Tobramycin/dexamethasone: Difference between revisions

Tobramycin/dexamethasone
Combination of
Tobramycin	Aminoglycoside antibiotic
Dexamethasone	Glucocorticoid
Clinical data
Trade names	Tobradex
AHFS/Drugs.com	Professional Drug Facts
Routes of; administration	Eye drops, topical
ATC code	S01CA01 (WHO) ;
Legal status
Legal status	US: ℞-only;
Identifiers
CAS Number	32986-56-4 ; 50-02-2 ;
DrugBank	DB00684 ;
ChemSpider	10123949 ;
UNII	VZ8RRZ51VK; 7S5I7G3JQL ;
KEGG	D11178 ;
ChEBI	CHEBI:28864 ;
ChEMBL	ChEMBL1747 ;
CompTox Dashboard (EPA)	DTXSID50183039 ;
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Tobramycin/dexamethasone, sold under the brand name Tobradex, is a fixed-dose combination medication in the form of eye drops and eye ointment, marketed by Alcon.^[1]^[2]^[3] The active ingredients are tobramycin (an antibiotic) and dexamethasone (a corticosteroid).^[2] It is prescribed for the treatment of pink eye in combination with bacterial infections.^[2]

Contraindications

It is contraindicated with herpetic and other viral eye infections. Other contraindications include fungal and mycobacterial infections because tobramycin is inactive against those, and the corticoid acts as an immunosuppressive agent, preventing the body's immune system from dealing with the infection. The drops are also contraindicated in patients with corneal lesions.^[5]^[1]^[2]^[3]

Side effects

Similarly to other corticosteroid eye drops, side effects include hypersensitivity and, especially after long-term use, secondary eye infections, cataract (clouding of the eye lens) and increased intraocular pressure, leading to glaucoma. Consequently, the drug should not be applied longer than 24 days^[5]^[6]^[7] without further medical evaluation.^[2]^[3]

Interactions

Anticholinergic eye drops potentiate the risk of increased intraocular pressure. Systemic aminoglycoside antibiotics increase toxicity for ears, nerves and kidney.^[5]

Brand names

Tobrason is a brand name in Jordan.^[8]^{[failed verification]}

References

^ ^a ^b ^c "Tobradex- tobramycin and dexamethasone ointment". DailyMed. 24 April 2020. Retrieved 24 September 2020.
^ ^a ^b ^c ^d ^e ^f "Tobradex- tobramycin and dexamethasone suspension/ drops". DailyMed. 24 April 2020. Retrieved 24 September 2020.
^ ^a ^b ^c ^d "Tobradex ST- tobramycin / dexamethasone suspension/ drops". DailyMed. 9 September 2019. Retrieved 24 September 2020.
^ "Dexamethasone / tobramycin ophthalmic Use During Pregnancy". Drugs.com. 28 November 2018. Retrieved 13 September 2020.
^ ^a ^b ^c Haberfeld H, ed. (2009). Austria-Codex (in German) (2009/2010 ed.). Vienna: Österreichischer Apothekerverlag. Tobradex-Augentropfen. ISBN 978-3-85200-196-8.
^ Faschinger C (3 January 2011). "TobraDex". Österreichische Apothekerzeitung (in German) (1/2011): 13.
^ Dinnendahl V, Fricke U, eds. (2010). Arzneistoff-Profile (in German). Vol. 2 (23 ed.). Eschborn, Germany: Govi Pharmazeutischer Verlag. ISBN 978-3-7741-9846-3.
^ "Jordanian Food and Drug Administration".

External links

"Dexamethasone mixture with tobramycin". Drug Information Portal. U.S. National Library of Medicine.

[Tobradex_ointment_FDA_label-1] "Tobradex- tobramycin and dexamethasone ointment". DailyMed. 24 April 2020. Retrieved 24 September 2020.

[Tobradex_drops_FDA_label-2] ^ ^a ^b ^c ^d ^e ^f "Tobradex- tobramycin and dexamethasone suspension/ drops". DailyMed. 24 April 2020. Retrieved 24 September 2020.

