Tobramycin/dexamethasone

Tobramycin/dexamethasone (INNs, trade name Tobradex, Tobrason in Jordan[1]) is a prescription medication in the form of eye drops and eye ointment, marketed by Alcon. The active ingredients are tobramycin 0.3% (an antibiotic) and dexamethasone 0.1% (a corticosteroid). It is prescribed for a wide spectrum of bacterial eye infections. Tobradex can also be used to clear or contract styes that are also found in the eye. It is prescribed for the treatment of pink eye in combination with bacterial infections. Because it contains a steroid, careful use with gradual reduction of doses is required.

Tobramycin/dexamethasone
Combination of
TobramycinAminoglycoside antibiotic
DexamethasoneGlucocorticoid
Clinical data
Pregnancy
category
  • US: C (Risk not ruled out)
    Routes of
    administration    		Ophthalmic
    ATC code
    Legal status
    Legal status
    Identifiers
    CAS Number
    DrugBank
    ChemSpider
    UNII
    KEGG
    ChEBI
    ChEMBL
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    Contraindications

    It is strongly contraindicated with herpetic and other viral eye infections. Other contraindications include fungal and mycobacterial infections because tobramycin is inactive against those, and the corticoid acts as an immunosuppressive agent, preventing the body's immune system from dealing with the infection. The drops are also contraindicated in patients with corneal lesions.[2][3]

    Side effects

    Similarly to other corticosteroid eye drops, side effects include hypersensitivity and, especially after long-term use, secondary eye infections, cataract (clouding of the eye lens) and increased intraocular pressure, leading to glaucoma. Consequently, the drug should not be applied longer than 24 days[2][4][5] without further medical evaluation.[6]

    Interactions

    Anticholinergic eye drops potentiate the risk of increased intraocular pressure. Systemic aminoglycoside antibiotics increase toxicity for ears, nerves and kidney.[2]

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    References
    1. http://www.jfda.jo/
    2. Haberfeld, H, ed. (2009). Austria-Codex (in German) (2009/2010 ed.). Vienna: Österreichischer Apothekerverlag. Tobradex-Augentropfen. ISBN 3-85200-196-X.
    3. Tobradex Prescribing Information. Alcon.
    4. Faschinger, Ch (3 January 2011). "TobraDex". Österreichische Apothekerzeitung (in German) (1/2011): 13.
    5. Dinnendahl, V; Fricke, U, eds. (2010). Arzneistoff-Profile (in German). 2 (23 ed.). Eschborn, Germany: Govi Pharmazeutischer Verlag. ISBN 978-3-7741-9846-3.
    6. Novartis (October 2015). "TobraDex Manufacturer's Information Sheet" (PDF). Alcon Laboratories Inc. Fort Worth, Texas, USA. p. 1. Retrieved 27 January 2017. Not more than 20 ml. should be prescribed initially and the prescription should not be refilled without further evaluation as outlined [...] above.
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