Major
Gentamicin × Iopromide
Aminoglycoside antibiotic×X-ray contrast media. Watersoluble nephrotropic low-osmolar iodinated agents
Mechanism
Additive nephrotoxicity. Gentamicin (an aminoglycoside) directly injures proximal renal tubules; iodinated contrast (iopromide) adds osmotic load. Acute tubular necrosis risk multiplies.
Symptoms
Reduced urine output, rising creatinine and urea, proteinuria. Severe cases include oliguria and need for haemodialysis. Symptoms appear 1–3 days after contrast.
Management
Postpone the contrast study until the gentamicin course ends where possible. If contrast is urgent, ensure adequate hydration (saline 1 mL/kg/h for 12 hours before and after), stop other nephrotoxic drugs, and check creatinine daily.
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.
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.