tobramycin injection

Generic Name: tobramycin (injection) (toe bra MYE sin)

Brand Names: Nebcin

What is tobramycin injection?

Tobramycin is in a group of antibiotics called aminoglycosides (ah-meen-oh-GLY-ko-sides). Tobramycin fights infections that are caused by bacteria.

Tobramycin injection is used to treat bacterial infections of the skin, heart, stomach, brain and spinal cord, respiratory system, and urinary tract. It is also used in the treatment of cystic fibrosis. Tobramycin injection is sometimes used together with other antibiotics.

Tobramycin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about tobramycin injection?

Do not use this medication without telling your doctor if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

There may be other drugs that can affect tobramycin injection. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Contact your doctor promptly if you have any hearing loss or ringing in your ears, even if these side effects occur long after you have stopped using tobramycin injection.

Other serious side effects include urinating less than usual or not at all, muscle stiffness or uncontrolled twitching, and wheezing, chest tightness, or trouble breathing.

Use this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Tobramycin injection will not treat a viral infection such as the common cold or flu. Tobramycin injection can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my health care provider before using tobramycin injection?

Do not use this medication if you are allergic to tobramycin or other aminoglycosides such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Mycifradin, Neo-Fradin, Neo-Tab), netilmicin (Netromycin), or streptomycin.

Before using this medication, tell your doctor if you are allergic to any drugs, or if you have:

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  kidney disease;

  
  


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  a muscle disorder such as myasthenia gravis;

  
  


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  Parkinson's disease;

  
  


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  asthma; or

  
  


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  a metabolic disorder such as high or low levels of potassium, calcium, or magnesium in your blood.

  
  

If you have any of these conditions, you may need a dose adjustment or special tests to safely use tobramycin.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use tobramycin injection without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Tobramycin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication.

How should I use tobramycin injection?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Tobramycin is given as an injection through a needle placed into a vein or as a shot given into a muscle. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Drink 6 to 8 full glasses of water each day while you are using tobramycin injection. You may become easily dehydrated while using this medication. Use this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Tobramycin injection will not treat a viral infection such as the common cold or flu.

To be sure this medication is not causing harmful effects, your doctor will need to check your progress on a regular basis. Your hearing and kidney function may also need to be tested. Do not miss any scheduled appointments.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using tobramycin injection. You may need to stop using the medicine for a short time.

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include dizziness, ringing in your ears, and urinating more or less than usual, or not at all.

What should I avoid while using tobramycin injection?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using tobramycin.

Tobramycin injection can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tobramycin injection side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

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  hearing loss or ringing in your ears (even after you have stopped using tobramycin injection);

  
  


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  urinating less than usual or not at all;

  
  


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  muscle stiffness or uncontrolled twitching;

  
  


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  wheezing, chest tightness, trouble breathing;

  
  


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  confusion, seizure (convulsions); or

  
  


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  fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

  
  

Less serious side effects may include:

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  muscle weakness; or

  
  


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  numbness or tingly feeling.

  
  

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Tobramycin Dosing Information

Usual Adult Dose for Bacterial Infection:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours, or 5 to 7 mg/kg IV every 24 hours
Duration: 7 to 21 days, depending on the nature and severity of the infection
Limiting the duration of tobramycin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic intravenous or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Bacteremia:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration: 14 days, depending on the site, nature and severity of the bacteremia
Limiting the duration of tobramycin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic intravenous or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Burns - External:

2 to 2.5 mg/kg loading dose, followed by 1.7 to 2 mg/kg IV every 8 hours
Duration: 10 to 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Cystic Fibrosis:

IV: 5 to 10 mg/kg/day IV in 2 to 4 divided doses or 10 to 15 mg/kg/day IV in 3 to 4 divided doses; alternatively, 7 to 15 mg/kg IV every 24 hours has been used
Duration: 14 to 21 days, depending on the nature and severity of the infection and improvement of pulmonary function

Solution for inhalation:
Initial dose: 300 mg via nebulizer over approximately 15 minutes twice daily (every 12 hours) for 28 days
Maintenance dose: Administer in alternating cycles of 28 days on and 28 days off. If patient is on multiple therapies, the following order of administration is recommended: Bronchodilator, chest physiotherapy, other inhaled medications, and lastly, tobramycin solution.

Usual Adult Dose for Endocarditis:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV every 8 hours for the first 2 weeks
Duration: Antibiotic therapy for enterococcal endocarditis should be continued for 4 to 6 weeks and for more than 6 weeks in patients with Gram-negative endocarditis, depending on the nature and severity of the infection.

Usual Adult Dose for Febrile Neutropenia:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours
Duration: Once the patient is stable, afebrile for 24 hours, and the absolute neutrophil count is greater than 500/mm3, oral antibiotics may be substituted if antibiotic therapy is to be continued.

Usual Adult Dose for Intraabdominal Infection:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration: 14 days, depending on the nature and severity of the infection
Less toxic antibiotics may be substituted once the patient is stable for at least 48 hours.

