Tobramycin: Uses, Dosage, Side Effects & Brands | MedexInfo

Tobramycin (Ophthalmic)

Rx

Generic NameTobramycin

Therapeutic ClassAminoglycoside Antibiotic

Common DoseIV/IM: 3–5 mg/kg/day in divided doses; Ophthalmic: 0.3% solution 1–2 drops every 4–6h

PregnancyUse only if clearly needed

Indications ▼

Serious Gram-negative infections (e.g., Pseudomonas, Enterobacter, Klebsiella)

Severe infections in neutropenic patients

Cystic fibrosis-related Pseudomonas infections (inhalation)

Ocular infections: conjunctivitis, keratitis, blepharitis

Mechanism & Pharmacokinetics ▼

Mechanism: Tobramycin binds to the 30S ribosomal subunit of bacteria, inhibiting protein synthesis and causing cell death (bactericidal).

Pharmacokinetics: Poor oral absorption; administered IV, IM, or topically. Distributed widely in extracellular fluid. Excreted unchanged by kidneys. Half-life ~2–3 hours in normal renal function.

Dosage & Administration ▼

Indication	Form	Dose	Frequency
Serious Gram-negative infection	IV / IM	3–5 mg/kg/day	Divided 2–3 times daily
Cystic fibrosis (Pseudomonas)	Inhalation solution	300 mg	Twice daily via nebulizer
Ocular infection	Eye drops 0.3%	1–2 drops	Every 4–6 hours

Note: Adjust IV/IM dose in renal impairment; monitor serum drug levels for systemic therapy. Complete full course for topical use.

Side Effects ▼

Ototoxicity: hearing loss, tinnitus

Nephrotoxicity: increased creatinine, acute kidney injury

Neuromuscular blockade (rare)

Ocular irritation, redness, burning (topical)

Hypersensitivity reactions: rash, fever, eosinophilia

Contraindications ▼

Hypersensitivity to tobramycin or other aminoglycosides

Myasthenia gravis (risk of neuromuscular blockade)

Severe renal impairment without dose adjustment

Drug Interaction ▼

Other nephrotoxic drugs (e.g., vancomycin, cisplatin): increased renal toxicity

Other ototoxic drugs (e.g., loop diuretics): increased risk of hearing loss

Neuromuscular blockers: enhanced effect

Pregnancy & Lactation ▼

Use only if clearly needed; risk of fetal nephrotoxicity

Excreted in breast milk; avoid systemic therapy during breastfeeding if possible

Clinical / Research Summary ▼

Clinical Role: Aminoglycoside of choice for serious Gram-negative infections and topical ocular infections.

Advantage: Broad-spectrum Gram-negative coverage; effective in Pseudomonas infections.

Monitoring: Renal function, serum drug levels (IV/IM), hearing assessment for prolonged therapy.

Patient Counseling Points ▼

Complete full course even if symptoms improve

Report hearing changes, dizziness, or reduced urine output

For eye drops: avoid touching tip to eye and wash hands before and after use

Regular follow-up required for systemic therapy

Storage & Handling ▼

Store 2–25°C, protect from light

Do not freeze; keep vial or bottle tightly closed

Keep out of reach of children

Brand Names (Bangladesh & Global) ▼

Bangladesh:

T‑Mycin® 0.3% Eye Drops T‑Mycin® 0.3% Ophthalmic Ointment Tobam® 0.3% Eye Drops Tobirax® 0.3% Eye Drops Tobirax® 0.3% Ophthalmic Ointment Tobrabac® 0.3% Eye Drops Tobrabac® 0.3% Ophthalmic Ointment Tobracin® 0.3% Eye Drops Tobracin® 0.3% Ophthalmic Ointment Tobram® 0.3% Eye Drops Tobramin® 0.3% Eye Drops Tobrel® 0.3% Eye Drops Tobi® 0.3% Eye Drops Xitob® 0.3% Eye Drops Gentob® 0.3% Eye Drops Ocutob® 0.3% Eye Drops

Global:

Tobrex Nebcin

Medical Disclaimer: For educational purposes only. Not a substitute for professional medical advice.

Reference Hubs:

• Drug Class: Aminoglycosides • Condition: Gram-negative infections • Condition: Ocular Infections