Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction

Ototoxicity and nephrotoxicity
Concurrent administration of gentamicin and other potentially ototoxic or nephrotoxic drugs should be avoided. Potent diuretics such as etacrynic acid and furosemide are expected to enhance the risk of ototoxicity whilst amphotericin B, cisplatin and ciclosporin are potential enhancers of nephrotoxicity.
Any potential nephrotoxicity of cephalosporins, and in particular cephaloridine, may also be increased in the presence of gentamicin. Consequently, if this combination is used, monitoring of kidney function is advised.
Neuromuscular blockade
Neuromuscular blockade and respiratory paralysis have been reported from administration of aminoglycosides to patients who have received curare-type muscle relaxants during anaesthesia. Concomitant use of gentamicin with drugs with neuromuscular blocking effects, such as botulinum toxin, may increase the risk of toxicity due to enhanced neuromuscular block.
Aminoglycosides such as gentamicin can also act as neuromuscular blockers and may therefore antagonise the effects of neostigmine or pyridostigmine.
The following combinations with gentamicin may require dose adjustment:
•Concomitant use of indomethacin possibly increases plasma concentrations of gentamicin in neonates.
•Concomitant use with oral anticoagulants may decrease thrombin levels and increase the risk of bleeding.
• Concomitant use of bisphosphonates with gentamicin may increase the risk of hypocalcaemia.