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Brand Name
Tobradex
Common Name
tobramycin - dexamethasone
How does this medication work? What will it do for me?

Tobramycin - dexamethasone eye drops and ointment are combination medications used for the treatment of inflammatory eye conditions for people who have a bacterial eye infection or are at risk of a bacterial eye infection.

Tobramycin belongs to the class of medications called antibiotics. It works by killing certain types of bacteria that may cause eye infections.

Dexamethasone belongs to the class of medications called corticosteroids. It helps to reduce eye irritation, redness, and inflammation.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

Drops: The usual adult dose is 1 to 2 drops instilled into the eye every 4 hours. In the first 24 to 48 hours, your doctor may increase the dose to 1 or 2 drops every 2 hours. Your doctor will reduce the dose gradually based on how your condition improves. Shake the drops well before using them. To prevent contamination of the dropper, make sure it does not touch the eye, skin, or other surfaces.

Ointment: The usual adult dose is a 1.25 cm (one-half inch) ribbon applied into the eye (along the edge of the lower eyelid) up to 3 or 4 times daily, or used in addition to the drops at bedtime. To prevent contamination of the tip of the ointment container, make sure it does not touch the eye, skin, or other surfaces.

Many things can affect the dose of medication that a person needs, such as other medical conditions and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

What form(s) does this medication come in?

Suspension
Each mL of sterile, isotonic, aqueous suspension contains tobramycin 3 mg and dexamethasone 0.1% with benzalkonium chloride 0.01% as a preservative. Nonmedicinal ingredients: edetate disodium, hydroxyethyl cellulose, purified water, sodium chloride, sodium hydroxide and/or sulfuric acid (to adjust pH), sodium sulfate, and tyloxapol.

Ointment
Each gram of sterile ophthalmic ointment contains tobramycin 3 mg and dexamethasone 0.1% with chlorobutanol 0.5% as a preservative in a mineral oil and petrolatum base.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to tobramycin, dexamethasone, or any ingredients of this medication
  • are allergic to any other aminoglycosides (e.g., amikacin, gentamicin)
  • have just had a foreign object removed from your eye
  • have a bacterial infection of the eye, tuberculosis of the eye, a fungal disease of the eye, or an acute weeping untreated infection of the eye
  • have vaccinia, varicella, herpes simplex, or other viral diseases of the eye
What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dry eye
  • eye redness
  • headache
  • increased tearing
  • itching and swelling of eyelid
  • metallic taste
  • nausea
  • stomach upset
  • temporarily blurred vision

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • dizziness
  • drooping eyelid
  • eye pain
  • symptoms of a new eye infection (e.g., eye discharge, redness, itchiness, or pain)
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • blurring or loss of vision
  • itching, redness, swelling, or other sign of allergic reaction or eye irritation not present before use of this medication

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blurred vision: This medication may cause a temporary blurring of vision. Do not drive or operate machinery until your vision has cleared.

Contact lenses: If you use contact lenses, ask your doctor about their use while using this medication. Usually, contact lenses should not be worn when treating an eye infection. The drop form of this medication contains an ingredient that can discolour contact lenses. Contact lenses must be removed from the eye before putting the drops in the affected eye and should not be reinserted until at least 15 minutes after using the drops.

Long-term use: Prolonged use of this medication may result in glaucoma, with damage to the optic nerve, vision problems, perforation of the cornea, and cataracts. Prolonged use of this medication may also result in problems with metabolism and delayed healing and overgrowth of microorganisms (e.g., certain bacteria or fungi) that are not killed by the antibiotic. If there is no improvement after 5 or 7 days of therapy or if your condition worsens, call your doctor. If you are using this medication for a prolonged period of time, your doctor should check your eye pressure regularly.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if this medication passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

For a full list of interactions, use the Drug Interaction Checker available on the Drugs.com website.

If you are taking other medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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