Tobradex

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 08, 2022

Warnings

What are the risks of taking Tobradex?

Tobradex can cause serious health problems in certain groups of people. You should talk to your healthcare provider if you have any concerns or other treatment options.
For topical ophthalmic use only - Tobradex is intended to be used on the surface of the eyes only. Do not drink, swallow, or use it as an injection.

Allergic Reactions:
Risk factor: Allergy to other aminoglycoside antibiotics
Tobramycin, an aminoglycoside antibiotic, can cause an allergic reaction. An anaphylactic reaction is a severe, life-threatening allergic reaction that can sometimes happen. Symptoms of anaphylactic allergic reactions include hives, skin rash, swollen lips or tongue, or difficulty breathing. If you notice any of these symptoms or feel like your throat is closing after using Tobradex, call 911 immediately. Let your healthcare providers know you have any hypersensitivity reactions to Tobradex or aminoglycoside antibiotics, including over-the-counter Neosporin products. If hypersensitivity develops, Tobradex needs to be discontinued immediately and replaced with other appropriate therapy.
Glaucoma (increased intraocular pressure or eye pressure):
Risk factor: Long-term use of Tobradex
Dexamethasone is a steroid; thus, long-term use of Tobradex can lead to high eye pressure or glaucoma. If left untreated, high eye pressure can damage your optic nerve (eye nerve) and affect your vision. You should watch out for signs such as eye pain, eye pressure, or any vision changes, and let your doctor know if you notice any of these signs. If you are instructed to use Tobradex for a long time, you should have a follow-up appointment with your eye doctor to check the pressures in your eyes.
Eye injury or damage:
Risk factor: Long-term use of Tobradex; long-term use of steroids in the eye; existing diseases causing thinning corneas or sclera (the white part of the eye)
Dexamethasone is a steroid, and it can make your corneas or sclera thinner. When these parts of your eye(s) get thinner, they get damaged more easily. Persistent corneal ulceration posed an increased risk of fungal infections. The risk is higher when you already have thin corneas or sclera or are using Tobradex or other steroids for the eyes for a long time. Inform your doctor right away if you experience any eye pain, discomfort, vision changes, or if your eye is tearing up more than usual.
New or worsened infection:
Risk factor: Long-term use of Tobradex
After using Tobradex for a while, secondary ocular infections can occur; you can get a new bacterial or fungal infection resistant to Tobradex. If you have an eye infection caused by fungi or parasites, the steroid component (dexamethasone) of Tobradex may mask the symptoms of the infection, which allows it to worsen without you knowing. An overgrowth of fungi or parasites that are not susceptible to antibiotics is considered a superinfection that would require appropriate therapy to be initiated. Let your doctor know right away if your symptoms do not improve after a few days or if you experience any changes in vision, eye pain, discomfort. After finishing your prescription of Tobradex, you should follow up with your doctor so you can be examined. Your doctor will determine if you need to have refills on Tobradex.

What should I tell my doctor before starting Tobradex?

Tobramycin is an antibiotic; it only works against bacteria. You should not use Tobradex if you have a viral or fungal infection in the eye(s), such as herpes, vaccina, or varicella.

Do not use Tobradex for mycobacterial infections of the eye(s).

Let your healthcare professional know if you are allergic to aminoglycoside antibiotics such as amikacin, gentamicin, neomycin, tobramycin, streptomycin, and others; this includes over-the-counter Neosporin products. If you are allergic to an aminoglycoside antibiotic, you may have an allergic reaction to Tobradex.

Let your doctor know if you are pregnant or plan to get pregnant. There are no adequate clinical studies on pregnant women.

Also, let your doctor know if you are breastfeeding or planning to breastfeed, as tobramycin or dexamethasone may pass into breast milk.

What proper medical care should I take while on Tobradex?

After a few days using Tobradex, let your doctor know if your symptoms worsen or do not get better. Also, let your doctor know if you notice any changes in vision, eye pain, eye pressure, or discomfort.

Wash your hands thoroughly with soap and water before administering the eye drops. Tobradex is a sterile ophthalmic suspension. Do not touch the dropper or tube opening to any surface, including your eyes or hands. The dropper and tube opening are sterile, allowing them to come into contact with other surfaces may contaminate themcan cause a new infection.

After each drop, apply light pressure to the inside corner of your eye, near your nose bridge, to prevent the medication from draining down your tear duct.

Use this medication as directed. Do not use it for a longer duration than your doctor’s instruction. Prolonged use of this product can cause unwanted adverse reactions and infection.

What drugs can interact with Tobradex?

Do not use any other prescription or over-the-counter eye drops during treatment with Tobradex unless directed by your doctor.

Since Tobradex contains a steroid (dexamethasone), let your doctor know if you are taking any oral steroid medication such as prednisone (Deltasone, Orasone), prednisolone (Orapred), methylprednisolone (Medrol, Solumedrol).

This is not a complete list. Other drugs, including prescriptions, over-the-counter products, herbal supplements, and vitamins, may interact with Tobradex. Not all potential drug interactions are listed in this guide. It is highly recommended to keep a list of all the drug products you are using (prescriptions, over-the-counter products, herbal supplements, natural products, and vitamins) and share it with your doctor and pharmacist.

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