Generic Name: tobramycin
Product Name: DBL Tobramycin Injection BP
Indication: What DBL Tobramycin Injection BP is used for
Tobramycin is used for the treatment of serious infections caused by bacteria, including:
- Meningitis (infection of the brain);
- Septicaemia (infection of the blood);
- Respiratory tract infections;
- Gastrointestinal tract infections;
- Skin and skin structure infections, including infected burns;
- Bone infections;
- Urinary tract infections.
Your doctor may have prescribed tobramycin for another reason. Ask your doctor if you have any questions about why tobramycin has been prescribed for you.
This medicine is available only with a doctor’s prescription.
Action: How DBL Tobramycin Injection BP works
Tobramycin is bactericidal in activity. It enters the cells via a complex active transport mechanism and exerts its activity primarily on the 30S ribosomal subunit, interfering with initial and subsequent steps in protein synthesis. It also acts to induce misreading of the genetic code of the mRNA template, resulting in incorporation of incorrect amino acids.
Tobramycin, in common with all other aminoglycosides, is primarily antibacterial against aerobic gram-negative bacilli. Tobramycin is considered more active than most other aminoglycosides against Pseudomonas aeruginosa. Tobramycin is usually active against most strains of the following organisms:
- Pseudomonas aeruginosa;
- Proteus species (indole-positive and indole-negative) including: Pr. mirabilis; Pr. morganii; Pr. rettgeri and Pr. vulgaris;
- Escherichia coli;
- Klebsiella, Enterobacter, Serratia species;
- Citrobacter species;
- Providencia species;
- Staphylococci, including Staph. aureus (coagulase-positive and coagulase-negative).
Aminoglycosides have a low order of activity against most gram-positive organisms, including Streptococcus pyogenes, S. Pneumoniae and enterococci.
DBL Tobramycin Injection BP contains the active ingredient tobramycin. It also contains the inactive ingredients disodium edetate, sodium metabisulfite, and sulfuric acid.
DBL Tobramycin Injection BP does not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.
Dose advice: How to use DBL Tobramycin Injection BP
Before you are given DBL Tobramycin Injection BP
When you must not be given it
You must not be given DBL Tobramycin Injection BP if you have an allergy to tobramycin or any of the ingredients listed here.
You must not be given tobramycin if you have an allergy to any other aminoglycoside antibiotics such as:
Symptoms of an allergic reaction may include:
- Shortness of breath, wheezing or difficulty breathing;
- Swelling of the face, lips, tongue or other parts of the body;
- Rash, itching or hives on the skin.
You must not be given tobramycin if you have experienced serious reactions (such as hearing loss or kidney problems) to tobramycin or other aminoglycosides, such as amikacin, gentamicin, or neomycin, in the past.
If you are not sure whether you should be given tobramycin, talk to your doctor or pharmacist.
Before you are given it
Tell your doctor or pharmacist if you have allergies to:
- Any other medicines;
- Any other substances, such as foods, preservatives or dyes.
Tell your doctor if you are pregnant or intend to become pregnant. Like most aminoglycoside antibiotics, tobramycin is not recommended for use during pregnancy. If there is a need for you to be given tobramycin, your doctor will discuss with you the benefits and risks of using it during your pregnancy.
Tell your doctor if you are breastfeeding or plan to breastfeed. Tobramycin passes into breast milk and is not recommended for use during breastfeeding. If there is a need for you to be given tobramycin, your doctor will discuss the possible risks and benefits of using it during breastfeeding.
Tell your doctor or pharmacist if you have or have had any medical conditions, especially the following:
- Kidney problems;
- Muscular disorders (e.g. myasthenia gravis, Parkinson’s disease);
- Hearing problems.
If you have not told your doctor or pharmacist about any of the above, tell them before you are given tobramycin.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.
Some medicines and tobramycin may interfere with each other. These include:
- Fluid tablets (diuretics) e.g. frusemide, ethacrynic acid, bumetanide;
- Cisplatin, a medicine used to treat cancer;
- Other antibiotics to treat infections such as colistin, vancomycin, cephalosporins and penicillins;
- Amphotericin, an antifungal medicine;
- Opioid analgesics (e.g. codeine, morphine, pethidine, fentanyl);
- Some general anaesthetic agents;
- Muscle relaxants (e.g. succinylcholine).
These medicines may be affected by tobramycin or may affect how well it works. You may need different amounts of your medicine, or you may need to take/use different medicines. Your doctor or pharmacist will advise you.
Your doctor and pharmacist may have more information on medicines to be careful with or avoid while receiving tobramycin.
How DBL Tobramycin Injection BP is given
How much is given
Your doctor will decide what dose you will receive. This depends on your condition and other factors, such as your weight and kidney function.
How it is given
Tobramycin is given as an injection into a muscle or as a slow injection into a vein (intravenously).
Tobramycin should only be given by a doctor or nurse.
If you take too much (overdose)
As DBL Tobramycin Injection BP is usually given to you in hospital under the supervision of your doctor, it is very unlikely that you will receive an overdose. However, if you experience severe side effects tell your doctor or nurse immediately or if you are not already in hospital, go to the Accident & Emergency Department at your nearest hospital.
Symptoms of a tobramycin overdose may include the side effects listed below in the ‘Side Effects’ section but are usually of a more severe nature.
In case of overdose, immediately contact the Poisons Information Centre for advice. (In Australia, call 13 11 26; in New Zealand call 0800 764 766.)
While you are being given DBL Tobramycin Injection BP
Things you must do
Tell any other doctors, dentists, and pharmacists who are treating you that you are being given tobramycin.
If you are about to be started on any new medicine, tell your doctor, dentist or pharmacist that you are being given tobramycin.
If you plan to have surgery that needs a general anaesthetic, tell your doctor or dentist that you are being given tobramycin.
If you become pregnant while being treated with tobramycin, tell your doctor immediately.
Things to be careful of
Be careful driving or operating machinery until you know how tobramycin affects you. As with other aminoglycoside medicines, tobramycin may cause feelings of tiredness or drowsiness in some people. Make sure you know how you react to tobramycin before you drive a car, operate machinery, or do anything else that could be dangerous if you are tired or drowsy. If this occurs do not drive.
After using DBL Tobramycin Injection BP
DBL Tobramycin Injection BP will be stored in the pharmacy or on the ward. The injection is kept in a cool dry place, protected from light, where the temperature stays below 25°C.
Schedule of DBL Tobramycin Injection BP
DBL Tobramycin Injection BP is a Schedule 4 medicine.
Side effects of DBL Tobramycin Injection BP
Tell your doctor or nurse as soon as possible if you do not feel well while you are being treated with tobramycin. Tobramycin helps most people with certain infections, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
If you are over 65 years of age you may have an increased chance of getting side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor or nurse if you notice any of the following and they worry you:
These side effects are usually mild.
Tell your doctor or nurse immediately if you notice any of the following:
- Signs of an allergic reaction, such as rash, itching or hives on the skin; swelling of the face, lips, tongue or other parts of the body; shortness of breath, wheezing or difficulty breathing;
- Hearing problems;
- Ringing in the ears;
- Muscle weakness;
- Decreased urination.
These are very serious side effects. You may need urgent medical attention. Serious side effects are rare.
Other side effects not listed above may occur in some patients. Tell your doctor or pharmacist if you notice anything that is making you feel unwell.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
For further information talk to your doctor.