Tobramycin, Inj
Aminoglycoside · Aminoglycoside
Indications
Infections of respiratory tracts, central nervous system, skin and soft tissue; septicaemia, bone infection.
Dosage
Adults: 3-5 mg/kg daily in three or four divided doses by IM/IV inj or infusion. Children: Neonates, up to 4 mg/kg daily in two equal doses; others, 6-7.5 mg/kg daily in 3 or 4 divided doses. Bone Infection: IM/IV: Adults: 3 mg/kg/day given every 8 hr. Max: 5 mg/kg/day in 3-4 doses. Reduce to 3 mg/kg/day as soon as clinically indicated. Children: >1 wk: 2-2.5 mg/kg every 8 hr or 1.5-1.89 mg/kg every 6 hr. 1 wk or less: Up to 2 mg/kg every 12 hr. Lower Respiratory Infection, Meningitis & Septicaemia: IV: Adults: 3 mg/kg/day given every 8 hr. Max: 5 mg/kg/day in 3-4 doses. Reduce to 3 mg/kg/day as soon as clinically indicated. Children: >1 wk: 2-2.5 mg/kg every 8 hr or 1.5-1.89 mg/kg every 6 hr. <1 wk: Up to 2 mg/kg every 12 hr. Brucellosis: IM/IV: Adults: 240 mg IM daily or 5 mg/kg IV daily for 7 days; either regimen recommended in combination with doxycycline. Cholangitis: IM, IV:…
Administration
IV: Infuse over 30-60 min. Give penicillins or cephalosporins at least 1 hour apart from tobramycin. Reconstitution: Standard diluent: Dose/100 mL NS; minimum volume: 50 mL NS Compatibility: Stable in dextran 40 10% in dextrose, D5NS, D5W, D10W, mannitol 20%, LR, NS. Don’t mix tobramycin in same solution with parenteral aminoglycosides or beta lactam antibiotics because mutual inactivation may occur. Y-site administration: Drug to Drug IV Compatibility: Acyclovir, amikacin, amiodarone, aztreonam, bumetanide, calcium gluconate, ciprofloxacin, cisatracurium, diltiazem, diphenhydramine, dobutamine, dopamine, enalapril, epinephrine, esmolol, famotidine, fentanyl, fluconazole, furosemide, gentamicin, hydromorphone, imipenem, labetalol, levofloxacin, linezolid, lorazepam, magnesium sulphate, methylprednisolone, metoclopramide, midazolam, milrinone, nitroglycerin, nitroprusside,…
Adverse Effects
Voice alteration, cough, dyspnoea, nausea. Rarely, bronchospasm, tinnitus, dysphonia, lung disorders, laryngitis, sputum discolouration, GI upset, rhinitis, malaise, myalgia, hearing loss, dysgeusia, rash, haemoptysis, epistaxis, chest pain, pyrexia, nasal congestion.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Caution advised or effect undetermined. Precautions: First dose must be given under supervision. Renal, auditory, vestibular or neuromuscular dysfunction, haemoptysis. Monitor auditory and renal function during therapy. If ototoxicity or nephrotoxicity occurs, discontinue therapy.
Interactions
Drugs with nephrotoxic or ototoxic potential, diuretics, urea, anticholinesterases, botulinum toxin.
Advice to Patient
Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Contact prescriber if there is decreased urine output, swelling of ankles/hands/feet, difficulty in breathing, vaginal itching, vaginal discharge, rash, diarrhoea that is severe or lasts longer than 3 days , oral thrush, unhealed wounds, dizziness, changes in hearing, ringing in ears or if there is no improvement or worsening of condition. Watery or bloody stools can occur 2 or more months after therapy and can be serious, requiring immediate treatment.
Pharmacokinetics
Absorption: Oral: Poorly absorbed. IM: Rapid and complete. Half-life elimination: Neonates: =1200 gm: 11 hrs. >1200 gm: 2-9 hrs. Infants: 4 ± 1 hr. Children: 2 ± 1 hr. Adolescents: 1.5 ± 1 hr. Adults: IV: 2-3 hrs. Adults with impaired renal function: 5-70 hrs. Time to peak, serum: IM: 30-60 mins. IV: Approx. 30 mins. Excretion: Normal renal function: Urine (approx. 90%-95%) within 24 hrs.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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