Important Note

The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

TOBRAMYCIN INHALATION SOLUTION - ORAL

(toe-bruh-MY-sin)

COMMON BRAND NAME(S): Tobi

WARNING: This drug has caused kidney problems, nerve damage or permanent hearing loss, even at usual doses. Hearing loss can occur even after the drug is stopped. If you already have kidney problems or hearing difficulty, tell your doctor. Notify your doctor immediately if any of the following occur: ringing in your ears, hearing loss, unusual change in amount of urine, dizziness, numbness, skin tingling, muscle twitching or seizures. This drug may be stopped if you develop kidney or hearing problems. Your doctor will monitor your progress to minimize the possibility of these effects occurring and may run certain tests (e.g., hearing and/or kidney tests). Do not use this medication with other drugs that can cause nerve, kidney or hearing problems. Other factors that increase the risk of these side effects occurring include advanced age or dehydration (unusual thirst).

Uses

This drug is used for lung infections (e.g., Pseudomonas) occurring with certain lung conditions (e.g., cystic fibrosis).

How To Use

This drug is inhaled via a nebulizer, generally twice daily for 28 days, then 28 days off, then repeat the cycle. It is advised to inhale this product last if other inhalers are used at the same time of day. Follow all directions and learn proper use of this product (information is in the Patient Guide contained with the product), and the nebulizer (including cleaning). Consult your pharmacist. Do not mix this drug with dornase alfa in the nebulizer. Antibiotics work best when the amount of medicine in your body is kept at a constant level. Do this by taking the medication at evenly spaced 12 hour intervals throughout the day and night. Stopping the medication too early may allow bacteria to continue to grow resulting in a relapse of the infection. Continuing the drug beyond the prescribed period may result in increased side effects.

Side Effects

Hoarseness of voice might occur. If this effect persists or worsens, notify your doctor. Report promptly: wheezing, trouble breathing. Unlikely but report promptly: ringing in the ears, hearing trouble, dizziness or unsteadiness. Very unlikely but report promptly: a major change in urine amount, muscle weakness. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Before using this drug, tell your doctor your entire medical history, including: allergies, hearing or balance (ear) problems, kidney problems, muscle diseases (e.g., Parkinson's disease), asthma. This drug is not recommended for use during pregnancy. Consult your doctor before using this drug. It is not known whether this drug is excreted into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Drug Interactions

Tell your doctor of all nonprescription and prescription medication you may use, especially of: other antibiotics (e.g., other aminoglycosides; vancomycin, minocycline), dornase alfa, "platin"-type cancer drugs (e.g., cisplatin), urea, certain "water pills" (e.g., ethacrynic acid, furosemide), mannitol. Do not start or stop any medicine without doctor or pharmacist approval.

Overdose

If overdose is suspected, contact your local poison control center or emergency room immediately. This medicine may be harmful if swallowed.

Notes

This medication has been prescribed for your current condition only. Do not share this with others. Medical tests will be performed to monitor your treatment.

Missed Dose

If you miss a dose, use it as soon as you remember. If it is less than six hours before the next dose, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage

Store this product in the refrigerator between 36 and 46 degrees F (2-8 degrees C) away from light and moisture. However, if necessary (e.g., transporting this drug) you may store the foil pouches (opened or unopened) at room temperature up to 77 degrees F (25 degrees C) for up to 28 days. Do not freeze.