Tobramycin OphthalmicTobramycin

About Tobramycin Ophthalmic

Tobramycin is an aminoglycoside antibiotic that kills susceptible bacteria. The labels approve it for external infections of the eye and its adnexa (the eyelids and surrounding tissue) caused by susceptible bacteria (the labels list laboratory activity against staphylococci, some streptococci, Pseudomonas aeruginosa and Haemophilus influenzae, among others), and say the response to treatment should be monitored. Clinical studies showed it safe and effective in children; it is not established below 2 months of age. For mild to moderate infections the usual dose is one or two drops in the affected eye every four hours, or a half inch ribbon of ointment two or three times a day. For severe infections the drops are two drops every hour, and the ointment every three to four hours, until the eye improves; the dose is then reduced before treatment stops.

There is no boxed warning. The products are for use on the eye only and are not for injection into the eye. Some people are sensitive to aminoglycosides applied to the eye, with reactions that range from local irritation to generalized reactions, including anaphylaxis; the drug is stopped if a sensitivity reaction occurs, and cross-sensitivity with other aminoglycosides may occur. Anyone allergic to an ingredient must not use it. Prolonged use can let fungi or other resistant organisms overgrow. The most frequent side effects are allergic reactions and local eye irritation: itching and swelling of the eyelid and redness of the eye. Stevens-Johnson syndrome and erythema multiforme have been reported after marketing.

Brand Tobrex solution is discontinued, so the drops are dispensed as generic tobramycin 0.3 percent solution, made under FDA generic approvals and preserved with benzalkonium chloride. The ointment, Tobrex, contains chlorobutanol, mineral oil and white petrolatum, can blur vision for a while after use, and, like other eye ointments, may slow healing of the cornea. Contact lenses are not worn while there are signs of an eye infection. In pregnancy the labels advise use only if clearly needed. A combination with dexamethasone (TobraDex) is a separate product with its own label.

Taking Tobramycin Ophthalmic

How to take it

Wash your hands, pull down the lower lid and put the drop or a half inch strip of ointment into the pocket without letting the tip touch your eye or any surface (MedlinePlus advises tilting the head back for drops and slightly forward for ointment). Close the eye for two to three minutes after drops, or one to two minutes after ointment. Use it exactly as often as prescribed, and call the prescriber if the infection has not cleared when the medicine is finished.

If you miss a dose

Use the missed dose as soon as you remember, unless it is almost time for the next one; then skip it. Do not use a double dose.

Storage

Keep the bottle or tube tightly closed, between 36 and 77 degrees Fahrenheit, out of reach of children; it can be used until the expiration date once opened. Return unwanted medicine through a take-back program rather than flushing it.

Interactions to know about

Tell the prescriber about every medicine you use and any past reaction to tobramycin or another aminoglycoside antibiotic. If more than one drop is needed, MedlinePlus advises waiting at least five minutes between drops.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Tobramycin Ophthalmic differs from pharmacy to pharmacy

The eye drops are an old generic, and a course is usually a single 5 mL bottle. That bottle costs pharmacies little, so much of the quote is the dispensing fee and whatever generic the pharmacy happens to stock; quotes for the same bottle can still differ between pharmacies that list it as a flat-price generic and those that do not.

The ointment is a different story: Tobrex ointment has no generic, so it is priced as a brand; ask whether the pharmacy has it in stock. A pharmacist cannot swap the drops for the ointment, or the reverse, at the counter; changing the form needs a new prescription from the prescriber.

Ways to pay less for Tobramycin Ophthalmic without insurance

• If the prescription is for drops, make sure it allows a generic, since brand Tobrex solution is no longer sold.
• If you were prescribed the ointment, ask the prescriber whether generic tobramycin eye drops would suit you instead.
• Ask whether the drops are on the pharmacy’s flat-price generic list, and compare more than one pharmacy, since one bottle is mostly dispensing fee.
• For Tobrex ointment, ask the maker whether its savings or patient assistance program applies to someone paying cash.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Tobramycin Ophthalmic

1. 1.How many times a day should I use my drops, and when should I cut back as my eye improves?
2. 2.How long should I wait between my tobramycin drops and my other eye drops?
3. 3.When can I go back to wearing my contact lenses?
4. 4.Which signs mean my eye infection is not improving and I should call my eye doctor?

Related medications