Tobrin Eye Ointment 3 mg/gm

Aminoglycoside antibiotic used as:

• Eye drops/ointment 0.3%: bacterial conjunctivitis, blepharitis, keratitis and other external eye infections
• Injection (hospital): serious Gram-negative infections (including Pseudomonas) — septicaemia, pneumonia, complicated urinary infections
• Inhalation: chronic Pseudomonas lung infection in cystic fibrosis (specialist)

Eye drops 0.3%: mild–moderate: 1–2 drops every 4 hours; severe: 2 drops every hour until improving, then reduce.

Eye ointment 0.3%: a 1–1.5 cm strip 2–3 times daily (or at night with drops in the day).

Injection: 3–5 mg/kg/day (once daily or divided every 8 hours), adjusted by blood levels and kidney function — hospital only.

• Usually 7 days for eye infections. Do not touch the dropper to the eye.

• Allergy to tobramycin or other aminoglycosides
• Myasthenia gravis (injection)

Eye: temporary stinging, itching, redness, eyelid swelling; allergic reactions; blurred vision with ointment.

Injection: kidney damage, hearing loss and balance problems (may be permanent), neuromuscular weakness.

• Stop eye drops if signs of allergy appear; prolonged use may cause fungal or resistant infection.
• Remove contact lenses during treatment.
• Injection: monitor blood levels, kidney function and hearing.

Eye drops can be used in pregnancy and breastfeeding if needed. Injection: avoid in pregnancy unless essential (ear damage to the baby).

• Eye: wait 5 minutes between different eye drops
• Injection: loop diuretics, vancomycin, ciclosporin, cisplatin, other aminoglycosides (ear/kidney toxicity); neuromuscular blockers

Eye overdose: rinse with water. Injection overdose: kidney and ear damage — haemodialysis may help.

Store below 25–30°C. Discard eye drops 4 weeks after opening.