Amphotericin Amikacin

Clinically important, potentially hazardous interactions with amikacin, amphotericin B, delavirdine, drugs causing kidney toxicity, foscarnet, gentamicin, hydroxyurea, pentamidine, tobramycin... 

Noninterfering amikacin, amphotericin B, azathioprine, carhenicillin, chloral hydrate, ci-metidine, dopamine, fluphenazine, ftirosemide, hydrochlorothiazide, insulin, levothyrox-ine, methylprednisolone, nitroglycerin, oxacillin, prednisone, procainamide, sulfamethoxazole, tolazamide, tolbutamide, triamterene, trimethoprim... 

Noninterfering acyclovir, amikacin, amphotericin B, cefazolin, ceftazidime, clindamycin, gentamicin, metronidazole, piperacillin, trimethoprim, sulfamethoxazole... 

However, it is important to note that the addition of nephrotoxic agents, such as amphotericin B, aminoglysides (e.g., gentamicin, tobramidn, or amikacin), and non-steroidal anti-inflammatory drugs (NSAIDs e.g., naproxen, ibuprofen, or ketorolac) may potentiate the nephrotoxic effects of the calcineurin inhibitors. 

Amikacin and amphotericin B have both been prepared in liposomal formulations for different reasons. Amikacin can be targeted to macrophages for the treatment of intracellular microorganisms such as Mycobacterium avium complex (MAC).30 31... 

One study su ested that amphotericin B decreased the clearance of amikacin and gentamicin. The concurrent use of aminoglycosides and amphotericin B can result in nephrotoxicity. 

A study found that amikacin or gentamicin clearance was impaired in 12 of 17 children given amphotericin B. Serum creatinine increased by 50% or more in 3 of them, but there was no significant increase in creatinine levels in 7 others. As a result, the aminoglycoside dose was decreased or the dose interval lengthened in 7 children. ... 

The renal function of 4 patients receiving moderate doses of gentamicin deteriorated when they were given amphotericin B. Both drugs are known to be nephrotoxic and it is suggested, on the basis of what was seen, that eombined use may have had additive nephrotoxic effects. A further ret-rospeetive analysis found that the use of amikacin tended to increase am-photeriein B-related nephrotoxicity. ... 

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