Tobramycin
- Atc Codes:J01GB01#S01AA12
- CAS Codes:32986-56-4#79645-27-5
- PHARMGKB ID:32986-56-4#79645-27-5
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Bramitob, Cromycin, Tobi, Tobrasix, Tobrex; Belgium: Obracin, Tobi, Tobramycine, Tobravisc, Tobrex; Bulgaria: Dex-Tobrin, Tobi, Tobramycin, Tobrex, Tobrin, Tobrom; Cyprus: Ikobel, Tobramycine, Tobrex; Czech Republic: Bramitob, Tobi, Tobramycin, Tobrex; Denmark: Tobi, Tobrex; Estonia: Tobrex; Finland: Tobi, Tobrex, Tomycin; France: Tobi, Tobrex; Germany: Actitob, Bramitob, Gernebcin, Tobi, Tobra, Tobramaxin, Tobramycin; Greece: Bramitob,Colther, Eyebrex, Eyetobrin, Ikobel, Thilo-Micine, Tobi, Tobrabact, Tobramycin, Tobrex; Hungary: Bramitob, Brulamycin, Tobi, Tobrex, Tobrexan; Ireland: Bramitob, Tobi, Tobramycin, Tobravisc; Italy: Bramicil, Bramitob, Nebicina, Tobi, Tobrabact, Tobral, Tobramicina, Tobrastill; Latvia: Tobrex; Lithuania: Tobrex, Tobrin; Luxembourg: Obracin, Tobrex; Malta: Tobi, Tobramycin, Tobrex; Netherlands: Bramitob, Obracin, Tobi, Tobrabact, Tobramycine, Tobrex; Poland: Bramitob, Brulamycin, Nebcin, Tobi, Tobrex, Tobrexan, Tobrosopt; Portugal: Bramitob, Tobi, Tobra-Gobens, Tobramicina, Tobrex, Tobrexan; Romania: Tobi, Tobrex, Tobrom; Slovakia: Bramitob, Brulamycin, Tobi, Tobramycin, Tobravisc, Tobrex; Slovenia: Tobrex; Spain: Bramitob, Tobi, Tobrabact, Tobra-Gobens, Tobramicina, Tobrex; Sweden: Nebcina, Tobi, Tobrex; UK: Bramitob, Tobi, Tobramycin, Tobravisc.
North America
Canada: Tobi, Tobramycin, Tobrex; USA: AKTob, Tobi, Tobramycin, Tobrex.
Latin America
Argentina: Belbarmicina, Bideon Biotic, Bioptic, Fotex, Gotabiotic, Klonamicin, Oftalbrax, Pulbronkal, Radina, Tobi, Tobrabiotic, Tobradosa, Tobragan, Tobral, Tobraler, Tobramicina, Tobranet, Tobrex, Tuberbut, Xibrax; Brazil: Tobracin, Tobragan, Tobramicina, Tobramina, Tobranom, Tobrex; Mexico: Eyebrex, Isenia, Micitrex, Obry, Poentobral, Tobrex, Trazil.
Asia
Japan: Tobracin.
Drug combinations
Tobramycin and Dexamethasone
Tobramycin and Diclofenac
Tobramycin and Loteprednol
Tobramycin, Dexamethasone, and Hyaluronic Acid
Tobramycin, Dexamethasone, and Naphazoline
Chemistry
Tobramycin: C~18~H~37~N~5~O~9~. Mw: 467.51. Antibiotic produced by Streptomyces tenebrarius. (1) D-Streptamine, O-3-amino-3-deoxy-α-D-glucopyranosyl-(1→6)-O-[2,6-diamino-2,3,6-trideoxy-α-D-ribo-hexopyranosyl-(1→4)]-2-deoxy-; (2) O-3-Amino-3-deoxy-α-D-glucopyranosyl-(1→4)-O-[2,6-diamino-2,3,6-trideoxy-α-D-ribo-hexopyranosyl-(1→6)]-2-deoxy-L-streptamine. CAS-32986-56-4 (1972).
Tobramycin Sulfate: (C~18~H~37~N~5~O~9~)~2~ 5H~2~SO~4~. Mw: 1425.42. (1) D-Streptamine, O-3-amino-3-deoxy-α-D-glucopyranosyl-(1→6)-O-[2,6-diamino-2,3,6-trideoxy-α-D-ribo-hexopyranosyl-(1→4)]-2-deoxy-,sulfate (2:5); (2) O-3-Amino-3-deoxy-α-D-glucopyranosyl-(1→4)-O-[2,6-diamino-2,3,6-trideoxy-α-D-ribo-hexopyranosyl-(1→6)]-2-deoxy-L-streptamine, sulfate (2:5). CAS-79645-27-5.
Pharmacologic Category
Antibacterials; Aminoglycosides. EENT Preparations; Antibacterials. Ophthalmic Antibiotic. (ATC-Code: J01GB01; S01AA12).
Mechanism of action
Interferes with bacterial protein synthesis by binding to 30 S and 50 S ribosomal subunits resulting in defective bacterial cell membrane.
Therapeutic use
Treatment of documented or suspected infections caused by susceptible Gram-negative bacilli including Pseudomonas aeruginosa; topically used to treat superficial ophthalmic infections caused by susceptible bacteria. Tobramycin solution for inhalation indicated for management of cystic fibrosis patients (>6 years of age) with Pseudomonas aeruginosa.
Pregnancy and lactiation implications
Use contraindicated in pregnancy. Enters breast milk (not recommended in nursing women).
Unlabeled use
Contraindications
Hypersensitivity to tobramycin, other aminoglycosides, or any component of the formulation. Pregnancy (injection/inhalation).
Warnings and precautions
Use with caution in neuromuscular disorders, including myasthenia gravis. May cause nephrotoxicity (usual risk factors include pre-existing renal impairment, concomitant nephrotoxic medications, advanced age and dehydration). Use with caution in pre-existing renal insufficiency. May cause neuromuscular blockade and respiratory paralysis (especially when given soon after anesthesia or muscle relaxants). Use with caution in hypocalcemia. May cause neurotoxicity (usual risk factors include pre-existing renal impairment, concomitant neuro-/nephrotoxic medications, advanced age and dehydration). Ototoxicity might occur (proportional to amount of drug given and duration of treatment). Tinnitus or vertigo may be indications of vestibular injury and impending bilateral irreversible damage (use with caution in pre-existing vertigo, tinnitus, or hearing loss). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Solution may contain sodium metabisulfate (use caution in sulfite allergy).