Interaction between Tobramycin and Neomycin (topical)
Moderate
Synergy
| ID | DDInter1822 and DDInter1278 |
| Interaction | Topically applied aminoglycosides may be systemically absorbed and have potentially additive effects with systemically administered aminoglycosides. The risk of oto- and nephrotoxicity and other adverse effects of aminoglycosides may be increased. |
| Management | Topical preparations containing an aminoglycoside should not be used with other aminoglycosides in circumstances where significant systemic absorption could occur (e.g., application to burnt or broken skin; use of large quantities or on large areas for prolonged periods). The normally recommended dosages of these products should not be exceeded. |
| References | |
| Alternative for Tobramycin |
S01A
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| Alternative for Neomycin (topical) |
A07A
R02A Chlorhexidine
Cocaine (topical)
Flurbiprofen (ophthalmic)
Lidocaine (topical)
Benzocaine (topical)
Lidocaine (ophthalmic)
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Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.