Tobradex

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

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: when used, it may cause local irritation. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

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.

Do not use Tobradex if you:

• are allergic to tobramycin, dexamethasone, or any ingredients of Tobradex
• 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

There may be an interaction between tobramycin - dexamethasone and any of the following:

• Cobicistat
• non-steroidal anti-inflammatory (NSAID) eye drops (e.g., Diclofenac, Ketorolac)
• ritonavir
• other eye drops containing corticosteroids (e.g., Prednisolone eye drops)

If you are taking any of these 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.

Medications other than those listed above may interact with Tobradex. 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.

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 Tobradex.

Blurred vision: Tobradex 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 Tobradex. Usually, contact lenses should not be worn when treating an eye infection. The drop form of Tobradex 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 Tobradex may result in Glaucoma, with damage to the optic nerve, vision problems, perforation of the cornea, and Cataracts. Prolonged use of Tobradex 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 Tobradex for a prolonged period of time, your doctor should check your eye pressure regularly.

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

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

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

This medication is for the eye. To use: Wash your hands as well as the skin surrounding the affected eye. Shake the container. Gently pull down the lower lid of the affected eye. Apply 1 drop of the medication. Unless your condition prevents you from doing so, close the eye for at least 1 minute, while gently pressing on the inner corner of the eye, near the nose. To avoid contaminating the medication, do not let the tip of the applicator touch your fingers or any part of your eye. Close the container tightly after each use. Continue applying the product to complete the prescribed course of treatment, even after improvement is seen or felt. This medication is typically used 4 times a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Generally, a treatment with this medication lasts several days. Use it for the entire time prescribed in order to achieve the medication's full benefit. If you forget a dose, apply it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed one. Do not apply more to try to catch up.