tobramycin
Tobramycin (Tobrex) is an antibiotic that's used to treat different types of bacterial eye infections. It can be used for people ages 2 months and older. Tobramycin (Tobrex) comes as an ophthalmic solution (eye drops) and eye ointment that are used multiple times per day. It's available in both brand-name and generic versions. The most common side effects include eyelid itching, eyelid swelling, and eye redness. Like with all antibiotics, you shouldn't stop treatment too early because your infection could come back or get harder to treat.
What is Tobramycin (Tobrex)?
What is Tobramycin (Tobrex) used for?
- Bacterial infections of the eye or eyelid
How Tobramycin (Tobrex) works
Tobramycin (Tobrex) is an aminoglycoside antibiotic. It kills bacteria by blocking their ability to make proteins and by damaging their protective covering.
Drug facts
Side effects of Tobramycin (Tobrex)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
See Risks and Warnings.
Less Common Side Effects
- Eyelid itching
- Eyelid swelling
- Eye redness
Tobramycin (Tobrex) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: rash, swelling of the face or throat, trouble breathing
The following Tobramycin (Tobrex) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Itching, redness, swelling, or other sign of eye or eyelid irritation not present before use of this medicine
Symptoms of overdose
Increased watering of the eyes
itching, redness, or swelling of the eyes or eyelids
painful irritation of the clear front part of the eye
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Burning or stinging of the eyes
Eye ointments usually cause your vision to blur for a few minutes after application.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Tobramycin (Tobrex)
Pros
- Treats various bacterial eye and eyelid infections
- Ointment form requires fewer doses per day than most alternatives
- Eye drop form is available as a lower-cost generic
Cons
- Can cause temporary eye irritation
- Might require more frequent dosing throughout the day for severe infections
- Ointment form tends to be messy and harder to put in the eye
Pharmacist tips for Tobramycin (Tobrex)
- Be sure to use tobramycin (Tobrex) for the full amount of time that your healthcare provider instructs, even if your eye starts to get better. Stopping tobramycin (Tobrex) too soon can cause your infection to come back and be harder to treat.
- Wash your hands before and after using tobramycin (Tobrex). Don't let the tip of the container touch your eye, hands, or any other surface. This will help you avoid spreading germs to the medication and to your eyes.
- Don't put any other medications in the eye for at least 5 minutes before or after tobramycin (Tobrex).
- It's best not to wear contacts while you have an eye infection, since this can affect how quickly your symptoms improve. Be sure to throw away the contacts you were wearing before you started using tobramycin (Tobrex). They probably have bacteria on them. Wear a new pair of contacts once your infection is cleared up.
- How to use tobramycin (Tobrex) eye drops: To use the eye drops, tilt your head back a little and look up. Pull your lower eyelid down with one hand. With the other hand, hold the eye drop bottle upside down and close to your eye. Then, squeeze the number of drops you need into your eye. After placing the drop(s) in your eye, close your eye and press one finger to the inner corner of your eye by the nose for 1 to 2 minutes. This helps make sure your eye absorbs the medication.
- How to use tobramycin (Tobrex) eye ointment: Tilt your head back a little and gently pull down your lower eyelid. Put the ointment into the space between your eyelid and eyeball. Then, let go of the eyelid and close your eye for 1 to 2 minutes, so the medication is able to reach all the necessary parts of the eye. Roll your eyeball around in the meantime. If you want to wipe off extra ointment or greasiness on the outside the eye, do it carefully and make sure you're using a clean tissue. Eye ointments usually cause blurry vision, but this should only last a couple minutes.
Common questions about Tobramycin (Tobrex)
Yes, tobramycin (Tobrex) is an antibiotic, meaning that it fights against bacterial infections. It belongs to the class of antibiotics called "aminoglycosides." Other medications in the same class include gentamicin (Gentak) and neomycin.
Tobramycin (Tobrex) is a good treatment for pink eye if it's due to a bacterial infection. Keep in mind that pink eye could also be due to a viral infection, which tobramycin (Tobrex) won't be able to treat. If you have an eye infection, it's best to get it diagnosed by a healthcare provider so that you get the right treatment for it.
Since you're applying the medication directly where the infection is (in the eye), tobramycin (Tobrex) should start to work right away. But it might take a few days to see any changes. For most eye or eyelid infections, it usually takes about 3 days for your symptoms to start clearing up, though it might get better sooner if you're using the medication more often for a severe infection. Contact your provider if your infection isn't improving after a few days. Be sure to use tobramycin (Tobrex) for the full amount of time your healthcare provider instructed, even if your eye starts to get better.
