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Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified)

The Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified) is a potent antibiotic formulation designed for topical ocular use. This enhanced concentration solution is specifically compounded to provide effective treatment for severe and sight-threatening bacterial infections of the eye. It is indicated for the management of conditions such as bacterial keratitis, conjunctivitis, corneal ulcers, and endophthalmitis caused by susceptible strains of bacteria. The fortified formulation ensures a higher dose of the antibiotic is delivered directly to the site of infection, promoting rapid therapeutic action and aiding in the prevention of potential resistance.

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Ophthalmic Liquid
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Formula Information

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Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified) is a highly concentrated antibiotic solution specifically formulated for ocular use to treat severe and persistent bacterial infections of the eye. Tobramycin is an aminoglycoside antibiotic that works by inhibiting bacterial protein synthesis, leading to the death of susceptible bacteria. This fortified ophthalmic solution is typically used when standard antibiotic eye drops are not sufficient, particularly in cases of keratitis, conjunctivitis, corneal ulcers, and endophthalmitis caused by tobramycin-sensitive organisms.

The efficacy of Tobramycin 15 mg/ml Ophthalmic Liquid lies in its ability to achieve higher ocular tissue concentrations than standard preparations, which is crucial for treating sight-threatening infections. It is important for prescribers to note that this formulation should be used under close supervision due to the potential for ototoxicity and nephrotoxicity associated with aminoglycosides, although systemic absorption is generally minimal with ophthalmic administration. Patients should be instructed on proper administration techniques to maximize the drug's efficacy and minimize side effects. They should be advised to complete the full course of therapy as prescribed, even if symptoms improve, to prevent the development of antibiotic resistance.

For optimal results, the dosing regimen may vary depending on the severity of the infection, and it is often individualized to the patient's needs. The prescriber must monitor the patient's response to therapy and adjust the treatment plan accordingly. It is also essential to consider potential drug interactions, especially with other topical eye medications. Patients should be informed about the signs of adverse reactions, such as ocular irritation, redness, or hypersensitivity, and instructed to report any unusual symptoms promptly.

Bayview Pharmacy's team of compounding pharmacists ensures that each batch of Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified) is prepared with precision and in accordance with the highest standards of quality and safety. We are available to answer any questions and provide guidance to both patients and prescribers regarding the use of this specialized formulation. If you have any questions or require further information, please do not hesitate to reach out to us.

Drug Interactions

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Tobramycin is an aminoglycoside antibiotic used in the treatment of bacterial infections of the eye, such as conjunctivitis, keratitis, and blepharitis, caused by susceptible strains of bacteria. When considering the use of tobramycin 15 mg/ml ophthalmic liquid (fortified), it is important to be aware of potential drug interactions that may affect the efficacy of the treatment or the patient's overall health.

Systemic interactions with tobramycin are generally limited due to its topical administration; however, caution is advised if the patient is concurrently receiving other aminoglycoside antibiotics systemically, as this could potentially increase the risk of systemic toxicity, including nephrotoxicity and ototoxicity. Patients with pre-existing renal impairment or those on concurrent nephrotoxic drugs should be monitored closely for signs of worsening renal function.

Concomitant use of tobramycin with other topical eye medications should be approached with caution. If other topical ophthalmic drugs are being used, they should be administered at least 5-10 minutes apart to avoid dilution and ensure proper efficacy of each medication. Particular attention should be paid to the concurrent use of other potentially ototoxic or nephrotoxic drugs, even if they are used topically, as systemic absorption can occur, especially with prolonged use or in cases where the patient has a compromised corneal barrier.

Patients using anticoagulants or medications that affect platelet function should be aware that, although rare, hemorrhagic ocular reactions have been reported with the use of aminoglycosides. While the risk is low with topical administration, it is still something to be mindful of, especially in patients with a history of bleeding disorders.

It is also important to consider the potential for neuromuscular blockade when aminoglycosides are used in patients receiving neuromuscular blocking agents, such as succinylcholine or tubocurarine, or in patients with myasthenia gravis. While this interaction is more commonly associated with systemic administration, the possibility should not be completely disregarded with topical use.

Lastly, patients should be advised to avoid wearing contact lenses if they have signs of bacterial eye infections, as the use of contact lenses can exacerbate the condition and potentially lead to more serious complications. Additionally, the preservatives in some formulations of ophthalmic solutions can be absorbed by soft contact lenses, which may cause irritation.

It is essential for prescribers to review the patient's complete medication profile for potential interactions before prescribing tobramycin ophthalmic solution. Patients should be instructed to inform their healthcare provider of all medications they are currently taking, including over-the-counter drugs and herbal supplements. If you have any questions or concerns regarding the use of tobramycin 15 mg/ml ophthalmic liquid (fortified) or its potential interactions with other medications, please reach out to us at Bayview Pharmacy for further assistance.

How Does it Work

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Tobramycin is an aminoglycoside antibiotic that is commonly used in the treatment of bacterial infections of the eye, such as conjunctivitis, keratitis, and blepharitis. The 15 mg/ml ophthalmic liquid formulation of Tobramycin, often referred to as "fortified" Tobramycin, is a higher concentration than what is typically available in commercial eye drops. This fortified version is especially useful in treating severe and sight-threatening ocular infections caused by susceptible bacteria.