Usual Adult Dose for Meningitis:

IV or IM: 2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours
Duration: Parenteral therapy should be continued for at least one week after the patient becomes afebrile and cerebrospinal fluid normalizes.

Intracerebroventricular: 4 to 8 mg intracerebroventricularly (preservative-free formulation) up to every 24 hours, in addition to parenteral antibiotic therapy
Subsequent doses should be based on the CSF concentration.

Usual Adult Dose for Osteomyelitis:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration: 4 to 6 weeks, depending on the nature and severity of the infection
Chronic osteomyelitis may require an additional 1 to 2 months of oral antibiotics. Limiting the duration of tobramycin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic intravenous or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Peritonitis:

Intravenous: 2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration: 14 days, depending on the nature and severity of the infection
Limiting the duration of tobramycin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic intravenous or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Intraperitoneal in CAPD patients: 0.6 to 0.75 mg/kg intraperitoneally once daily or 16 to 20 mg per every 2 L dialysate

Usual Adult Dose for Pneumonia:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration: 14 to 21 days, depending on the nature and severity of the infection
Limiting the duration of tobramycin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic intravenous or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Pyelonephritis:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration: 7 to 14 days, depending on the nature and severity of the infection
Limiting the duration of tobramycin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic intravenous or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Sepsis:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration: 10 to 14 days, depending on the nature and severity of the infection
A longer duration may be necessary in immunocompromised or neutropenic patients.

Usual Adult Dose for Shunt Infection:

4 to 8 mg intracerebroventricularly (preservative-free formulation) up to every 24 hours, in addition to parenteral antibiotic therapy
Subsequent doses should be based on the CSF concentration. Shunt removal is usually necessary to achieve a cure.

Usual Adult Dose for Skin or Soft Tissue Infection:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration: 10 to 14 days, or until 3 days post acute inflammation, depending on the nature and severity of the infection
For severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required. Limiting the duration of tobramycin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic intravenous or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Tularemia:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration: 10 to 14 days, depending on the nature and severity of the infection
Once the patient's condition improves, less toxic intravenous or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Pediatric Dose for Bacterial Infection:

Preterm neonate, 999 g or less: 3.5 mg/kg IV or IM every 24 hours
0 to 4 weeks, 1199 g or less: 2.5 mg/kg IV or IM every 18 to 24 hours
7 days or less, 1200 g or more: 2.5 mg/kg IV or IM every 12 hours
8 days to 4 weeks, 1200 to 2000 g: 2.5 mg/kg IV or IM every 8 to 12 hours
8 days to 4 weeks, 2001 g or more: 2.5 mg/kg IV or IM every 8 hours
1 month to 4 years: 1 to 2.5 mg/kg IV or IM every 8 hours
5 years or older: 2 to 2.5 mg/kg IV or IM every 8 hours

Usual Pediatric Dose for Cystic Fibrosis:

IV or IM: 2.5 to 3.3 mg/kg every 6 to 8 hours

Solution for Inhalation:
5 years or less: 40 to 80 mg via nebulizer 2 to 3 times daily

6 to 18 years:
Initial dose: 300 mg via nebulizer over approximately 15 minutes twice daily (every 12 hours) for 28 days
Maintenance dose: Administer in alternating cycles of 28 days on and 28 days off. If patient is on multiple therapies, the following order of administration is recommended: Bronchodilator, chest physiotherapy, other inhaled medications, and lastly, tobramycin solution.

What other drugs will affect tobramycin injection?

Before using tobramycin injection, tell your doctor if you are using any of the following drugs:

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  pentamidine (Nebupent, Pentam);

  
  


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  tacrolimus (Prograf);

  
  


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  amphotericin B (Fungizone, AmBisome, Amphotec, Abelcet);

  
  


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  a diuretic (water pill);

  
  


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  antibiotics such as capreomycin (Capastat), rifampin (Rifadin, Rimactane, Rifater), vancomycin (Vancocin, Vancoled);

  
  


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  antiviral medicines such as acyclovir (Zovirax), adefovir (Hepsera), cidofovir (Vistide), or foscarnet (Foscavir); or

  
  


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  cancer medicine such as aldesleukin (Proleukin), carmustine (BiCNU, Gliadel), cisplatin (Platinol), ifosfamide (Ifex), oxaliplatin (Eloxatin), plicamycin (Mithracin), streptozocin (Zanosar), or tretinoin (Vesanoid).

  
  

This list is not complete and there may be other drugs that can interact with tobramycin injection. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More tobramycin resources

• Tobramycin Use in Pregnancy & Breastfeeding
• Tobramycin Drug Interactions
• Tobramycin Support Group
• 0 Reviews for Tobramycin - Add your own review/rating

Compare tobramycin with other medications

• Bacteremia
• Bacterial Infection
• Bone infection
• Burns, External
• Cystic Fibrosis
• Endocarditis
• Febrile Neutropenia
• Intraabdominal Infection
• Kidney Infections
• Meningitis
• Peritonitis
• Pneumonia
• Rabbit Fever
• Sepsis
• Shunt Infection
• Skin Infection

Where can I get more information?

• Your pharmacist can provide more information about tobramycin injection.