Yes. Make sure to check the expiration date on the tobramycin (Tobrex) packaging or container and throw it away if it's expired. You shouldn't use medications after they're past their expiration date because they might not work as well. What's more, bacteria could grow in them over time, which could put you at risk for an infection if you use it.
No. Tobramycin (Tobrex) is an antibiotic that fights bacterial infections. It doesn't have a steroid medication in it. This means it won't help directly with eye inflammation like steroid medications do.
No, tobramycin (Tobrex) isn't a penicillin antibiotic. It belongs to the antibiotic class called aminoglycosides. If you're allergic to penicillin antibiotics, you should be able to use tobramycin (Tobrex) since it's a different type of antibiotic.
Tobramycin (Tobrex) isn't FDA-approved for use in the ear for ear infections. Never use tobramycin (Tobrex) in your ears without consulting your provider.
Tobramycin (Tobrex) eye drops and eye ointment work against many different bacteria. You might have heard of some of them, such as Staphylococcus ("staph"), Streptococcus ("strep"), and Escherichia coli ("E.coli"). Your provider will prescribe antibiotic eye medications that target the bacteria that are most likely to be causing your eye infection.
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Risks and warnings for Tobramycin (Tobrex)
Tobramycin (Tobrex) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
New infection
- Risk factors: Using tobramycin (Tobrex) for too long
It's possible to get a new infection from fungi or bacteria after using tobramycin (Tobrex) for a while. Sometimes, these new infections can be hard to treat and can no longer be treated with tobramycin (Tobrex). Don't use this medication longer than prescribed. Let your provider know if you notice symptoms of a new infection or if the original symptoms don't get better after using tobramycin (Tobrex).
Allergic reaction
- Risk factors: Allergy to other aminoglycoside antibiotics
Tobramycin (Tobrex) can sometimes cause an allergic reaction, such as redness, itching, or rash. If you experience any of these symptoms, stop using the medication and contact your provider.
In some rare cases, the allergy can be serious and cause anaphylaxis (which can cause your throat to close). Call 911 or get medical attention right away if you're having a severe allergic reaction.
Let your provider know if you've had allergic reactions in the past to other aminoglycoside antibiotics like gentamicin (Gentak) eye drops.
Avoid contact lenses
Don't wear contact lenses while using tobramycin (Tobrex), since it can affect how quickly your symptoms improve. Throw away the lenses you were wearing before you started using tobramycin (Tobrex) because they'll most likely have bacteria on them. If you're still having symptoms of your infection after you've finished your tobramycin (Tobrex) treatment course, don't start wearing contacts again yet because you might still have an infection.
Slower healing (for eye ointment only)
Eye ointments like tobramycin (Tobrex) might slow healing of the cornea (the protective covering in the front of the eye). Remember to follow up with your provider to make sure that your eye is healing appropriately.
Risk of contamination (spreading germs)
If you use contaminated tobramycin (Tobrex) eye drops or eye ointments, you can develop a new eye infection or make your eye infection worse. Wash your hands each time before you use the eye drops or eye ointment. Don't touch the tip of the container to your eye, with your hands, or to any other surface. Remember to put the cap back on the container after each use.
Tobramycin (Tobrex) dosage
Eye dropper| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5ml of 0.3% | 1 eye dropper | $6.81 | $6.81 |
Typical dosage for Tobramycin (Tobrex)
- Eye drops: For mild-to-moderate infections, place 1 or 2 drops in the affected eye(s) every 4 hours. For severe infections, you'll typically start off using 2 drops every hour until the symptoms have improved.
- Eye ointment: For mild-to-moderate infections, apply a half-inch-sized ribbon to the affected eye(s) 2 or 3 times per day. For severe infections, you'll typically start off using it every 3 to 4 hours until symptoms have improved.
Interactions between Tobramycin (Tobrex) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Ataluren
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alcuronium
- Atracurium
- Cholera Vaccine, Live
- Cidofovir
- Cisatracurium
- Colistimethate Sodium
- Decamethonium
- Doxacurium
- Ethacrynic Acid
- Fazadinium
- Foscarnet
- Furosemide
- Gallamine
- Hexafluorenium
- Lysine
- Mannitol
- Metocurine
- Mivacurium
- Pancuronium
- Pipecuronium
- Rapacuronium
- Rocuronium
- Succinylcholine
- Tubocurarine
- Vancomycin
- Vecuronium
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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