Amikacide Drug Interactions

Neurotoxic, Ototoxic or Nephrotoxic Drugs: Avoid concurrent and/or sequential use with other drugs with similar toxic potential (e.g., other aminoglycosides, acyclovir, amphotericin B, bacitracin, capreomycin, cephalosporins, colistin, cisplatin, methoxyflurane, polymyxin B, vancomycin), if possible. In addition, do not give amikacin concurrently with ethacrynic acid, furosemide, urea, or mannitol because of the possibility of an increased risk of ototoxicity due to additive effects of altered serum and tissue concentrations of the antibiotics. Keep in mind the possibility that dimenhydrinate and other anti-emetics may mask symptoms of vestibular ototoxicity.
General Anesthetics and Neuromuscular Blocking Agents: Concurrent use of an aminoglycoside with general anesthetics of neuromuscular blocking agents (e.g., succinylcholine, tubocurarine) may potentiate neuromuscular blockade and cause respiratory paralysis. Use with caution in patients receiving such agents and observe signs of respiratory depression.
Neomycin: Oral neomycin may potentiate the effects of oral anticoagulants. Monitor prothrombin times in patients receiving concomitant oral aminoglycoside and oral anticoagulant therapy and adjust the dose of the anticoagulant as required.
Anti-infective Agents: In vitro studies indicate that the antibacterial activity of aminoglycosides and beta-lactam antibiotics or vancomycin may be additive or synergistic against some organisms including enterococci and P. aeruginosa. In vitro studies also indicate that aminoglycosides and extended-spectrum penicillins also exert a synergistic bactericidal effect against Enterobacteriaceae.