[Tobradex_ST_FDA_label-3] "Tobradex ST- tobramycin / dexamethasone suspension/ drops". DailyMed. 9 September 2019. Retrieved 24 September 2020.

[Drugs.com_pregnancy-4] "Dexamethasone / tobramycin ophthalmic Use During Pregnancy". Drugs.com. 28 November 2018. Retrieved 13 September 2020.

[AustriaCodex-5] Haberfeld H, ed. (2009). Austria-Codex (in German) (2009/2010 ed.). Vienna: Österreichischer Apothekerverlag. Tobradex-Augentropfen. ISBN 978-3-85200-196-8.

[ÖAZ-6] Faschinger C (3 January 2011). "TobraDex". Österreichische Apothekerzeitung (in German) (1/2011): 13.

[Arzneistoff-Profile-7] Dinnendahl V, Fricke U, eds. (2010). Arzneistoff-Profile (in German). Vol. 2 (23 ed.). Eschborn, Germany: Govi Pharmazeutischer Verlag. ISBN 978-3-7741-9846-3.

[8] "Jordanian Food and Drug Administration".

[1]

[2]

[3]

[5]

[6]

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[8]

@@ Line 1: / Line 1: @@
+{{Short description|Pharmaceutical preparation}}
 {{Drugbox
+| Verifiedfields = changed
-| verifiedrevid = 410208798
+| verifiedrevid = 477865033
-| type              = combo
+| type = combo
-| component1        = Tobramycin
-| class1            = [[Aminoglycoside antibiotic]]
+<!--Combo data-->
-| component2        = Dexamethasone
+| component1 = Tobramycin
-| class2            = [[Glucocorticoid]]
+| class1 = [[Aminoglycoside antibiotic]]
-| CAS_number        =
+| component2 = Dexamethasone
-| ATCvet            =
+| class2 = [[Glucocorticoid]]
-| ATC_prefix        = S01
-| ATC_suffix        = CA01
+<!--Clinical data-->
-| PubChem           =
+| tradename = Tobradex
-| DrugBank          =
+| Drugs.com = {{drugs.com|ppa|tobramycin-and-dexamethasone}}
-| pregnancy_AU      =  <!-- A / B1 / B2 / B3 / C / D / X -->
-| pregnancy_US      =  C
+| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
+| pregnancy_US = C
-| pregnancy_category=
+| pregnancy_US_comment = <ref name="Drugs.com pregnancy">{{cite web | title=Dexamethasone / tobramycin ophthalmic Use During Pregnancy | website=Drugs.com | date=28 November 2018 | url=https://www.drugs.com/pregnancy/dexamethasone-tobramycin-ophthalmic.html | access-date=13 September 2020}}</ref>
-| legal_AU =  <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->
+| pregnancy_category =
-| legal_CA =  <!-- Schedule I, II, III, IV, V, VI, VII, VIII -->
+| routes_of_administration = [[Ophthalmic administration|Eye drops]], [[Topical medication|topical]]
-| legal_UK =  <!-- GSL, P, POM, CD, or Class A, B, C -->
-| legal_US =  Rx-only
+| ATCvet =
+| ATC_prefix = S01
-| legal_status      =
+| ATC_suffix = CA01
-| routes_of_administration = [[Eye drops|Ophthalmic]]
+| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->
+| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII -->
+| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C -->
+| legal_US = Rx-only
+| legal_US_comment = <ref name="Tobradex ointment FDA label" /><ref name="Tobradex drops FDA label" /><ref name="Tobradex ST FDA label" />
+| legal_status =
+<!--Identifiers-->
+| CAS_number_Ref = {{cascite|correct|CAS}}
+| CAS_number = 32986-56-4
+| CAS_number2_Ref = {{cascite|correct|CAS}}
+| CAS_number2 = 50-02-2
+| PubChem =
+| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
+| DrugBank = DB00684
+| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}}
+| ChemSpiderID = 10123949
+| UNII_Ref = {{fdacite|correct|FDA}}
+| UNII = VZ8RRZ51VK
+| UNII2_Ref = {{fdacite|correct|FDA}}
+| UNII2 = 7S5I7G3JQL
+| KEGG_Ref = {{keggcite|changed|kegg}}
+| KEGG = D11178
+| ChEBI_Ref = {{ebicite|correct|EBI}}
+| ChEBI = 28864
