemia), lungs and airways, brain and spinal cord (meningitis), abdomen, skin, bones, and urinary tract.

Because antibiotic resistance is a growing concern, Tobramycin Injection should only be used when there is a proven or strongly suspected bacterial infection. Your care team will use culture and lab results to confirm it is the right choice.

See full Tobramycin Injection drug information
Keep checking

Other Drugs & Mountain Ash

Browse every other medication we’ve checked against Mountain Ash — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
354Moderate
0Minor
2,475No known interaction
354 Moderate 2,475 No interaction
Moderate

354 interactions

Showing 60 of 354 moderate interactions — see all 354 on the Mountain Ash page.

No interaction 2,475 drugs checked — show the list

We also checked Mountain Ash against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,475 medications checked with no known interaction — see the full Mountain Ash list.

See the full Mountain Ash interactions page
See every supplement checked against Tobramycin, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Mountain Ash monograph › Uses, safety, and every drug interaction in one place Tobramycin supplement interactions › Every supplement checked against Tobramycin, ranked by severity Tobramycin Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Mountain Ash and Tobramycin Together: Common Questions

Can you take Mountain Ash with Tobramycin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Mountain Ash and Tobramycin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tobramycin and Mountain Ash?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.