Amanda Turkiewicz

Inhaled TOBI®

TOBIWhy is this medication prescribed?
TOBI® is a special, preservative free formulation of tobramycin for inhalation. Compared to other forms of inhaled tobramycin, TOBI® is a more concentrated solution, which allows more antibiotic to reach the lungs. Depending on your drug coverage, you may qualify to use TOBI®.

How does this medication work?
TOBI® is given by inhalation to decrease the amount of bacteria (Pseudomonas aeruginosa) in the lungs. The main goal is to improve or maintain lung function.

What is the usual dose?
TOBI® is packaged with 4 ampoules per pouch. Each ampoule is 5mL. The usual dose for adults with CF is 300mg/5mL twice a day via nebulizer.

How should this medication be taken?
Your doctor may prescribe it for one month on, one month off, or continuously.  Take TOBI® at approximately the same time everyday so that it is easier to remember. Also take the doses as close to 12 hours apart as possible.

To prepare and take TOBI®, please also refer to Preparing Your Treatment and Taking Your Treatment.

To prepare your dose of TOBI®:

1. Gently separate one ampoule and store the remainder in the refrigerator.

2. Open the TOBI® ampoule by holding the bottom tab with one hand and twisting off the top of the ampoule with the other hand. Be careful not to squeeze the ampoule until you are ready to empty its contents into the nebulizer cup.

3. Squeeze all the contents of the ampoule into your nebulizer.

If you are taking other inhaled medication(s), please take them in this order.

Note: DO NOT dilute TOBI or mix it with any other medications. Make sure to store TOBI® in your REFRIGERATOR. DO NOT FREEZE. If absolutely necessary (i.e. during transportation), you can store TOBI® in the opened/unopened foil pouches at room temperature for up to 28 days away from heat, moisture and light. Do not store them in the bathroom. TOBI® may darken over time if it is left out of the refrigerator but this does not change its effectiveness. However, DO NOT use your TOBI® if it is cloudy, has particles in the solution, if it is expired, or if it has been stored outside of a refrigerator for more than 28 days.

After use, rinse your nebulizer well with warm water to prevent build up that can clog your nebulizer. For further instructions, see Cleaning and Disinfecting Your Equipment.

What should I do if I miss a dose?
Do not double any dose. If you forget to take a dose, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the next scheduled dose.

What should I expect from this medication?
You may or may not experience side effects. These side effects may disappear but let your doctor know if they are severe or if they persist for more than 2 days. These can include hoarseness, chest tightness and wheezing, but tell us if you have any other side effects as well.

Precautions
Remember to tell your doctor if you have ever had a previous reaction to tobramycin, any aminoglycoside antibiotic or any inhaled medication in the past.

As well, if you are pregnant or think you may be pregnant discuss this with your CF doctor. The intravenous form of tobramycin is NOT recommended but the INHALED form can be taken.

Patient Assistance Program

Novartis has an assistance program called the TOBI® Co-Pay Program. To learn more about this program, click here. Your social worker, pharmacist or doctor are also available if you have further questions.