Indication

Bacterial eye infections, Ocular inflammation, Pink eye

Adult dose

Ophthalmic Ocular inflammation with suspected or confirmed bacterial infection Adult: As Eye Drops: 1-2 drops instilled into the conjunctival sac(s) 4-6 hrly. Dosage may be increased to every 2 hrly during the initial 24-48 hr, decrease frequency gradually as improvement seen. As Ointment: Apply about ½ inch of ointment into the conjunctival sac(s) up to 3-4 times daily.

Child dose

Ophthalmic Ocular inflammation with suspected or confirmed bacterial infection <2 years Safety and efficacy not established >2 years As Eye Drops: 1-2 drops instilled into the conjunctival sac(s) 4-6 hrly. Dosage may be increased to every 2 hrly during the initial 24-48 hr, decrease frequency gradually as improvement seen. As Ointment: Apply about ½ inch of ointment into the conjunctival sac(s) up to 3-4 times daily.

Contraindication

Viral infections of corneal and conjunctiva (e.g. epithelial herpes simplex keratitis, vaccinia, varicella). Mycobacterial or fungal infection of the eye.

Mode of action

Tobramycin, an aminoglycoside antibiotic, has actions similar to that of gentamicin and is active against Staphylococci, Streptococci, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Proteus mirabilis, Morganella morganii, most Proteus vulgaris strains, Haemophilus influenzae and H. aegyptius, Moraxella lacunata, Acinetobacter calcoaceticus and some Neisseria species. Dexamethasone, a synthetic fluorinated corticosteroid, has mainly glucocorticoid activity and suppresses inflammatory response.

Precaution

Pregnancy and lactation. Avoid prolonged use, monitor intraocular pressure routinely. Safety and effectiveness in children <2 yr not established. Lactation: Excretion in milk unknown; use with caution

Side effect

Hypersensitivity reactions, lid itching and swelling, conjunctival erythema, increase in intraocular pressure, glaucoma, optic nerve damage, posterior subcapsular cataract formation and delayed wound healing. Secondary infections especially after prolonged use.

Pregnancy category

Note : C Lactation: Excretion in milk unknown; use with caution

Interaction

Antagonistic effect w/ neostigmine and pyridostigmine. May potentiate the effect of warfarin and phenindione.