Interactions : אינטראקציות

4.5 Interactions with other medicinal products and other forms of interaction

Muscle relaxants and ether
The neuromuscular blocking activity of aminoglycosides is enhanced by ether and muscle relaxants.
If gentamicin is administered during or immediately after surgery, the neuromuscular blockade may be enhanced and prolonged if non-depolarising muscle relaxants are used. These interactions may cause neuromuscular blockage and respiratory paralysis. Because of the increased risk, such patients should be monitored with particular care.
Injection with calcium chloride may reverse the neuromuscular blockade due to aminoglycosides.

Methoxyflurane anaesthesia
Aminoglycosides may increase the kidney damaging effect of methoxyflurane. When used concurrently, extremely severe nephropathies are possible. The anaesthetist should be made aware of the use of aminoglycosides before a surgical procedure.

Potentially nephrotoxic or ototoxic drugs
Because of the increased risk of undesired effects, careful monitoring is required of patients being treated concurrently or sequentially with potentially nephrotoxic or ototoxic drugs such as e.g. amphotericin B, colistin, ciclosporin, cisplatin, vancomycin, streptomycin, viomycin, aminoglycosides, some cephalosporins, and loop diuretics such as ethacrynic acid and frusemide.
In the case of drugs containing cisplatin, it must be noted that the nephrotoxicity of gentamicin can be increased even 3 to 4 weeks after these substances are administered.

Other antibiotics
A reduction in gentamicin serum half-life has been reported in patients with severe renal impairment receiving carbenicillin concomitantly with gentamicin.