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Tobramycin (By breathing)

Tobramycin (toe-bra-MYE-sin)

Treats lung infections in patients who have cystic fibrosis. This medicine is an aminoglycoside antibiotic.

Brand Name(s):

Bethkis, Tobi, Tobi Podhaler

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to tobramycin or similar medicines, such as amikacin, gentamicin, streptomycin, or Garamycin®. Do not use this medicine if you are pregnant.

How to Use This Medicine:

Capsule, Spray

  • Take your medicine as directed.
  • Your doctor may give you other medicine to use before your tobramycin dose. Carefully follow your doctor's instructions about how to use your medicines, because this medicine works best if used in the right order. Tobramycin is usually used last.
  • This medicine is usually used for 28 days in a row, and then you stop using it for 28 days. This 28-cycle may be repeated.
  • Use 1 dose of medicine every 12 hours. Never use 2 doses within 6 hours.
  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions. You should receive an information sheet that will tell you how to take care of the equipment that you use with the medicine.
  • Inhalation solution (liquid)
    • The medicine is a clear, colorless or pale yellow liquid that comes in a plastic vial (an ampule). Do not use the medicine if the liquid is cloudy or if you see particles in it. The color of the medicine might get darker if you store it at room temperature; you can still use the medicine if this happens.
    • You will use this medicine with an inhaler device called a nebulizer. The nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. Your caregiver will show you how to use your nebulizer. Use only the nebulizer that your doctor prescribes. Each brand of medicine must be used in a specific brand of nebulizer.
    • Do not mix other medicine with tobramycin unless your doctor tells you to.
    • Use the mouthpiece of the nebulizer to breathe in the medicine.
    • You will need to use the nebulizer for about 10 to 15 minutes, or until the medicine in the nebulizer cup is gone. You may hear a sputtering sound when the cup is empty.
    • Clean all the parts of the nebulizer after each use.
  • Inhalation capsule
    • Do not swallow the inhalation capsules.
    • This medicine must be used with the Podhaler? device.
    • Always use a new Podhaler? device every 7 days.
    • Do not take a capsule out of blister pack until you are ready to use it.
    • To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece in your mouth with the device upright.
    • Breathe in slowly and deeply.
    • Hold your breath for about 5 seconds, then breathe out slowly.
    • Repeat this cycle again (breathe out, put the mouthpiece in your mouth, breath in, hold your breath, and breath out).
    • Check to see if the capsule is empty. If some powder remains in the capsule, repeat inhalation until the capsule is empty.
    • Wipe the mouthpiece with a clean, dry cloth. Make sure that the Podhaler? stays dry at all times.
  • Take all of the medicine in your prescription to clear up your infection, even if you feel better after the first few doses.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. Do not use 2 doses less than 6 hour apart.

How to Store and Dispose of This Medicine:

  • Inhalation solution: Store in the refrigerator. Do not use the medicine after the expiration date. If you cannot keep the medicine in the refrigerator, store it in the foil pouch at room temperature, away from heat or direct light. Do not use medicine that has been stored at room temperature for more than 28 days.
  • Inhalation capsules: Store at room temperature, away from heat and direct light. Keep the capsules and the Podhaler? device in a dry place. Do not store the capsules inside the Podhaler?.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine. You will also need to throw away old medicine after the expiration date has passed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you use another aminoglycoside antibiotic (such as amikacin, gentamicin, kanamycin, neomycin, netilmicin, streptomycin, Garamycin®) or a diuretic (water pills, such as ethacrynic acid, furosemide, mannitol, urea, Edecrin®, Lasix®).

Warnings While Using This Medicine:

  • It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
  • Make sure your doctor knows if you are breastfeeding or if you have kidney problems, other breathing problems, or muscle problems (such as myasthenia gravis or Parkinson disease). Tell your doctor if you have had an organ transplant.
  • This medicine may cause hearing problems. Make sure your doctor knows if you already have problems with your ears, including hearing loss or balance problems. Call your doctor you have ringing in your ears, changes to your hearing, or if you feel dizzy or clumsy.
  • Call your doctor right away if you have a cough, trouble breathing, and tightness in your chest right after you use this medicine.
  • Never swallow the capsules or liquid medicine. This medicine only works if you breathe it into our lungs.
  • Talk to your doctor right away if any of your medicines do not seem to be working as well as usual. Do not change your doses or stop using your medicines without asking your doctor.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Change in how much or how often you urinate, bloody urine, swelling in your feet or lower legs
  • Dizziness, hearing loss, ringing in your ears
  • Feeling of constant movement, problems with balance
  • Noisy breathing, trouble breathing, chest tightness
  • Shakiness, trembling, or problems with muscle control or coordination
  • Unusual muscle weakness

If you notice these less serious side effects, talk with your doctor:

  • Change or loss of taste
  • Cough, sore throat
  • Fever
  • Headache
  • Hoarseness or voice changes

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 9/4/2014


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