Dosing & Uses
Dosage Forms & Strengths
dexamethasone/tobramycin
ophthalmic ointment
- 0.1%/0.3%
ophthalmic suspension
- 0.05%/0.3%
- 0.1%/0.3%
Ocular Inflammation & Bacterial Infection
Ophthalmic suspension: 1-2 gtt to affected eye(s) q4-6hr; if needed, may increase frequency to q2hr during the first 24-48 hr; then taper to less frequent intervals
Ophthalmic ointment: Apply small amount (ie, ~0.5-in ribbon) to conjunctival sac(s) q6-8hr
Dosage Forms & Strengths
dexamethasone/tobramycin
ophthalmic ointment
- (0.1%/0.3%)
(ophthalmic suspension)
- (0.05%/0.3%)
- (0.1%/0.3%)
Ocular Inflammation & Bacterial Infection
<2 years
- Safety and efficacy not established
>2 years
- Ophthalmic suspension: 1-2 gtt to affected eye(s) q4-6hr; if needed, may increase frequency to q2hr during the first 24-48 hr; then taper to less frequent intervals
- Ophthalmic ointment: Apply small amount (ie, ~0.5-in ribbon) to conjunctival sac(s) q6-8hr
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Adverse Effects
Frequency Not Defined
Ocular lid itching and swelling
Conjunctival erythema
Elevation of intraocular pressure (IOP) with possible development of glaucoma
Infrequent optic nerve damage
Cataract formation
Posterior subcapsular cataract formation
Delayed wound healing
Secondary infections
Keratitis
Postmarketing Reports
Anaphylactic reaction
Erythema multiforme
Warnings
Contraindications
Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, and many other viral diseases of the cornea and conjunctiva
Mycobacterial infection of the eye
Fungal diseases of ocular structures
Hypersensitivity to a component of the medication
Cautions
Sensitivity to topically administered aminoglycosides may occur; severity may vary from local effects to generalized reactions; discontinue use if sensitivity reactions occur
Bacterial keratitis reported from inadvertent contamination of multiple dose ophthalmic solution
Immunosuppression resulting from prolonged use of steroid use may result in secondary bacterial and fungal infections; steroids may also mask symptoms of infections and enhance existing ocular infections
Ocular hypertension and/or glaucoma reported with prolonged corticosteroid use
Discontinue use if sensitivity reaction to tobramycin develops
Corticosteroid use following cataract surgery may delay healing
Not for injection into eye
Pregnancy & Lactation
Pregnancy
There are no adequate and well-controlled studies in pregnant women; however, prolonged or repeated corticoid use during pregnancy has been associated with an increased risk of intra-uterine growth retardation; treatment should be used during pregnancy only if potential benefit justifies potential risk to fetus; infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be observed carefully for signs of hypoadrenalism
Animal data
- Corticosteroids found to be teratogenic in animal studies; ocular administration of 0.1% dexamethasone resulted in 15.6% and 32.3% incidence of fetal anomalies in two groups of pregnant rabbits; fetal growth retardation and increased mortality rates observed in rats with chronic dexamethasone therapy; reproduction studies have been performed in rats and rabbits with tobramycin at doses up to 100 mg/kg/day parenterally and have revealed no evidence of impaired fertility or harm to the fetus
Lactation
Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects; not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk; because many drugs are excreted in human milk, caution should be exercised when therapy is administered to a nursing woman
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.Pharmacology
Mechanism of Action
Dexamethasone prevents/reduces irritation & swelling by suppressing normal immune response, decreasing inflammatory mediators and reverses capillary permeability
Tobramycin: Alters bacterial cell membrane integrity by binding to 30S and 50S ribosomal subunits, which in turn interferes with bacterial protein synthesis
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Formulary
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