Friday, April 27, 2012

Tobramycin



Pronunciation: TOE-bra-MYE-sin
Generic Name: Tobramycin
Brand Name: Nebcin

Tobramycin has caused kidney problems, nerve damage, or permanent hearing loss, even at usual doses. Hearing loss can occur even after the medicine is stopped. If you already have kidney problems or hearing difficulty, tell your doctor. Notify your doctor right away if any of the following occur: ringing in ears, hearing loss, unusual change in amount of urine, dizziness, numbness, skin tingling, muscle twitching, or seizures. Tobramycin may be stopped if you develop kidney or hearing problems. Your doctor will monitor your progress to minimize the possibility of these effects occurring and to run certain tests (eg, hearing and/or kidney tests). Do not use Tobramycin with other medicines that can cause nerve, kidney, or hearing problems. Other factors that increase the risk of these side effects occurring include premature and newborn infants, advanced age, or dehydration. Avoid other medicines that may harm the kidneys or decrease hearing (eg, other aminoglycosides [eg, gentamicin], cephaloridine, viomycin, polymyxin B, colistin, cisplatin, vancomycin) while you are using Tobramycin. Do not use Tobramycin with certain diuretics (eg, furosemide, ethacrynic acid).


Tobramycin may cause fetal harm if used during pregnancy.





Tobramycin is used for:

Treating serious infections caused by certain bacteria.


Tobramycin is an aminoglycoside antibiotic. It works by killing sensitive bacteria.


Do NOT use Tobramycin if:


  • you are allergic to any ingredient in Tobramycin or another aminoglycoside antibiotic (eg, gentamicin)

  • you are taking certain diuretics (eg, furosemide, ethacrynic acid), cyclosporine, methoxyflurane, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen)

Contact your doctor or health care provider right away if any of these apply to you.



Before using Tobramycin:


Some medical conditions may interact with Tobramycin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

  • if you have myasthenia gravis (a condition in which the muscles become progressively paralyzed) or Parkinson disease

  • if you have hearing problems, nerve problems, kidney problems, or severe or extensive burns, or you are dehydrated

Some MEDICINES MAY INTERACT with Tobramycin. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Cephaloridine, cephalosporins (eg, ceftizoxime), cisplatin, colistin, cyclosporine, fludarabine, loop diuretics (eg, furosemide, ethacrynic acid), methoxyflurane, nitrosoureas (eg, carmustine), NSAIDs (eg, ibuprofen), polymyxin B, vancomycin, or viomycin because they may increase the risk of Tobramycin's side effects, including increased risk of kidney or hearing loss

  • Beta-lactam antibiotics (eg, penicillin, imipenem, ceftizoxime) because they may decrease Tobramycin's effectiveness

  • Nondepolarizing muscle relaxants (eg, atracurium) or succinylcholine because the risk of their side effects may be increased by Tobramycin

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tobramycin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Tobramycin:


Use Tobramycin as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Tobramycin is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Tobramycin at home, a health care provider will teach you how to use it. Be sure you understand how to use Tobramycin. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.

  • Do not use Tobramycin if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.

  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.

  • If you miss a dose of Tobramycin, use it as soon as possible. Check with your doctor or pharmacist for instructions on scheduling other doses.

Ask your health care provider any questions you may have about how to use Tobramycin.



Important safety information:


  • Tobramycin only works against bacteria; it does not treat viral infections (eg, the common cold).

  • Drinking extra fluids while you are using Tobramycin is recommended. Check with your doctor for instructions.

  • Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.

  • Be sure to use Tobramycin for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.

  • Long-term or repeated use of Tobramycin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.

  • Some of these products contain sulfites. Sulfites may cause an allergic reaction in some patients (eg, asthma patients). If you have ever had an allergic reaction to sulfites, ask your pharmacist if your product has sulfites in it.

  • Tell your doctor or dentist that you take Tobramycin before you receive any medical or dental care, emergency care, or surgery.

  • Lab tests, including kidney function, hearing tests, blood electrolyte levels, and tobramycin levels, may be performed while you use Tobramycin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

  • Use Tobramycin with caution in the ELDERLY; they may be more sensitive to its effects, especially kidney or hearing problems.

  • Tobramycin should be used with extreme caution in CHILDREN younger than 10 years old; safety and effectiveness in these children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: Tobramycin has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tobramycin while you are pregnant. It is not known if Tobramycin is found in breast milk. Do not breast-feed while taking Tobramycin.


Possible side effects of Tobramycin:


All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Diarrhea; headache; nausea; pain, swelling, or redness at the injection site; vomiting.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); clumsiness; confusion; decreased hearing or other hearing changes; decreased urination; dizziness or lightheadedness; feeling of a whirling motion; fever, chills, or persistent sore throat; hearing loss; loss of coordination; muscle weakness; numbness or tingling; red, swollen, blistered, or peeling skin; ringing or roaring in the ears; seizures; severe or persistent diarrhea; stomach pain or cramps; unusual bruising or bleeding; vaginal irritation or discharge.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.



If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms include decreased urination; dizziness; hearing loss; trouble breathing.


Proper storage of Tobramycin:

Tobramycin is usually handled and stored by a health care provider. If you are using Tobramycin at home, store Tobramycin as directed by your pharmacist or health care provider. Keep Tobramycin, as well as syringes and needles, out of the reach of children and away from pets.


General information:


  • If you have any questions about Tobramycin, please talk with your doctor, pharmacist, or other health care provider.

  • Tobramycin is to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Tobramycin. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Tobramycin resources


  • Tobramycin Use in Pregnancy & Breastfeeding
  • Tobramycin Drug Interactions
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