tobramycin ophthalmic (Rx)

Brand and Other Names:Tobrex, Tobramycin Ophth, more...AKTob
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

  • 0.3%

ophthalmic ointment

  • 0.3%

Eye Infection

Mild/moderate

  • Ointment: Apply ½ in. (1.25 cm) to affected eye(s) q8-12hr
  • Solution: 1-2 drops q4-6hr; may be increased to q1-2hr during initial 24-48 hours

Severe

  • Ointment: Apply ½ in. (1.25 cm) to affected eye(s) q3-4hr
  • Solution: 2 drops q30-60min, then less frequently after improvement; for Pseudomonas aeruginosa, 2 drops q5min for 1 hour, then q30min

Dosage Forms & Strengths

ophthalmic solution

  • 0.3%

ophthalmic ointment

  • 0.3%

Eye Infection

Mild/moderate

  • Ointment: Apply ½ in. (1.25 cm) to affected eye(s) q8-12hr
  • Solution: 1-2 drops q4-6hr; may be increased to q1-2hr during initial 24-48 hours

Severe

  • Ointment: Apply ½ in. (1.25 cm) to affected eye(s) q3-4hr
  • Solution: 2 drops q30-60min, then less frequently after improvement; for P aeruginosa, 2 drops q5min for 1 hour, then q30min
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Adverse Effects

Fraquency Not Defined

Localized ocular toxicity and hypersensitivity, including increased lacrimation, itching and edema of eyelid, and conjunctival erythema (<3%)

Sensitivity reaction, punctate keratitis

Postmarketing Reports

Anaphylactic reaction

Erythema multiforme

Stevens-Johnson syndrome

Additional adverse reactions reported with systemic aminoglycosides include neurotoxicity, ototoxicity and nephrotoxicity have occurred in patients receiving systemic aminoglycoside therapy. Aminoglycosides may aggravate muscle weakness in patients with known or suspected neuromuscular disorders, such as myasthenia gravis or Parkinson’s disease, because of their potential effect on neuromuscular function

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Warnings

Contraindications

Hypersensitivity to aminoglycosides or any component of formulation

Cautions

Sensitivity to topically administered aminoglycosides may occur; severity may vary from local effects to generalized reactions; discontinue use if sensitivity reactions occur

Monitor serum aminoglycoside concentrations if concurrent systemic aminoglycoside therapy is in progress

Concurrency with topical corticosteroids after uncomplicated removal of corneal foreign body; such concurrency may mask clinical signs of bacterial/fungal/viral infections

May result in overgrowth of nonsusceptible organisms, including fungi

Not for injection into eye

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Pregnancy & Lactation

Pregnancy

Reproduction studies in three types of animals at doses up to thirty-three times normal human systemic dose have revealed no evidence of impaired fertility or harm to the fetus due to drug; there are, however, no adequate and well-controlled studies in pregnant women; because animal studies are not always predictive of human response, drug should be used during pregnancy only if clearly needed

Lactation

Because of potential for adverse reactions in nursing infants, a decision should be made whether to discontinue nursing infant or discontinue drug, taking into account importance of drug to mother

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Appears to inhibit protein synthesis in susceptible bacteria by irreversibly binding to 30S and 50S ribosomal subunits

Absorption

Absorbed into aqueous humor; absorption greatest when cornea is abraded

Duration: Cleared from eye in ~15-30 min

Elimination

Excretion: Urine (primarily)

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Images

BRAND FORM. UNIT PRICE PILL IMAGE
tobramycin injection
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40 mg/mL vial
tobramycin injection
-
40 mg/mL vial
tobramycin injection
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40 mg/mL vial
tobramycin injection
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1.2 gram vial
tobramycin injection
-
1.2 gram vial
tobramycin injection
-
40 mg/mL vial
tobramycin injection
-
40 mg/mL vial
tobramycin injection
-
40 mg/mL vial
tobramycin injection
-
40 mg/mL vial
tobramycin injection
-
1.2 gram vial
tobramycin injection
-
40 mg/mL vial
tobramycin injection
-
40 mg/mL vial
tobramycin injection
-
40 mg/mL vial
tobramycin injection
-
40 mg/mL vial

Copyright © 2010 First DataBank, Inc.

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Patient Handout

Patient Education
tobramycin injection

TOBRAMYCIN - INJECTION

(TOE-bra-MYE-sin)

COMMON BRAND NAME(S): Nebcin

WARNING: This medication can cause serious kidney problems and nerve damage, resulting in permanent hearing loss (including deafness or decreased hearing) and balance problems. The risk is increased if you are older, already have kidney disease, or if you have a severe loss of body water (dehydration). Your risk is also increased if you receive high doses, or with longer use of this medication.Tell your doctor right away if you notice ringing/roaring sounds in the ears, hearing loss, dizziness, or an unusual decrease in the amount of your urine.Careful monitoring by your doctor will reduce the risk of these side effects. Monitoring may include hearing, kidney, urine, and drug blood level tests.Avoid other medications that may increase your risk for these serious side effects if taken together with tobramycin. See also Drug Interactions section.

USES: This medication is used to prevent or treat a wide variety of bacterial infections. Tobramycin belongs to a class of drugs known as aminoglycoside antibiotics. It works by stopping the growth of bacteria.

HOW TO USE: This medication is given by injection into a vein or muscle as directed by your doctor, usually every 8 hours. The dosage is based on your medical condition, weight, and response to treatment. Laboratory tests (such as kidney function, levels of drug in the blood) may be performed to help find the best dose for your condition.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection.Tell your doctor if your condition persists or worsens.

SIDE EFFECTS: See also Warning section.Nausea, vomiting, stomach upset, or loss of appetite may occur. Pain/irritation/redness at the injection site may rarely occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: numbness/tingling, muscle twitching or weakness, seizure.This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using tobramycin, tell your doctor or pharmacist if you are allergic to it; or to other aminoglycoside antibiotics (such as gentamicin); or if you have any other allergies. This product may contain inactive ingredients (such as sulfites), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: cystic fibrosis, hearing problems (including deafness, decreased hearing), kidney problems, low blood minerals (including potassium, magnesium, calcium), myasthenia gravis, Parkinson's disease.Tobramycin may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using tobramycin before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the effects of this drug, especially kidney damage.This medication is not recommended for use during pregnancy. Although there have been reports of harm in babies born to women using similar drugs, the risk for harm may not be the same with this drug. Discuss the risks and benefits with your doctor.This drug passes into breast milk in very small amounts. However, many doctors consider breastfeeding safe while using this medication. Consult your doctor before breastfeeding.

DRUG INTERACTIONS: See also Warning section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Other medications that may affect the kidneys or hearing may increase the risk of kidney damage or hearing loss if taken with tobramycin. Some affected drugs include: amikacin, amphotericin B, cidofovir, cisplatin, polymyxin B, cephalosporins such as cephaloridine, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, among others.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Laboratory and/or medical tests (such as kidney function, levels of drug in your blood) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised October 2021. Copyright(c) 2021 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.