Drug General Information (ID: DDIMLGZ90B)
Drug Name			Cefotaxime		Drug Info		Bumetanide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antibiotics				Diuretics
Structure

Mechanism of Cefotaxime-Bumetanide Interaction (Severity Level: Moderate)
Increased risk of nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Cefotaxime				Bumetanide
Mechanism		Cephalosporins				Increase the risk of cephalosporins-induced 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 Cefotaxime and Bumetanide

Recommended Action
Management		Although data are primarily limited to cephaloridine, which is no longer commercially marketed, caution may be advisable in patients receiving a loop diuretic in combination with other cephalosporins. Renal function should be monitored, particularly when high dosages are used or when these medications are administered in the elderly or patients with preexisting renal impairment.

References
1	Chrysos G, Gargalianos P, Lelekis M, Stefanou J, Kosmidis J "Pharmacokinetic interactions of ceftazidime and frusemide." J Chemother 7 Suppl (1995): 107-10. [PMID: 8904125]
2	Dodds MG, Foord RD "Enhancement by potent diuretics of renal tubular necrosis induced by cephaloridine." Br J Pharmacol 40 (1970): 227-36. [PMID: 5492895]
3	Korn A, Eichler HG, Gasic S "A drug interaction study of ceftriaxone and frusemide in healthy volunteers." Int J Clin Pharmacol Ther Toxicol 24 (1986): 262-4. [PMID: 3733274]
4	Lawson DH, Macadam RF, Singh H, et al "Effect of furosemide on antibiotic-induced renal damage in rats." J Infect Dis 126 (1972): 593-600. [PMID: 4664116]
5	Norrby R, Stenqvist K, Elgefors B "Interaction between cephaloridine and furosemide in man." Scand J Infect Dis 8 (1976): 209-12. [PMID: 968459]
6	Simpson IJ "Nephrotoxicity and acute renal failure associated with cephalothin and cephaloridine." N Z Med J 74 (1971): 312-5. [PMID: 5289757]
7	Tilstone WJ, Semple PF, Lawson DH, Boyle JA "Effects of furosemide on glomerular filtration rate and clearance of practolol, digoxin, cephaloridine, and gentamicin." Clin Pharmacol Ther 22 (1977): 389-94. [PMID: 902451]
8	Trollfors B, Norrby R, Kristianson K, Nilsson NJ "Effects on renal function of treatment with cefoxitin alone or in combination with furosemide." Scand J Infect Dis 13 (1978): 73-7. [PMID: 356182]