Amanda Turkiewicz

Inhaled TOBI® Podhaler

Why is this medication prescribed?
TOBI®
Podhaler is a dry powder formulation and device for inhaled tobramycin. Compared to other forms of inhaled tobramycin, TOBI® Podhaler does not require a nebulizer. Dry powder is filled  into capsules which are used with the Podhaler device. Depending on your drug coverage, you may qualify to use the TOBI® Podhaler.

How does this medication work?
TOBI® Podhaler 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® Podhaler is packaged into weekly boxes containing blsiter strips, an inhaler, and a storage case. Each weekly box contains 7 blister strips, and each blister strip contains eight capsules. Each capsule contains 28 mg of tobramycin.

The usual dose for adults with CF is 112 mg (4 capsules) twice a day via nebulizer.

Each blister strip contains the typical daily dose, and each box contains enough blister strips for a week.

How should this medication be taken?
Your doctor may prescribe it for one month on, one month off, or continuously.  Take TOBI® Podhaler 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 your dose of TOBI® Podhaler:

1. Wash and dry your hands before using the Podhaler.

2. Remove the Podhaler from its case by holding the base and twisting off the top of the case in a counter-clockwise direction.

3. Hold the body of the inhaler, unscrew and remove the mouthpiece from the inhaler body. Place the mouthpiece aside on a clean, dry surface.

4. Separate the morning and evening doses from the blister strip. Then peel back the foil from the blister strip to reveal one capsule, and remove it from the blister card.

5. Insert the capsule into the inhaler chamber. Replace the mouthpiece and screw it on firmly until it stops. Do not overtighten.

6. Hold the inhaler with the mouthpiece down, and press the blue button firmly with your thumb as far as it will go. Then release the button. This breaks the capsule open in the Podhaler. The powder is ready for inhalation now.

7. After inhalation, inspect the used capsule to make sure there is no powder left. If there is still some powder and the capsule looks punctured, place it back into the Podhaler chamber. Do not press the blue button again, and resume inhalation. However if the capsule appreas to be unpunctured, place it back into the Podhaler, repeat step 6, and resume inhalation. 

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

Note: Store TOBI® Podhaler at room temperature and protect from moisture.

 

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, shortness of breath, 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.  For more information and to see if you are eligible, click here. Your social worker, pharmacist or doctor are also available if you have further questions.