Dosing and uses of Tobrex, Tobramycin Ophth (tobramycin ophthalmic)
Adult dosage forms and 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
Pediatric dosage forms and 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
Tobrex, Tobramycin Ophth (tobramycin ophthalmic) adverse (side) effects
Localized ocular toxicity and hypersensitivity, including increased lacrimation, itching and edema of eyelid, and conjunctival erythema (<3%)
Sensitivity reaction, punctate keratitis
Warnings
Contraindications
Hypersensitivity to aminoglycosides or any component of formulation
Cautions
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
Pregnancy and lactation
Pregnancy category: B
Lactation: Unknown whether drug is safe for nursing infants; discontinue, or do not nurse
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 of Tobrex, Tobramycin Ophth (tobramycin ophthalmic)
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)
