Drug General Information (ID: DDIHO3E0N6)
Drug Name			Bumetanide		Drug Info		Plazomicin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Diuretics				Aminoglycosides//Antibiotics
Structure

Mechanism of Bumetanide-Plazomicin Interaction (Severity Level: Major)
Increased risk of nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Bumetanide				Plazomicin
Mechanism 1		Nephrotoxicity				Nephrotoxicity
Key Mechanism Factor 1
		Factor Name		Nephrotoxicity
		Factor Description		The combination of drugs that can induce nephrotoxicity may increase the risk of kidney injury. When kidney injury occurs, the inability to remove excess urine and waste from the body can lead to high levels of urea nitrogen, creatinine, and electrolytes (such as potassium and magnesium) in the blood.
Mechanism Description		Increased risk of nephrotoxicity by the combination of Bumetanide and Plazomicin
Increased risk of ototoxicity Click to Show/Hide Mechanism Graph
Drug Name		Bumetanide				Plazomicin
Mechanism 2		Ototoxicity				Ototoxicity
Key Mechanism Factor 2
		Factor Name		Ototoxicity
		Factor Description		Ototoxicity is the damage to the organs of hearing and/or balance following exposure to drugs or chemicals that affect the inner ear. Ototoxic drugs can impair hearing, balance, or both.
Mechanism Description		Increased risk of ototoxicity by the combination of Bumetanide and Plazomicin

Recommended Action
Management		The use of aminoglycoside antibiotics in combination with loop diuretics or intravenous mannitol should generally be avoided. Renal function tests and serial, vestibular, and audiometric tests should be performed as appropriate for the type of diuretic before and during therapy if coadministration is necessary.

References
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11	Product Information. Arikayce (amikacin liposome). Insmed Incorporated, Bridgewater, NJ.
12	Product Information. Lasix (furosemide). sanofi-aventis , Bridgewater, NJ.
13	Product Information. Tobi tobramycin solution for inhalation (tobramycin) PathoGenesis, Skokie, IL.
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