tobramycin and dexamethasone, Tobradex, Tobradex ST

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Medical Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: tobramycin and dexamethasone

BRAND NAME: Tobradex, Tobradex ST

DRUG CLASS AND MECHANISM: Tobradex is a combination of the antibiotic, tobramycin, plus the anti-inflammatory corticosteroid, dexamethasone (Decadron, DePaxe). The combination is used to treat conjunctivitis (inflammation of the inner side of the eyelids or pinkeye) when bacterial infection is thought to be the cause of the inflammation. Dexamethasone is a synthetic (man-made) corticosteroid. Corticosteroids are naturally-occurring chemicals produced by the adrenal glands. Corticosteroids affect the function of many cells within the body and suppress the immune system. Corticosteroids also block inflammation and are used in a wide variety of inflammatory diseases affecting many organs. Tobramycin is an antibiotic that is active against Staphylococci (S. aureus and S. epidermidis), Streptococcus pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Klebsiellla pneumoniae and many other types of bacteria. Tobradex was approved by the FDA in 1988.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS:

• Ophthalmic solution or ointment: 0.3% tobramycin and 0.1% dexamethasone.
• Opthalmic Suspension: 0.3% tobramycin and 0.05% dexamethasone.

STORAGE: Tobradex should be kept at room temperature, 15-30 C (59-86 F), and protected from direct light.

PRESCRIBED FOR: Tobradex is used for the treatment of steroid responsive ocular inflammation that requires steroid treatment and is caused by a bacterial infection or there is a risk of bacterial infection.

DOSING: The recommended dose is one or two drops (solution or ointment) or one drop (suspension) into the conjunctival sac every four to six hours. The dosing interval may be reduced to every two hours during the initial 24 to 48 hours. The hands should be washed before each use of Tobradex or any eye medication. The head is tilted back, and the lower eye lid is pulled down with the index finger to form a pouch. The tip of the dropper should not touch the eye or eyelid. The bottle of Tobradex should be squeezed slightly to allow the prescribed number of drops (generally one or two drops) into the pouch. If the ointment is being used, a small strip (about 1cm or 1/2 inch) of ointment should be squeezed into the pouch. The eye should then be closed gently for one to two minutes without blinking.

DRUG INTERACTIONS: No drug interactions have been described with Tobradex eye drops or ointment.

PREGNANCY: Although no human studies have assessed the effects of Tobradex on the fetus, animal studies have shown adverse fetal effects. Physicians should prescribe it to women who are pregnant only if its benefits are deemed to outweigh the potential risks.

NURSING MOTHERS: It is not known if Tobradex is excreted into breast milk.

SIDE EFFECTS: The most frequently reported side effects of Tobradex are itching, swelling of the eye lids, and redness of the conjunctivae. Increased intraocular pressure, delayed wound healing, optic nerve damage, and formation of cataract may also occur.

Reference: FDA Prescribing Information

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