Dosing & Uses
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
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
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
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.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)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| tobramycin injection - | 40 mg/mL vial |  | |
| tobramycin injection - | 40 mg/mL vial |  | |
| tobramycin injection - | 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 |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
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, lab tests, and response to treatment.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 lasts or gets worse.
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 last or get worse, 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: Lab and/or medical tests (such as kidney function, levels of drug in your blood) may be done while you are using this medication. Keep all medical and lab appointments. 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 August 2023. Copyright(c) 2023 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.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
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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.
