MajorLoop diuretics×Aminoglycoside antibiotic
Updated · Methodology
Mechanism
Gentamicin (an aminoglycoside) is directly oto- and nephrotoxic. Furosemide can also damage the cochlea and reduces renal perfusion via volume depletion. Effects are additive – irreversible sensorineural hearing loss and acute kidney injury have been reported.
Symptoms
Tinnitus, hearing loss, vertigo. Severe cases progress to deafness that does not recover after withdrawal. In parallel: reduced urine output, rising creatinine.
Management
Avoid the combination. If unavoidable, use the minimum effective furosemide dose with daily creatinine and hearing checks (audiometry where possible). Dose gentamicin once daily by weight and renal function, with protocol-driven level monitoring.
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
- FDA: Gentamicin injection prescribing information (2021)– ; DailyMed setid 84f5c763-1cd3-4d85-9afb-934db8666fbf
- AEMPS: Ficha técnica: Gentamicina (nº registro 63854), sección 4.5 (2024)– AEMPS, CIMA, nº registro 63854, revisión 10/2024, sección 4.5