The mechanism by which Tobramycin works involves the inhibition of protein synthesis in bacteria. It binds to the 30S subunit of the bacterial ribosome, which in turn prevents the formation of an initiation complex with messenger RNA. This action effectively halts the translation process, leading to a cessation of bacterial growth and replication. By doing so, Tobramycin helps to reduce the bacterial load in the eye, alleviating symptoms of the infection and allowing the body's immune system to clear the remaining bacteria.

For patients, it is important to understand that while Tobramycin can be highly effective in treating bacterial eye infections, it is not suitable for infections caused by viruses, fungi, or other non-susceptible organisms. The use of this antibiotic should be based on the susceptibility of the bacteria involved, which is often determined by culture and sensitivity testing performed by a healthcare provider. Patients should follow the dosing instructions carefully and complete the full course of therapy to ensure the best outcome and to prevent the development of antibiotic resistance.

Prescribers should consider Tobramycin 15 mg/ml ophthalmic liquid for severe ocular infections where less concentrated formulations may not be sufficient. It is important to monitor the patient's response to therapy and to be aware of potential side effects, such as ocular irritation, redness, and hypersensitivity reactions. Due to its potency, fortified Tobramycin should be used judiciously and reserved for cases where its use is clearly indicated.

If you have any questions about the Tobramycin 15 mg/ml ophthalmic liquid formulation or its use in treating specific disease states, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide you with the information and support you need to ensure the safe and effective use of this medication.

Other Uses

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Tobramycin is an aminoglycoside antibiotic primarily used for treating bacterial infections of the eye, such as conjunctivitis and keratitis. Beyond these common indications, however, the fortified tobramycin 15 mg/ml ophthalmic liquid has been utilized off-label for the management of serious corneal infections like bacterial corneal ulcers and some cases of endophthalmitis where the infecting organism is susceptible to tobramycin. Due to its higher concentration, it can be effective against organisms that are resistant to the commercially available tobramycin ophthalmic solution. It may also be prescribed for microbial prophylaxis in patients with corneal abrasions or after ocular surgeries to prevent infection. In certain cases, it has been utilized as part of combination therapy with other antibiotics or antifungals, depending on the susceptibility pattern of the microbes involved in the infection.

Additionally, it is worth noting that while tobramycin ophthalmic preparations are specifically designed for ocular use, they have sometimes been used off-label for treating ear infections, particularly when there is a known sensitivity or resistance to other antibiotics. However, such use should be approached with caution and under the guidance of a physician, especially considering the ototoxic potential of aminoglycosides. In all off-label circumstances, clinicians should carefully consider the benefits and potential risks before prescribing this medication and closely monitor patient response and side effects.

As with all medications, it is crucial to follow the prescribing information and use tobramycin ophthalmic liquid as directed by a healthcare provider. If you are a patient or prescriber with questions about the use of tobramycin 15 mg/ml ophthalmic liquid or its potential applications beyond the treatment of common ocular infections, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is available to provide you with detailed information and support to ensure safe and effective use of this formulation.

Frequently Asked Questions

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What is Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified)?

Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified) is a higher concentration, antibiotic eye drop used for the treatment of bacterial infections that affect the outer parts of the eye. The 'fortified' designation means that it has a greater strength of medication than what is typically available commercially and is usually prepared by a compounding pharmacy.

What types of eye infections is Tobramycin 15 mg/ml used for?

It is primarily used for severe corneal infections, such as bacterial keratitis or conjunctivitis, and other severe ocular bacterial infections that require a stronger antibiotic solution to be effectively treated.

How often should I use Fortified Tobramycin eye drops?

The dosing of Fortified Tobramycin eye drops varies depending on the severity of the infection. Your healthcare provider will give you specific instructions on how often to use it, but it can be as frequent as one drop every hour for severe infections.

Can I buy Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified) over the counter?

No, Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified) is a prescription medication and you cannot buy it over the counter. It must be prescribed by a healthcare provider and is typically custom-made by a compounding pharmacy.

Are there any side effects associated with Fortified Tobramycin eye drops?

Yes, like all medications, Fortified Tobramycin eye drops can cause side effects, though not everyone will experience them. Common side effects may include eye irritation, discomfort, redness, or itching. Severe side effects are rare but can include allergic reactions or worsening of symptoms.

Is it safe to use Tobramycin 15 mg/ml with contact lenses?

No, you should not wear contact lenses while using Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified) or while you have an active eye infection. Contact lenses can interfere with the healing process and increase the risk of further infection.

How should I store Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified)?

This medication should be stored in a refrigerator, typically between 2 to 8 degrees Celsius (35.6 to 46.4 degrees Fahrenheit). Keep it away from light and do not freeze it. Always check with your pharmacist for specific storage instructions.

What should I do if I miss a dose?

If you miss a dose of Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified), instill the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one.

Can children use Fortified Tobramycin eye drops?

Use in children should only be under the guidance of a healthcare provider. Dosage and frequency may need to be adjusted based on the child's weight and the severity of the infection.

How long should I use Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified)?

The duration of use for Tobramycin 15 mg/ml Ophthalmic Liquid (Fortified) will depend on the type and severity of the infection. Your healthcare provider will specify the duration of treatment. It is important to complete the full course of treatment to ensure the infection is properly cleared, even if symptoms improve before the medication is finished.

What should I do if I experience severe discomfort or an allergic reaction to Fortified Tobramycin eye drops?

If you experience severe discomfort, swelling, rash, or other signs of an allergic reaction, discontinue use immediately and contact your healthcare provider or seek emergency medical attention.

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Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.