Tobramycin (toe-bra-MYE-sin)

Helps treat Pseudomonas infections in patients with cystic fibrosis. Belongs to a class of drugs called aminoglycoside antibiotics.

Brand Name(s):

Tobi

When This Medicine Should Not Be Used:

How to Use This Medicine:

Spray

• Your doctor will tell you how much medicine to use and how often. You may be told to use the medicine 2 times a day for 28 days, then stop using the medicine for 28 days, and then repeat the cycle.
• If you use 2 treatments daily, try to space them 12 hours apart and not less than 6 hours apart.
• You should receive another information sheet that will tell you how to use the medicine and take care of the equipment needed to give the medicine.
• The medicine is a clear yellow liquid that comes in a plastic vial called an ampule. You may be told to use one ampule of medicine for each treatment. Check the medicine before your treatment. If the liquid is cloudy or if you see specks, you should not use the medicine.
• An air compressor is used with a nebulizer to turn the medicine into a fine spray. You will breathe the spray in through your mouth and to your lungs.
• You will need to use the nebulizer for about 10 to 15 minutes, or until the medicine in the nebulizer cup is gone. You may hear a sputtering sound when the cup is empty.
• Clean all the parts of the nebulizer after each use.
• You may want to rinse your mouth or suck on hard candy if the medicine leaves a bad taste in your mouth.
• Never share your medicine with anyone.

If a dose is missed:

• Use the medicine as soon as possible. Then wait at least 6 hours before using your next dose.
• You should not use two doses at the same time.

How to Store and Dispose of This Medicine:

• Store the medicine in the refrigerator. You should not use the medicine after the expiration date on the ampule has passed.
• If you can't keep the medicine in the refrigerator, store the medicine in the foil pouch at room temperature away from heat or direct light. You should not use the unrefrigerated medicine after 28 days.
• Keep all medicine out of the reach of children.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not mix other medicine with tobramycin in the nebulizer unless your doctor tells you to.
• Make sure your doctor knows if you are using other aminoglycoside medicines (such as streptomycin, amikacin, kanamycin, neomycin, netilmicin, or gentamicin) or diuretics (water pills such as furosemide).

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or become pregnant while being treated with this medicine. Tobramycin used during a pregnancy may cause hearing problems in an unborn baby. You should not breastfeed while using this medicine, because you may give the medicine to your baby through breast milk.
• This medicine may cause hearing loss. Call your doctor right away if you notice any changes in your hearing or if you have ringing in your ears, headaches, nausea, vomiting, or dizziness.
• Your doctor may want to test your hearing while you are being treated with tobramycin. Tell your doctor if you already have hearing problems before you are given this medicine.
• Tell your doctor if you have kidney disease or a muscle disorder such as Parkinson's disease or myasthenia gravis.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Increased coughing, wheezing, or trouble breathing
• Changes in your hearing, ringing in your ears
• Skin rash, itching, or hives

If you notice these less serious side effects, talk with your doctor:

• Sore throat or hoarseness
• Bad taste in your mouth

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088