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%
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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%
more...

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

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

Sensitivity reaction, punctate keratitis

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Warnings

Contraindications

Hypersensitivity to aminoglycosides or any component of formulation

Cautions

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

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Pregnancy & Lactation

Pregnancy category: B

Lactation: Unknown whether drug is safe for nursing infants; discontinue, or do not nurse

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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Formulary

FormularyPatient Discounts

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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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