Tobramycin and dexamethasone

The most frequently reported side effects of Tobradex are: 

• itching,
• swelling of the eye lids, and
• redness of the conjunctivae.

Other side effects include:

• Increased intraocular pressure,
• delayed wound healing,
• optic nerve damage, and
• formation of cataract.

Do not touch the dropper or tube opening to any surface, including your eyes or hands. The dropper or tube opening is sterile. If it becomes contaminated, it could cause an infection in the eye.

Use caution when driving, operating machinery, or performing other hazardous activities. Tobramycin and dexamethasone ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities.

If you wear contact lenses, ask your doctor if you should wear them during treatment with tobramycin and dexamethasone ophthalmic. After applying the medication, wait at least 15 minutes before inserting contact lenses, unless otherwise directed by your doctor.

Do not use other eye drops or medications during treatment with tobramycin and dexamethasone ophthalmic unless otherwise directed by your doctor.

Adverse reactions have occurred with steroid/anti-infective combination drugs which can be attributed to the steroid component, the anti-infective component, or the combination. Exact incidence figures are not available. The most frequent adverse reactions to topical ocular tobramycin [TOBREX® (tobramycin ophthalmic solution)] are hypersensitivity and localized ocular toxicity, including lid itching and swelling, and conjunctival erythema. These reactions occur in less than 4% of patients. Similar reactions may occur with the topical use of other aminoglycoside antibiotics. Other adverse reactions have not been reported; however, if topical ocular tobramycin is administered concomitantly with systemic aminoglycoside antibiotics, care should be taken to monitor the total serum concentration. The reactions due to the steroid component are: elevation of intraocular pressure (IOP) with possible development of glaucoma, and infrequent optic nerve damage; posterior subcapsular cataract formation; and delayed wound healing.

Secondary Infection

The development of secondary infection has occurred after use of combinations containing steroids and antimicrobials. Fungal infections of the cornea are particularly prone to develop coincidentally with long-term applications of steroids. The possibility of fungal invasion must be considered in any persistent corneal ulceration where steroid treatment has been used. Secondary bacterial ocular infection following suppression of host responses also occurs.

Read the entire FDA prescribing information for Tobradex (Tobramycin and Dexamethasone)

Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, and many other viral diseases of the cornea and conjunctiva. Mycobacterial infection of the eye. Fungal diseases of ocular structures. Hypersensitivity to a component of the medication.

• Dexamethasone and Tobramycin
• Tobramycin/Dexamethasone

• Antibiotic/Corticosteroid, Ophthalmic

Ocular inflammatory conditions: Treatment of steroid-responsive ocular inflammatory conditions (where either a superficial bacterial ocular infection or the risk of a bacterial ocular infection exists) of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe; chronic anterior uveitis; corneal injury from chemical, radiation or thermal burns; penetration of foreign bodies.

Ocular inflammatory conditions: Children ≥2 years and Adolescents: Refer to adult dosing.

Ceritinib: Corticosteroids may enhance the hyperglycemic effect of Ceritinib. Monitor therapy

CYP3A4 Inhibitors (Strong): May increase the serum concentration of Dexamethasone (Ophthalmic). Monitor therapy

NSAID (Ophthalmic): May enhance the adverse/toxic effect of Corticosteroids (Ophthalmic). Healing of ophthalmic tissue during concomitant administration of ophthalmic products may be delayed. Monitor therapy

Frequency not always defined.

Dermatologic: Allergic contact dermatitis

Infection: Secondary infection

Ophthalmic: Conjunctival erythema (<4%), eyelid pruritus (<4%), swelling of eye (<4%), cataract, glaucoma, increased intraocular pressure, keratitis, lacrimation, optic nerve damage

Miscellaneous: Wound healing impairment