In the U.S.—

• Corticosteroid, ophthalmic
• anti-inflammatory, steroidal, ophthalmic
• antibacterial, ophthalmic

Tobramycin (toe-bra-MYE-sin) and dexamethasone (dex-a-METH-a-sone) is a combination of an antibiotic and a corticosteroid ( kor-ti-ko-STER-oid) . It is used in the eye to prevent permanent damage, which may occur with certain eye problems.

This medicine is available only with your doctor's prescription, in the following dosage forms:

Ophthalmic
• Ointment (U.S.)
• Suspension (eye drops) (U.S.)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to tobramycin or related medicines (amikacin, gentamicin, kanamycin, neomycin, netilmicin, streptomycin) or to dexamethasone. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies with ophthalmic tobramycin and dexamethasone have not been done in humans. However, in animals, the dexamethasone part of the medicine caused birth defects when it was applied to the eyes.

Breast-feeding—It is not known how much ophthalmic tobramycin and dexamethasone is absorbed into the body, or how much passes into breast milk. Discuss with your doctor whether or not you should breast-feed during treatment with this medicine.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of ophthalmic tobramycin and dexamethasone in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of ophthalmic tobramycin and dexamethasone in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Glaucoma—The dexamethasone in the eyedrops may cause glaucoma or make it worse if the eyedrops are used for a long time

• Herpes infection of the eye or
• Any other eye infection, including bacterial and fungal—The dexamethasone in the eyedrops may make existing infections worse or cause new infections

For patients using the ophthalmic suspension (eye drops) form of this medicine:

• Always shake the container very well just before applying the eye drops.
• To use:
  • First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
  • If you think you did not get the drop of medicine into your eye properly, use another drop.
  • To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Always keep the container tightly closed.

For patients using the ophthalmic ointment form of this medicine:

• To use:
  • First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Squeeze a thin strip of ointment into this space. A 1/2-inch strip of ointment is usually enough. Let go of the eyelid and gently close the eyes. Keep the eyes closed for 1 or 2 minutes to allow the medicine to come into contact with the irritation.
  • To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). After using the eye ointment, wipe the tip of the ointment tube with a clean tissue. Do not wash the tip with water. Always keep the tube tightly closed.

Dosing—

The dose of ophthalmic tobramycin and dexamethasone will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

• For ophthalmic ointment dosage form:
  • For eye disorders:
    • Adults—Use about a 1/2-inch strip of ointment in the eye up to three or four times a day.
    • Children—Use and dose must be determined by your doctor.
• For ophthalmic suspension (eye drops) dosage form:
  • For eye disorders:
    • Adults—Use 1 or 2 drops in the eye every four to six hours. Your doctor may have you use the drops more frequently during the first day or two and will probably have you space the doses farther apart as the eye gets better.
    • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

If you will be using this medicine for more than a few weeks, an ophthalmologist (eye doctor) should examine your eyes at regular visits to make sure it does not cause unwanted effects.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• Less common
  • Itching and swelling of eyelid;  redness of eye 
  
  

• Rare
  • Delayed wound healing;  eye pain;  gradual blurring or loss of vision 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.