Furosemide and Gentamicin Interaction in Dogs: Risks & Management

References

1. Revised: April 2025 AN: 00774/2024 & 00775/2024 Page 1 of 8www.vmd.defra.gov.uk · Mar 8, 2021
   Passage read from this source

   3.8 Interaction with other medicinal products and other forms of interaction In order to ensure efficacy, the veterinary medicinal product should not be used in combination with bacteriostatic antibiotics. Concurrent use of first generation cephalosporins with polypeptide antibiotics, aminoglycosides or some diuretics such as furosemide can enhance nephrotoxicity risks. Refer to section 3.3. 3.9 Administration routes and dosage Oral use. The recommended dose is 15 mg of cefalexin per kg of body weight (0.3 ml of reconstituted product per kg of body weight), twice a day. In severe or acute conditions, the dose may be doubled to 30 mg/kg (0.6 ml/kg) twice daily.

2. Gentamicin injection - accessdata.fda.govwww.accessdata.fda.gov
   Passage read from this source

   Interactions with Other Antimicrobials In vitro studies show that an aminoglycoside com - bined with an antibiotic that interferes with cell wall synthesis may act synergistically against some enterococcal strains. The combination of gentamicin and penicillin G has a synergistic bactericidal effect against strains of Enterococcus faecalis, E. faecium and E. durans. An enhanced killing effect against many of these strains has also been shown in vitro with combinations of gentamicin and ampicillin, carbenicillin, nafcillin or oxacillin. The combined effect of gentamicin and carbenicil- lin is synergistic for many strains of Pseudomonas aeruginosa. In vitro synergism against other Gram- negative organisms has been shown with combina- tions of gentamicin and cephalosporins. Gentamicin may be active against clinical isolates of bacteria…

   The rate of removal of gentamicin is considerably lower by peritoneal dialysis than it is by hemodialysis. In the newborn infant, exchange transfu- sions may also be considered. Concurrent and/or sequential systemic or topical use of other potentially neurotoxic and/or nephrotoxic drugs, such as cisplatin, cepha- loridine, kanamycin, amikacin, neomycin, poly- myxin B, colistin, paromomycin, streptomycin, tobramycin, vancomycin and viomycin, should be avoided. Other factors which may increase patient risk of toxicity are advanced age and dehydration. The concurrent use of gentamicin with potent diuretics, such as ethacrynic acid or furosemide, should be avoided, since certain diuretics by themselves may cause ototoxicity. In addition, when administered intravenously, diuretics may enhance aminoglycoside toxicity by altering the antibiotic concentration in serum and…

3. Gentamicin Sulfate Injection, USP 80mg/2ml (40 mg/mL as ...dailymed.nlm.nih.gov
   Passage read from this source

   Concurrent and/or sequential systemic or topical use of other potentially neurotoxic and/or nephrotoxic drugs, such as cisplatin, cephaloridine, kanamycin, amikacin, neomycin, polymyxin B, colistin, paromomycin, streptomycin, tobramycin, vancomycin, and viomycin, should be avoided. Other factors which may increase patient risk to toxicity are advanced age and dehydration. The concurrent use of gentamicin with potent diuretics, such as ethacrynic acid or furosemide, should be avoided, since certain diuretics by themselves may cause ototoxicity. In addition, when administered intravenously, diuretics may enhance aminoglycoside toxicity by altering the antibiotic concentration in serum and tissue. Aminoglycosides can cause fetal harm when administered to a pregnant woman (see WARNINGS section).

   Interaction With Other Antimicrobials In vitro studies show that an aminoglycoside combined with an antibiotic that interferes with cell wall synthesis may act synergistically against some enterococcal strains. The combination of gentamicin and penicillin G has a synergistic bactericidal effect against strains of Enterococcusfaecalis, E. faecium and E. durans. An enhanced killing effect against many of these strains has also been shown in vitro with combinations of gentamicin and ampicillin, carbenicillin, nafcillin or oxacillin. The combined effect of gentamicin and carbenicillin is synergistic for many strains of Pseudomonas aeruginosa. In vitro synergism against other Gram-negative organisms has been shown with combinations of gentamicin and cephalosporins. Gentamicin may be active against clinical isolates of bacteria resistant to other aminoglycosides. Antimicrobial Activity

   Although the in vitro mixing of gentamicin and carbenicillin results in a rapid and significant inactivation of gentamicin, this interaction has not been demonstrated in patients with normal renal function who received both drugs by different routes of administration. A reduction in gentamicin serum half-life has been reported in patients with severe renal impairment receiving carbenicillin concomitantly with gentamicin. Treatment with gentamicin may result in overgrowth of nonsusceptible organisms. If this occurs, appropriate therapy is indicated. See WARNINGS box regarding concurrent use of potent diuretics and regarding concurrent and/or sequential use of other neurotoxic and/or nephrotoxic antibiotics and for other essential information. Do not administer unless solution is clear and package undamaged. Pregnancy (see WARNINGS section). General

4. Gentamicin - Veterinary Medicines Directoratewww.vmd.defra.gov.uk
   Passage read from this source

   Use only based on the benefit-risk assessment by the responsible veterinarian. 4.8 Interaction with other medicinal products and other forms of interaction This product should not be used in conjunction with other aminoglycoside antibiotics, or with other drugs known to induce either ototoxicity or nephrotoxicity. 4.9 Amounts to be administered and administration route Administer by slow intravenous injection. Single dose of 6.6 mg gentamicin/kg body weight (equivalent to 0.066 ml/kg b.w. of the product) given intravenously once daily for 3–5 consecutive days. To ensure a correct dosage, bodyweight should be determined as accurately as possible to avoid under- or over-dosing. The dosing regimen must not be exceeded. The use of gentamicin in foals and neonates is not recommended.

5. AmiJect D for Dogswww.drugs.com · May 28, 2026
   Passage read from this source

   -Appearance in the urine of casts, albumin, glucose or blood. Continued use of aminoglycosides where any functional renal impairment has occurred may lead to enhanced renal damage as well as increased likelihood of ototoxicity and/or neuromuscular blockade.(6) Concurrent or sequential use of topically or systemically administered nephrotoxic, ototoxic, or neuromuscular blocking drugs, particularly other aminoglycosides such as streptomycin, gentamicin, kanamycin and neomycin should be avoided because of the potential for additive effects. Concurrent administration of furosemide with aminoglycosides may enhance nephrotoxicity.(7) Not for use in breeding dogs as reproductive studies have not been conducted.

6. Fatal nephrotoxicosis associated with furosemide and ... - PubMedpubmed.ncbi.nlm.nih.gov · Oct 15, 1983
   Passage read from this source

   MeSH terms Animals Bacterial Infections / drug therapy Bacterial Infections / veterinary Dog Diseases / drug therapy Dog Diseases / pathology* Dogs Drug Therapy, Combination Furosemide / poisoning* Furosemide / therapeutic use Gentamicins / poisoning* Gentamicins / therapeutic use Kidney / pathology* Pneumonia / drug therapy Pneumonia / veterinary