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tobramycin (inhalation)

Pronunciation: toe bra MY sin

Brand: Bethkis, Kitabis Pak, Tobi, Tobi Podhaler

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

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is tobramycin?

Tobramycin is an antibiotic that is inhaled into the lungs using a nebulizer. Tobramycin inhalation is used to treat lung infections in patients with cystic fibrosis.

This medicine is for use in adults and children who are at least 6 years old.

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

What should I discuss with my healthcare provider before using tobramycin?

You should not use this medicine if you are allergic to tobramycin or similar antibiotics (amikacin, gentamicin, kanamycin, neomycin, paromomycin, streptomycin).

Tell your doctor if you have ever had:

  • hearing problems;
  • breathing problems (cough, wheezing, chest tightness);
  • dizzy spells;
  • a neuromuscular disease such as myasthenia gravis or Parkinson's disease; or
  • kidney disease.

If you take this medicine during pregnancy, your baby could have irreversible hearing damage. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.

If you breast-feed while using tobramycin, watch the baby for signs of diarrhea, blood in the stools, or a fungal diaper rash with white patches on the skin.

Tobramycin is not approved for use by anyone younger than 6 years old.

How should I use tobramycin?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Tobramycin is inhaled into the lungs with the use of a nebulizer or an inhaler device. Do not swallow the medicine by mouth.

Use only the inhaler device provided with your medicine.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Tobramycin is given in a treatment cycle of 28 days on and 28 days off. Follow your doctor's dosing instructions very carefully. Keep using tobramycin on this schedule, even if you feel fine.

Use your doses at regular intervals of 12 hours apart but not less than 6 hours apart.

If you use other inhaled medicines, or if you perform chest physiotherapy to remove mucus from the lungs, use these other treatments first before using your tobramycin dose.

Do not use tobramycin inhalation solution if it looks cloudy or has particles in it. Call your pharmacist for new medicine.

Store tobramycin ampules in the refrigerator between 36 and 46 degrees Fahrenheit (2 and 8 degrees Celsius).

If refrigeration is not available, store the ampules at cool room temperature for up to 28 days. Protect from light. The solution may become darker in color at room temperature, but this should not affect the quality of the medicine.

Store Tobi Podhaler capsules in their original blister pack at room temperature away from moisture and heat. Remove a Tobi Podhaler capsule from the blister pack only when you are ready to load it into your inhaler device.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 6 hours. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using tobramycin?

Do not mix tobramycin solution with dornase alfa (Pulmozyme) in the nebulizer.

What are the possible side effects of tobramycin?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • new or worsening breathing problems, such as wheezing, cough, chest tightness, or trouble breathing;
  • hearing problems, ringing in your ears;
  • hoarse voice;
  • severe dizziness, spinning sensation, balance problems;
  • weak or shallow breathing;
  • muscle weakness; or
  • kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath.

Common side effects may include:

  • cough, sore throat, hoarse voice;
  • noisy breathing;
  • worsening of lung problems or cystic fibrosis;
  • coughing up mucus or blood;
  • altered sense of taste;
  • fever;
  • headache; or
  • rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect tobramycin?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects.

Tell your doctor about all your other medicines, especially:

  • urea;
  • a diuretic or "water pill" --furosemide, Lasix, ethacrynic acid, and others; or
  • other medicine that may harm your kidneys, hearing, or nervous system --certain medicines for infections, cancer, osteoporosis, organ transplant rejection, bowel disorders, or pain or arthritis (including aspirin, Tylenol, Advil, and Aleve).

This list is not complete. Other drugs may affect tobramycin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about tobramycin inhalation.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2019 Cerner Multum, Inc. Version: 4.01. Revision date: 11/12/2018.

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