Version May 2024
Ocular infections: Ophthalmic:
Ointment: Apply half-inch ribbon into affected eye(s) 2 or 3 times daily for mild to moderate infections; for severe infections, apply every 3 to 4 hours until improvement (then reduce prior to discontinuation).
Solution: Instill 1 to 2 drops into affected eye(s) every 4 hours for mild to moderate infections; for severe infections, instill 2 drops every hour until improvement (then reduce prior to discontinuation).
Viscous solution (Tobrexan [Canadian product]): Instill 1 drop into affected eye(s) 2 times daily for 7 days for mild to moderate infections; for severe infections, instill 1 drop 4 times daily on day 1 and then 2 times daily for duration of treatment period.
There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.
Refer to adult dosing.
(For additional information see "Tobramycin (ophthalmic): Pediatric drug information")
Ocular infections: Ophthalmic: Infants ≥2 months, Children, and Adolescents:
Ointment:
Mild to moderate infections: Apply 1/2 inch ribbon into the affected eye(s) 2 to 3 times daily
Severe infections: Apply 1/2 inch ribbon into the affected eye(s) every 3 to 4 hours initially until improvement, then reduce to less frequent intervals prior to discontinuation
Solution:
Mild to moderate infections: Instill 1 to 2 drops into the affected eye(s) every 4 hours
Severe infections: Instill 2 drops into the affected eye(s) every hour initially until improvement, then reduce to less frequent intervals prior to discontinuation
There are no dosage adjustments provided in the manufacturer’s labeling; however, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer’s labeling; however, dosage adjustment unlikely due to low systemic absorption.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
<1%:
Hypersensitivity: Hypersensitivity reaction
Ophthalmic: Conjunctival erythema, eyelid edema, eyelid pruritus, ocular toxicity (localized)
Postmarketing:
Dermatologic: Erythema multiforme, Stevens-Johnson syndrome
Hypersensitivity: Anaphylaxis
Hypersensitivity to tobramycin or any component of the formulation
Canadian labeling: Additional contraindications (not in US labeling): Known hypersensitivity to any aminoglycoside
Concerns related to adverse effects:
• Hypersensitivity reactions: Sensitivity varying from local to generalized effects (eg, erythema, pruritus, urticaria, skin rash, anaphylaxis, anaphylactoid reaction, bullous reaction) to topically applied aminoglycosides and cross sensitivity to other aminoglycosides antibiotics may occur; discontinue use if hypersensitivity develops.
• Superinfection: Prolonged use may lead to overgrowth of nonsusceptible organisms, including fungi. If superinfection is suspected, institute appropriate alternative therapy.
Special populations:
• Contact lens wearers: Some products may contain benzalkonium chloride or benzododecinium bromide which may be absorbed by soft contact lenses; contact lenses should not be worn during treatment of ophthalmologic infections.
Other warnings/precautions:
• Appropriate use: For topical application to the eye only; not for injection. To avoid contamination, do not touch tip of container to any surface.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Ointment, Ophthalmic:
Tobrex: 0.3% (3.5 g [DSC])
Tobrex: 0.3% (3.5 g) [contains chlorobutanol (chlorobutol)]
Solution, Ophthalmic:
Tobrex: 0.3% (5 mL [DSC])
Generic: 0.3% (5 mL)
May be product dependent
Ointment (Tobrex Ophthalmic)
0.3% (per gram): $87.35
Solution (Tobramycin Ophthalmic)
0.3% (per mL): $1.25 - $6.80
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, Ophthalmic:
Tobrex: 0.3% (3.5 g) [contains chlorobutanol (chlorobutol)]
Solution, Ophthalmic:
Crown Ak-Tobra: 0.3% (5 mL)
Tobrex: 0.3% (5 mL) [contains benzalkonium chloride]
Generic: 0.3% (5 mL)
For topical ophthalmic use only; not for injection into the eye. Contact lenses should not be worn during treatment of ophthalmic infections. Avoid contaminating the applicator tip with affected eye(s).
Ointment: Apply into conjunctival sac(s) of eye; patient should look downward before closing eye.
For topical ophthalmic use only; not for injection into the eye. Contact lenses should not be worn during treatment of ophthalmic infections. Avoid contact of tube or bottle tip with skin or eye.
Ointment: Apply into conjunctival sac(s) of eye; patient should look downward before closing eye
Solution: Apply gentle pressure to lacrimal sac during and immediately following instillation (1 minute) or instruct patient to gently close eyelid after administration, to decrease systemic absorption of ophthalmic drops (Ref).
Ocular infections: Treatment of external infections of the eye and its adnexa caused by susceptible bacteria.
Tobramycin may be confused with Trobicin, vancomycin
Tobrex may be confused with TobraDex
None known.
There are no known significant interactions.
Adverse events have not been observed in animal reproduction studies. The amount of tobramycin available systemically following topical application of the ophthalmic drops is undetectable (<0.2 mcg/mL) (Filatov 1994). If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease systemic absorption (Samples 1988).
The amount of tobramycin available systemically following topical application of the ophthalmic drops is undetectable (<0.2 mcg/mL) (Filatov 1994). If ophthalmic agents are needed in lactating women, the minimum effective dose should be used in combination with punctal occlusion to decrease systemic absorption (Samples 1988).
Due to the potential for serious adverse reactions in the nursing infant, the manufacturer recommends a decision be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of treatment to the mother.
Interferes with bacterial protein synthesis by binding to 30S ribosomal subunit resulting in a defective bacterial cell membrane
Absorption: Systemic absorption: Undetectable (<0.2 mcg/mL) (Filatov 1994); tear film exposure and time above MIC90 are significantly greater with viscous ophthalmic solution [Canadian product] (Tobrexan Canadian product labeling).
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
