Tobra-D (0.3/0.1%) 5ml Eye Drops

Dexamethasone, a potent synthetic corticosteroid, primarily works by suppressing the immune system and reducing inflammation. It binds to glucocorticoid receptors in various cells, altering gene expression and inhibiting the production of pro-inflammatory mediators, such as cytokines and prostaglandins. This results in decreased vascular permeability, stabilization of cellular membranes, and inhibition of leukocyte migration to the site of inflammation. Tobramycin, on the other hand, is an aminoglycoside antibiotic that acts by binding to the bacterial 30S ribosomal subunit, disrupting protein synthesis in susceptible bacteria. It has a broad spectrum of activity against gram-negative bacteria, primarily targeting the cell wall and inhibiting bacterial protein synthesis, leading to bacterial death. The combination of dexamethasone and tobramycin in eye drop form provides both anti-inflammatory and antibacterial effects, making it effective in treating ocular infections and reducing associated inflammation.

Dexamethasone, Tobramycin

Corticosteroid, Aminoglycoside antibiotic.

Drop

The following are the uses of Dexamethasone, Tobramycin Drop:

• Used for treating eye infections, particularly bacterial conjunctivitis, to reduce inflammation and prevent further damage.
• Used for relieving eye irritation, redness, and discomfort caused by infections or allergies.
• Used for managing post-operative eye inflammation and infections after eye surgeries or procedures.
• Used for treating corneal ulcers and infections, promoting healing and reducing the risk of scarring.
• Used for controlling inflammation in the anterior part of the eye, including the cornea and conjunctiva.
• Used for preventing and treating eye infections in patients with compromised immune systems or those at high risk.
• Used for providing relief from dry eyes and associated discomfort, especially when caused by inflammation.
• Used for managing eye conditions with an inflammatory component, aiding in the overall eye health and comfort.

Tailoring Treatment for Optimal Health, Prescribed Medication Dosage is:

• For Tobramycin 0.3%- For adults, the recommended dose is 1-2 drops in the affected eye every 6 hours in a 12-hour interval. For children 1 year or older, the recommended dose is 1-2 drops in the affected eye every 6 hours in a 12-hour interval.
• For Dexamethasone 0.1%- For adults, the recommended dose is 1-2 drops in the affected eye every 6 hours in a 12-hour interval. For children 2 years or older, the recommended dose is 1-2 drops in the affected eye every 6 hours in a 12-hour interval.

In the case of an overdose of Dexamethasone, symptoms may include increased heart rate, elevated blood pressure, and excessive thirst. It is important to seek medical advice for appropriate management. For Tobramycin eye drops, overdose is unlikely to cause significant issues, but excessive use may lead to eye irritation and redness. Rinsing the eyes with water and consulting a healthcare professional is recommended in such cases. Prompt action and medical guidance are essential in managing any potential side effects.

In the case of a missed dose of Dexamethasone, it is generally advised to take the missed dose as soon as you remember, unless it is close to the time for your next scheduled dose. In this case, skip the missed dose and continue with your regular dosing schedule. For Tobramycin eye drops, if you miss a dose, apply the drops as soon as you remember, but if it's almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. It is important not to double the dose to make up for a missed one.

To use Dexamethasone and Tobramycin eye drops, gently tilt your head back, pull the lower eyelid down to create a pocket, and instill the prescribed number of drops into the eye, then close your eyes gently and apply light pressure to the inner corner of the eye for 1-2 minutes to minimize drainage.

Following are the conditions/situations when Dexamethasone and Tobramycin eye drops should not be used:

• Do not use if you have a known allergy to Dexamethasone, Tobramycin, or any other ingredients in the eye drops.
• Not suitable for individuals with a history of hypersensitivity or severe reactions to similar corticosteroids or antibiotics.
• Should not be used if you have a fungal infection in or around the eye(s).
• Contraindicated in patients with viral, mycobacterial, or fungal infections of the eye, as corticosteroids can worsen these infections.
• Avoid using if you have a perforated ear drum or untreated eye infections like herpes simplex.
• Not recommended for individuals with a history of glaucoma or raised intraocular pressure.
• Should not be used if you have a condition that weakens the immune system, as it can increase the risk of infection.
• Avoid using these eye drops if you are currently using contact lenses, as they may contain preservatives that can discolour soft contact lenses.