+| ChEMBL_Ref = {{ebicite|correct|EBI}}
+| ChEMBL = 1747
 }}
-'''Tobramycin/dexamethasone''' ([[International Nonproprietary Name|INNs]], trade name '''Tobradex''') is a prescription medication in the form of [[eye drops]] and eye ointment, marketed by [[Alcon]]. The active ingredients are [[tobramycin]] 0.3% (an [[antibiotic]]) and [[dexamethasone]] 0.1% (a [[corticosteroid]]). It is prescribed for a wide spectrum of [[bacterial infection|bacterial]] [[human eye|eye]] infections. Tobradex can also be used to clear or contract [[stye]]s that are also found in the eye. It is prescribed for the treatment of pink eye in combination with bacterial infections. Because it contains a steroid, careful use with gradual reduction of doses is required.
+'''Tobramycin/dexamethasone''', sold under the brand name '''Tobradex''', is a fixed-dose [[combination medication]] in the form of [[eye drops]] and eye [[ointment]], marketed by [[Alcon]].<ref name="Tobradex ointment FDA label" /><ref name="Tobradex drops FDA label" /><ref name="Tobradex ST FDA label" /> The active ingredients are [[tobramycin]] (an [[antibiotic]]) and [[dexamethasone]] (a [[corticosteroid]]).<ref name="Tobradex drops FDA label" /> It is prescribed for the treatment of [[conjunctivitis|pink eye]] in combination with bacterial infections.<ref name="Tobradex drops FDA label" />
-==Contraindications==
-It is strongly contraindicated with [[Herpetic infection|herpetic]] and other [[viral infection|viral]] eye infections. Other contraindications include [[fungal infection|fungal]] and [[mycobacterial]] infections because tobramycin is inactive agains those, and the corticoid acts as a [[immunosuppressive]] agent, preventing the body's immune system from dealing with the infection. The drops are also contraindicated in patients with [[cornea]]l lesions.<ref name="AustriaCodex">{{cite book|title=Austria-Codex|editor=Haberfeld, H|publisher=Österreichischer Apothekerverlag|location=Vienna|year=2009|edition=2009/2010|isbn=3-85200-196-X|language=German}}</ref><ref>[http://ecatalog.alcon.com/pi/TobraDexSusp_us_en.pdf Tobradex Prescribing Information]. Alcon.</ref>
+== Contraindications ==
-==Side effects==
+It is contraindicated with [[Herpetic infection|herpetic]] and other [[viral infection|viral]] eye infections. Other contraindications include [[Mycosis|fungal]] and [[mycobacteria]]l infections because tobramycin is inactive against those, and the corticoid acts as an [[immunosuppressive]] agent, preventing the body's immune system from dealing with the infection. The drops are also contraindicated in patients with [[cornea]]l lesions.<ref name="AustriaCodex">{{cite book|title=Austria-Codex|at=Tobradex-Augentropfen| veditors = Haberfeld H |publisher=Österreichischer Apothekerverlag|location=Vienna|year=2009|edition=2009/2010|isbn=978-3-85200-196-8|language=German}}</ref><ref name="Tobradex ointment FDA label">{{cite web | title=Tobradex- tobramycin and dexamethasone ointment | website=DailyMed | date=24 April 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5538d748-215c-4e3e-b940-ac9baf07d8a1 | access-date=24 September 2020}}</ref><ref name="Tobradex drops FDA label">{{cite web | title=Tobradex- tobramycin and dexamethasone suspension/ drops | website=DailyMed | date=24 April 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=22b59456-d26a-4f23-b052-3d73e00181eb | access-date=24 September 2020}}</ref><ref name="Tobradex ST FDA label">{{cite web | title=Tobradex ST- tobramycin / dexamethasone suspension/ drops | website=DailyMed | date=9 September 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d1d48422-8cfc-4e9e-a7f8-56c274d8eb83 | access-date=24 September 2020}}</ref>
