gentamicin and furosemide

Both gentamicin and furosemide are nephrotoxic and ototoxic. Furosemide may increase gentamicin concentration inrenal tubular cells and reduce gentamicin clearance through volume depletion, potentiating renal and hearing damage.

The risk of acute kidney injury and irreversible ototoxicity is significantly increased, particularly with high doses, prolonged therapy, or in patients with pre-existing renal impairment or advanced age.

Avoid concurrent use if possible. If unavoidable, ensure adequate hydration, monitor renal function (serum creatinine and urea) and hearing before and during therapy. Adjust gentamicin doses based on renal function and consider alternative diuretics or antibacterial agents when appropriate.

Well-established interaction supported by clinical reports and experimental studies; guidelines recommend caution and monitoring when these drugs are co-administered.