Amanda Turkiewicz

Inhaled tobramycin

Why is this medication prescribed?
Tobramycin belongs to a class of antibiotics called aminoglycosides. Tobramycin is used to treat or prevent bacterial infections.

How does this medication work?
It can be 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?
The inhaled form of tobramycin is available as an 80mg/2mL solution in a vial that can be stored at room temperature. The usual dose for adults is 80mg to 160mg twice a day via nebulizer.

How should this medication be taken?
Take your tobramycin 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 tobramycin, please also refer to Preparing Your Treatment and Taking Your Treatment.

To mix your inhaled dose of tobramycin:

1. Remove the lid from the vial(s).

2. Carefully pour all the medication (2mL or 4mL) from the vial into the nebulizer.

3. Using a syringe, withdraw 0.5 – 1mL (2.5mg – 5mg) of undiluted Ventolin® and add it to the nebulizer with the tobramycin.

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

Note: you can mix your inhaled tobramycin with ventolin or atrovent but do NOT mix it with other inhaled medications (e.g. Pulmozyme®).

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 or wheezing, but tell us if you have any other side effects as well.

Although these side effects are very rare, contact your doctor if you experience ringing of the ears or hearing loss.

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.