-Similarly to other corticosteroid eye drops, [[side effects]] include [[hypersensitivity]] and, especially after long-term use, secondary eye infections, [[cataract]] (clouding of the eye lens) and increased [[intraocular pressure]], leading to [[glaucoma]]. Consequently, the drug should not be applied longer than 24 days.<ref name="AustriaCodex"/><ref name="ÖAZ">{{cite journal
- | author = Ch. Faschinger
+== Side effects ==
- | date = 3 January 2011
+Similarly to other corticosteroid eye drops, [[side effect]]s include [[hypersensitivity]] and, especially after long-term use, secondary eye infections, [[cataract]] (clouding of the eye lens) and increased [[intraocular pressure]], leading to [[glaucoma]]. Consequently, the drug should not be applied longer than 24 days<ref name="AustriaCodex"/><ref name="ÖAZ">{{cite journal | vauthors = Faschinger C | date = 3 January 2011 | journal = Österreichische Apothekerzeitung | title = TobraDex | issue = 1/2011 | pages = 13 | language = German }}</ref><ref name="Arzneistoff-Profile">{{cite book|title=Arzneistoff-Profile| veditors = Dinnendahl V, Fricke U |publisher=Govi Pharmazeutischer Verlag|location=Eschborn, Germany|year=2010|edition=23|volume=2|isbn=978-3-7741-9846-3|language=German}}
- | journal = Österreichische Apothekerzeitung
+</ref> without further medical evaluation.<ref name="Tobradex drops FDA label" /><ref name="Tobradex ST FDA label" />
- | issue = 1/2011
- | pages = 13
- | language = German
- }}</ref><ref name="Arzneistoff-Profile">{{cite book|title=Arzneistoff-Profile|editor=Dinnendahl, V, Fricke, U|publisher=Govi Pharmazeutischer Verlag|location=Eschborn, Germany|date=2010|edition=23|volume=2|isbn=978-3-7741-98-46-3|language=German}}</ref>
 ==Interactions==
 [[Anticholinergic]] eye drops potentiate the risk of increased intraocular pressure. Systemic [[aminoglycoside antibiotic]]s increase toxicity for ears, nerves and kidney.<ref name="AustriaCodex" />
+== Brand names ==
+Tobrason is a brand name in Jordan.<ref>{{cite web | title = Jordanian Food and Drug Administration | url = http://www.jfda.jo/}}</ref>{{failed verification|date=September 2020}}
 ==References==
 {{reflist}}
+== External links ==
+* {{cite web | url = https://druginfo.nlm.nih.gov/drugportal/name/dexamethasone%20mixture%20with%20tobramycin | publisher = U.S. National Library of Medicine | work = Drug Information Portal | title = Dexamethasone mixture with tobramycin }}
 {{AminoglycosideAntiBiotics}}
 {{Corticosteroids}}
+{{Portal bar | Medicine}}
+{{DEFAULTSORT:Tobramycin Dexamethasone}}
 [[Category:Antibiotics]]
 [[Category:Glucocorticoids]]
 [[Category:Combination drugs]]
+[[Category:Drugs developed by Novartis]]

v t e Mineralocorticoids and antimineralocorticoids (H02)
Mineralocorticoids	11-Deoxycorticosterone (desoxycortone) 11-Deoxycortisol (cortodoxone) Aldosterone Corticosterone Cortisol (hydrocortisone) Desoxycortone acetate Desoxycortone enanthate Fludrocortisone Fludrocortisone acetate
Antimineralocorticoids	Amlodipine Benidipine Canrenoate potassium (potassium canrenoate) Canrenoic acid Canrenone Drospirenone Eplerenone Felodipine Finerenone Gestodene Nifedipine Nimodipine Nitrendipine Progesterone Spironolactone
Synthesis modifiers	Acetoxolone Aminoglutethimide Carbenoxolone Enoxolone Ketoconazole Metyrapone Mitotane Osilodrostat Trilostane
^#WHO-EM ^‡Withdrawn from market Clinical trials: ^†Phase III ^§Never to phase III