ModerateAntiplatelet agents (low dose) / NSAIDs (analgesic dose)×Aminoglycoside antibiotic
Updated · Methodology
Mechanism
Additive nephrotoxicity. Aspirin suppresses prostaglandin-dependent renal blood flow (at high doses); gentamicin causes direct tubulotoxicity.
Symptoms
Reduced urine output, rising creatinine. Symptoms appear earlier in older patients and chronic kidney disease.
Management
Cardioprotective aspirin doses (75–100 mg) do not require withdrawal. At high doses, check creatinine before and 3–5 days into gentamicin therapy. Ensure adequate hydration; consider switching to a less nephrotoxic antibiotic (a cephalosporin, carbapenem).
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- KDIGO: KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of CKD (2024)– Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int 2024;105(4S):S117-S314.