The side effects of Dexamethasone, Tobramycin Drop may include:

• Eye burning or irritation
• Eye itching or redness
• Blurred vision
• Dry eyes
• Eye discharge
• Increased eye pressure (especially in patients with glaucoma)
• Skin rash or itching around the eyes
• Sensitivity to light

Following are the precautions and warnings for Dexamethasone, Tobramycin Eye Drops:

• Do not use if you are allergic to any of the ingredients, including dexamethasone or tobramycin.
• This medication is for external eye use only. Do not inject or swallow the drops.
• If you wear contact lenses, remove them before applying the drops and wait at least 15 minutes after administration before reinserting them.
• Prolonged use of corticosteroids like dexamethasone may lead to increased intraocular pressure, glaucoma, and cataracts. Regular eye pressure checks are advised.
• Avoid using this medication if you have a viral, fungal, or mycobacterial infection in the eye, as it may worsen the infection.
• Do not use this medication in children without medical advice.
• Inform your doctor if you have or have ever had a history of herpes viral infections of the eye before using these drops.
• Patients with a history of corneal ulcers should use this medication with caution and under close medical supervision.

Following are the drug interactions for Dexamethasone, Tobramycin Eye Drops:

• Concomitant use with other ophthalmic medications containing corticosteroids may increase the risk of ocular side effects, such as glaucoma and cataract formation.
• Dexamethasone can enhance the effects of non-steroidal anti-inflammatory drugs (NSAIDs), potentially increasing the risk of gastrointestinal bleeding.
• Tobramycin, when used with other aminoglycoside antibiotics, can increase the risk of ototoxicity and nephrotoxicity.
• The use of loop diuretics (e.g., furosemide) with Tobramycin may increase the risk of hearing loss and kidney damage.
• Antifungal medications like amphotericin B and voriconazole can increase Tobramycin levels, potentially leading to increased toxicity.
• Dexamethasone may decrease the effectiveness of live vaccines, and its use should be separated by several weeks before and after vaccination.
• Drugs that affect renal function, such as vancomycin or cyclosporine, may alter Tobramycin clearance, requiring dosage adjustments.
• Concurrent use of other drugs with similar side effects (e.g., ototoxicity, nephrotoxicity) may increase the risk of these adverse reactions.

Following are the food interactions for Dexamethasone and Tobramycin Drops:

• Dexamethasone may cause increased appetite, leading to potential weight gain. Monitoring calorie intake and making healthy food choices is essential.
• High-sodium foods should be limited as Dexamethasone can cause sodium retention, affecting fluid balance.
• Avoid excessive caffeine intake as Dexamethasone can interfere with calcium absorption, and caffeine may exacerbate calcium loss.
• Tobramycin drops are typically administered into the eyes or ears, so direct food interactions are minimal.
• However, patients should avoid contaminating the dropper with any food or liquid to prevent bacterial growth.
• There is no known interaction between Tobramycin and specific foods, but maintaining a balanced diet is advisable for overall health.
• Staying well-hydrated is essential, especially if experiencing side effects like nausea or vomiting associated with these medications.

Dexamethasone, Tobramycin eye drops should be stored properly to maintain their effectiveness and safety. Keep the bottle tightly closed in a cool and dry place, preferably at room temperature, ensuring it is away from direct sunlight, heat, and moisture. Avoid freezing the drops as it may affect their potency. Always check the expiration date, and do not use the medication if it has expired. Dispose of any unused or expired drops by following local guidelines for pharmaceutical waste disposal; do not pour them down the drain or flush them. It is crucial to keep the medication out of children's reach to prevent accidental exposure.

Following are the quick tips for Dexamethasone and Tobramycin Drops:

• Wash your hands thoroughly before administering the eye drops to maintain hygiene.
• Tilt your head back, gently pull down your lower eyelid, and instill the prescribed number of drops into the eye.
• Avoid touching the dropper tip to your eye or any surface to prevent contamination.
• If using more than one type of eye drop, wait for at least 5 minutes between applications.
• Store the eye drops at room temperature, away from direct sunlight and moisture.
• Do not wear contact lenses while using Tobramycin drops unless advised by your eye doctor.
• Inform your doctor if you have any eye infections or injuries before using these medications.

While on Tobramycin 0.3% and Dexamethasone 0.1%, lab tests are important to monitor your health and ensure the medications are effective. These tests include: