Saturday, December 31, 2005

Tobramycin (Ophthalmic)

Description Return to top

Ophthalmic tobramycin (toe-bra-MYE-sin) is used in the eye to treat bacterial infections of the eye. Tobramycin works by killing bacteria.

Ophthalmic tobramycin may be used alone or with other medicines for eye infections. Either the drops or the ointment form of this medicine may be used alone during the day. In addition, both forms may be used together, with the drops being used during the day and the ointment at night.

Tobramycin ophthalmic preparations are available only with your doctor's prescription, in the following dosage forms:

Ophthalmic

Ophthalmic ointment (U.S. and Canada)
Ophthalmic solution (eye drops) (U.S. and Canada)

Before Using This Medicine Return to top

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ophthalmic tobramycin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to ophthalmic tobramycin or to any related medicines, such as amikacin (e.g., Amikin), gentamicin (e.g., Garamycin), kanamycin (e.g., Kantrex), neomycin (e.g., Mycifradin), netilmicin (e.g., Netromycin), streptomycin, or tobramycin by injection (e.g., Nebcin). Also tell your health care professional if you are allergic to any other substances, such as preservatives.

Pregnancy—Studies have not been done in humans. However, tobramycin ophthalmic preparations have not been shown to cause birth defects or other problems in animals even when given at high doses.

Breast-feeding—Tobramycin ophthalmic preparations may be absorbed into the eye. However, tobramycin is unlikely to pass into the breast milk in large amounts and little would be absorbed by the infant. Therefore, this medicine is unlikely to cause serious problems in nursing babies.

Children—This medicine has been tested in children and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of ophthalmic tobramycin in the elderly with use in other age groups.

Other medicines—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. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine that is to be used in the eye.

Proper Use of This Medicine Return to top

For patients using tobramycin ophthalmic solution (eye drops):

The bottle is only partially full to provide proper drop control.

To use:

First, wash your hands. Tilt the head back and with the index finger of one hand, press gently on the skin just beneath the lower eyelid and pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed for 1 or 2 minutes, to allow the medicine to come into contact with the infection.

If you think you did not get the drop of medicine into your eye properly, use another drop.

To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.

If your doctor ordered two different ophthalmic solutions to be used together, wait at least 5 minutes between the times you apply the medicines. This will help to keep the second medicine from ``washing out'' the first one.

For patients using tobramycin ophthalmic ointment (eye ointment):

To use:

First, wash your hands. Tilt the head back and with the index finger of one hand, press gently on the skin just beneath the lower eyelid and pull the lower eyelid away from the eye to make a space. Squeeze a thin strip of ointment into this space. A 1.25-cm (approximately ½-inch) strip of ointment usually is enough, unless you have been told by your doctor to use a different amount. Let go of the eyelid and gently close the eyes and keep them closed for 1 or 2 minutes, to allow the medicine to come into contact with the infection.

To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). After using tobramycin eye ointment, wipe the tip of the ointment tube with a clean tissue and keep the tube tightly closed.

To help clear up your eye infection completely, keep using tobramycin for the full time of treatment, even if your symptoms have disappeared. Do not miss any doses.

Dosing

The dose of ophthalmic tobramycin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average dose of ophthalmic tobramycin. If your dose is different, do not change it unless your doctor tells you to do so.

The number of doses you use each day, the time allowed between doses, and the length of time you use the medicine depend on the medical problem for which you are using ophthalmic tobramycin.

For ophthalmic ointment dosage forms:

For mild to moderate infections:

Adults and children—Use every eight to twelve hours.

For severe infections:

Adults and children—Use every three to four hours until improvement occurs.
For ophthalmic solution (eye drops) dosage forms:
For mild to moderate infections:
Adults and children—One drop every four hours.

For severe infections:

Adults and children—One drop every hour until improvement occurs.

Missed dose

If you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage

To store this medicine:

Keep out of the reach of children.
Store away from heat and direct light.
Keep the medicine from freezing.
Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine Return to top

If your eye infection does not improve within a few days, or if it becomes worse, check with your doctor.

Side Effects of This Medicine Return to top

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

Other 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. However, check with your doctor if either of the following side effects continues or is bothersome:

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 above may also occur in some patients. If you notice any other effects, check with your doctor.

Brand Names Return to top

In the U.S.—

AKTob
Tobrex

In Canada—
Tobrex

Category Return to top

Antibacterial, ophthalmic

Medline Plus

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