Check out our most popular compounded medications! Get Started
Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Tobramycin is an aminoglycoside antibiotic that compounding pharmacies prepare as fortified sterile eye drops, otic and nasal preparations and inhalation solutions by prescription.
Tobramycin is a water-soluble aminoglycoside antibiotic. It blocks bacterial protein synthesis and kills bacteria rather than just slowing them; it is strongest against gram-negative organisms such as Pseudomonas aeruginosa, Enterobacter, Serratia and Proteus, with some activity against Staphylococcus aureus and weak activity against most other gram-positive bacteria. Manufactured products include tobramycin injection (Hospira and others), FDA-approved for serious infections caused by susceptible bacteria including septicemia and lower respiratory, central nervous system, intra-abdominal, skin, bone and complicated urinary tract infections; Tobrex ophthalmic ointment (Novartis) and generic tobramycin 0.3% ophthalmic solution, approved for external infections of the eye and its adnexa; and TOBI inhalation products for cystic fibrosis. No manufactured eye drop exists above the standard ophthalmic strength, so a prescriber might order compounded fortified tobramycin drops for a severe corneal infection, a preservative-free or otic vehicle, or a combination with another antibiotic. Compounded preparations are not FDA-approved and require a prescription.
Tobramycin injection carries the FDA boxed warning for the aminoglycoside class: it can damage the kidneys, cause hearing loss and balance problems that are usually permanent and may begin after the drug is stopped, and cause nerve effects such as numbness, tingling, twitching and seizures. Blood levels, kidney function and hearing must be monitored, and it should not be given with potent diuretics such as furosemide or with other kidney- or nerve-toxic drugs such as vancomycin, cisplatin, polymyxin B or another aminoglycoside. Aminoglycosides cross the placenta and can harm the fetus. People with the m.1555A>G mitochondrial variant can lose hearing even at normal blood levels. Do not use it if you are allergic to any aminoglycoside. Do not wear contact lenses during an eye infection. Drugs.com's breastfeeding monograph, citing primary studies, reports that tobramycin passes poorly into milk and that eye, ear and inhaled use poses little or no risk to a nursing infant. Call your prescriber for hearing changes, ringing in the ears, dizziness or reduced urine. If side effects bother you, talk to your prescriber or pharmacist.
Tobramycin is a bactericidal aminoglycoside that inhibits bacterial protein synthesis; cross-resistance within the class occurs. It is negligibly protein bound, poorly absorbed from the GI tract, and eliminated almost entirely by glomerular filtration with a half-life of about 2 hours that lengthens in renal impairment and neonates. Systemic absorption after inhalation is expected to be minimal. Labeled indications: tobramycin injection for serious gram-negative infections, with cultures and susceptibility guiding therapy; Tobrex for external ocular infections including in children; TOBI for management of cystic fibrosis in patients six and older with Pseudomonas aeruginosa. Prescribers have ordered compounded fortified tobramycin drops, usually paired with a fortified cephalosporin, for bacterial keratitis; a 2014 evidence-based review of 16 randomized trials found no difference in treatment success or perforation risk between fortified aminoglycoside-cephalosporin regimens and fluoroquinolone monotherapy, but roughly three times more ocular discomfort with fortified tobramycin-cefazolin (McDonald et al., British Journal of Ophthalmology 2014). Dosing, strength and interval are per prescriber. For systemic exposure, monitor peak and trough serum levels, creatinine clearance and audiometry; for fortified drops, monitor corneal epithelial toxicity and clinical response. Not a controlled substance.
Wash your hands. Open one capsule and empty the powder into the volume of saline or water on your label, using only distilled, sterile, or boiled and cooled water if you are mixing it yourself. Stir or shake until dissolved. For a sinus rinse, lean over a sink and rinse each nostril with the device. For a nebulizer, pour the solution into the medicine cup and breathe normally through the mouthpiece or mask until the mist stops. Wash and air dry the rinse device or nebulizer cup after each use. Discard any mixed solution you do not use.
Keep the unopened capsules tightly closed in a dry place at room temperature and out of reach of children. The beyond-use date on your label depends on how the capsules were prepared and what they are for; the pharmacist sets it. Mix only one dose at a time and discard capsules after the beyond-use date on your label.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Empty contents of 1 capsule and mix with saline solution and irrigate/nebulize
