Indications

Antibiotic

Contraindication

Hypersensitivity to tobramycin and other aminoglycosides.

Special Precautions

Patient w/ neuromuscular disorders (e.g. myasthenia gravis, parkinsonism). Prolonged use may result in overgrowth of non-susceptible organisms. Renal impairment. Childn, premature and neonatal infants (inj). Renal impairment. Pregnancy and lactation. Patient Counselling This drug may cause temporary blurred vision, if affected, do not drive or operate machinery. Contact lens wear is not recommended during treatment (ophth). Monitoring Parameters Monitor serum Ca, Mg, and Na; renal and auditory function.

Side Effects

Inj: Ototoxicity; increased AST, ALT and serum bilirubin; decreased serum Ca, Mg, Na and K; anaemia, granulocytopenia, thrombocytopenia, leucopenia, leucocytosis and eosinophilia; fever, rash, itching, urticaria, nausea, vomiting, diarrhoea, headache, lethargy, pain on inj site, mental confusion, disorientation. Inhalation: Voice disorder, cough, pulmonary disease, reduced forced expiratory vol, sputum discolouration, rales, dyspnoea, oropharyngeal pain, haemoptysis, pharyngolaryngeal pain, fever, chest discomfort, malaise, skin rash, increased serum glucose, nausea, dysgeusia, vomiting, diarrhoea, xerostomia, increased erythrocyte sedimentation rate, increased serum Ig, myalgia, hypoacusis, deafness. Ophth oint/soln: Localized ocular toxicity and hypersensitivity (e.g. itching and oedema of the eyelid), conjunctival erythema, punctate keratitis, increased lacrimation.

Drug Interactions

Enhanced neurotoxic and nephrotoxic effects w/ other aminoglycosides (e.g. amikacin, streptomycin), cefaloridine, viomycin, polymyxin B, colistin, cisplatin and vancomycin. Enhanced toxicity w/ potent diuretics (e.g. ethacrynic acid, furosemide). Prolonged secondary apnoea may occur when given to anaesthetised patients receiving neuromuscular blocking agents (e.g. succinylcholine, tubocurarine, decamethonium). Increased risk of nephrotoxicity w/ ciclosporin and other antibacterials (e.g. cephalosporins). Antagonistic effect w/ neostigmine and pyridostigmine. May potentiate the effect of warfarin and phenindione.

Route of Administration

Oral, Opthalmic, Parenteral

Dosage

As directed by the physician