Tobramycin/dexamethasone, sold under the brand name Tobradex, is a fixed-dose
combination medication
A combination drug or a fixed-dose combination (FDC) is a medicine that includes two or more active ingredients combined in a single dosage form. Terms like "combination drug" or "combination drug product" can be common shorthand for a FDC prod ...
in the form of
eye drops
Eye drops or eyedrops are liquid drops applied directly to the surface of the eye usually in small amounts such as a single drop or a few drops. Eye drops usually contain saline to match the salinity of the eye. Drops containing only saline an ...
and eye
ointment
A topical medication is a medication that is applied to a particular place on or in the body. Most often topical medication means application to body surfaces such as the skin or mucous membranes to treat ailments via a large range of classe ...
, marketed by
Alcon
Alcon is an American Swiss medical company specializing in eye care products with headquarters in Geneva, Switzerland, and incorporated in Fribourg, Switzerland. Alcon began as a US company and its US subsidiary’s headquarters remain in Fort ...
.
The active ingredients are
tobramycin
Tobramycin is an aminoglycoside antibiotic derived from ''Streptomyces tenebrarius'' that is used to treat various types of bacterial infections, particularly Gram-negative infections. It is especially effective against species of ''Pseudomonas ...
(an
antibiotic
An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting pathogenic bacteria, bacterial infections, and antibiotic medications are widely used in the therapy, ...
) and
dexamethasone
Dexamethasone is a glucocorticoid medication used to treat rheumatic problems, a number of skin diseases, severe allergies, asthma, chronic obstructive lung disease, croup, brain swelling, eye pain following eye surgery, superior vena cav ...
(a
corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are in ...
).
It is prescribed for the treatment of
pink eye
Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The ...
in combination with bacterial infections.
Contraindications
It is contraindicated with
herpetic and other
viral
Viral means "relating to viruses" (small infectious agents).
Viral may also refer to:
Viral behavior, or virality
Memetic behavior likened that of a virus, for example:
* Viral marketing, the use of existing social networks to spread a marke ...
eye infections. Other contraindications include
fungal
A fungus ( : fungi or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are classified as a kingdom, separately from ...
and
mycobacteria
''Mycobacterium'' is a genus of over 190 species in the phylum Actinomycetota, assigned its own family, Mycobacteriaceae. This genus includes pathogens known to cause serious diseases in mammals, including tuberculosis (''M. tuberculosis'') and ...
l infections because tobramycin is inactive against those, and the corticoid acts as an
immunosuppressive
Immunosuppression is a reduction of the activation or efficacy of the immune system. Some portions of the immune system itself have immunosuppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse react ...
agent, preventing the body's immune system from dealing with the infection. The drops are also contraindicated in patients with
cornea
The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical ...
l lesions.
Side effects
Similarly to other corticosteroid eye drops,
side effect
In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...
s include
hypersensitivity
Hypersensitivity (also called hypersensitivity reaction or intolerance) refers to undesirable reactions produced by the normal immune system, including allergies and autoimmunity. They are usually referred to as an over-reaction of the immune ...
and, especially after long-term use, secondary eye infections,
cataract
A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble w ...
(clouding of the eye lens) and increased
intraocular pressure
Intraocular pressure (IOP) is the fluid pressure inside the eye
Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response fu ...
, leading to
glaucoma
Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye re ...
. Consequently, the drug should not be applied longer than 24 days
[
] without further medical evaluation.
Interactions
Anticholinergic
Anticholinergics (anticholinergic agents) are substances that block the action of the neurotransmitter called acetylcholine (ACh) at synapses in the central and peripheral nervous system.
These agents inhibit the parasympathetic nervous syste ...
eye drops potentiate the risk of increased intraocular pressure. Systemic
aminoglycoside antibiotic
Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside ( sugar). The term can also refer ...
s increase toxicity for ears, nerves and kidney.
Brand names
Tobrason is a brand name in Jordan.
References
External links
*
{{DEFAULTSORT:Tobramycin Dexamethasone
Antibiotics
Glucocorticoids
Combination drugs
Drugs developed by Novartis