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Tobradex hormonal drops. Tobradex: instructions for use of drops

INSTRUCTIONS
ON THE USE OF THE DRUG

Registration number:

P N016323/02-230710

Trade name:

Tobradex ®

INN or group name:

dexamethasone + tobramycin.

Chemical name:

Tobramycin: 4-O-(3-amino-3-deoxy-α-D-glucopyranosyl)-2-deoxy-6-O-(2,6-diamino-2,3,6-trideoxy-α-D-ribo -hexopyranosyl)-L-streptamine.
Dexamethasone: 9-fluoro-11β, 17, 21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione.

Dosage form:

eye drops.

Composition per 1 ml:

Active substances:
Tobramycin – 3 mg
Dexamethasone – 1 mg
Excipients:
Benzalkonium chloride, solution, equivalent to benzalkonium chloride 0.1 mg; disodium edetate 0.1 mg; sodium chloride 3.0 mg; sodium sulfate anhydrous 12.0 mg; tyloxapol 0.5 mg; hyaetellose (hydroxyethylcellulose) 2.5 mg; sulfuric acid and/or sodium hydroxide to adjust pH; purified water to 1.0 ml.

Description: suspension from white to almost white.

Pharmacotherapeutic group:

glucocorticosteroid for local use + aminoglycoside antibiotic.

ATX code: S01CA01.

Pharmacological action

Combined drug. Tobramycin is a broad-spectrum antibiotic from the aminoglycoside group. It disrupts protein synthesis and the permeability of the cytoplasmic membrane of the microbial cell.
Active against gram-positive and gram-negative microorganisms: staphylococci (including Staphylococcus aureus. Staphylococcus epidermidis). including strains resistant to methicillin; streptococci, including some group A beta-hemolytic species, non-hemolytic species and some strains of Streptococcus pneumonie; Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter spp, Proteus mirabilis, Morganella morganii, Citrobacter spp, Haemophilus influenzae, Moraxella spp, Acinetobacter spp, Serratia marcescens.
Dexamethasone is a synthetic fluorinated glucocorticosteroid that does not have mineralocorticoid activity. It has a pronounced anti-inflammatory, antiallergic and desensitizing effect. Dexamethasone actively suppresses inflammatory processes, inhibiting the release of inflammatory mediators by eosinophils, the migration of mast cells and reducing capillary permeability and vasodilation.
The combination of a glucocorticosteroid with an antibiotic (tobramycin) reduces the risk of an infectious process.

Pharmacokinetics
At local application Tobradex ® systemic absorption of dexamethasone is low. The maximum concentration (Cmax) of dexamethasone in blood plasma ranges from 220 to 888 pg/ml (about 555 ± 217 pg/ml) after using 1 drop of Tobradex ® in each eye 4 times a day for 2 days. About 77-84% of dexamethasone entering the systemic circulation is bound to plasma proteins. T1/2 averages 3-4 hours. It is excreted by metabolism, about 60% in the form of 6-β-hydroxydexamethasone in the urine.
When Tobradex ® is applied topically, systemic absorption of tobramycin is low. The concentration of tobramycin in the blood plasma after using 1 drop of Tobradex ® in each eye 4 times a day for 2 days was below the detection limit in 9 of 12 patients. The maximum measurable concentration (Cmax) of tobramycin in plasma was 247 ng/ml, which is eight times lower than the concentration threshold associated with nephrotoxicity. It is excreted by the kidneys, mainly unchanged.

Indications for use

Inflammatory diseases of the eye and its appendages caused by pathogens sensitive to the drug:
- blepharitis;
- conjunctivitis;
- keratoconjunctivitis;
- blepharoconjunctivitis;
- keratitis;
- iridocyclitis.
Prevention and treatment of inflammatory phenomena in the postoperative period after cataract extraction.

Contraindications

Individual hypersensitivity to the components of the drug;
- viral diseases eye (including keratitis caused by Herpes simplex, chicken pox):
- mycobacterial eye infections:
- fungal diseases eye;
- purulent eye diseases;
- state after removal foreign body corneas;
- period of breastfeeding;
- childhood up to 12 years old.

Use during pregnancy

There is no sufficient experience with the use of the drug during pregnancy. It can be used for the treatment of pregnant women as prescribed by the attending physician, if the expected healing effect for the mother exceeds the risk of developing possible side effects in the fetus.
Teratogenic effect
Animal studies have shown nephrotoxicity and ototoxicity in the fetus when administered high doses tobramycin. Fetal developmental anomalies were identified during chronic administration of high doses of dexamethasone.

Use in children

Tobradex ® eye drops can be used in pediatrics for children over 12 years of age.
The duration of treatment should not exceed 7 days!

Directions for use and doses

Locally. Shake the bottle before use!
For children over 12 years of age and adults, instill 1-2 drops into the conjunctival sac every 4-6 hours.
In the first 24-48 hours, the dose can be increased to 1-2 drops into the conjunctival sac every 2 hours, followed by a decrease in the frequency of drug instillations as inflammation decreases.
In acute severe infectious process 1-2 drops into the conjunctival sac every 60 minutes until the severity of the condition decreases. Then reduce the frequency of drug instillations to 1-2 drops into the conjunctival sac every 2 hours for 3 days. Then 1-2 drops into the conjunctival sac every 4 hours for 5-8 days. If necessary, continue instillation: 1-2 drops into the conjunctival sac for 5-8 days.
To prevent inflammatory phenomena in the postoperative period: 1 drop into the conjunctival sac 4 times a day, starting from the day surgical intervention up to 24 days. Therapy can be started before surgery: 1 drop into the conjunctival sac 4 times a day 1 day before surgery, 1 drop on the day of surgery, then 1 drop into the conjunctival sac 4 times a day for 23 days. If necessary, the frequency of drug instillations can be increased to 1-2 drops into the conjunctival sac every 2 hours during the first 2 days after surgery.
After using the drug, to reduce the risk of developing systemic side effects, it is recommended to apply light pressure with a finger on the projection area of the lacrimal sacs at the inner corner of the eye for 1-2 minutes after instillation of the drug - this reduces the systemic absorption of the drug.
You can combine the use of Tobradex ® ointment and drops: ointment - in the evening before bed, drops - during the day (while maintaining the frequency of use of the drug 3-4 times a day).

Side effects

Local. In 1-10% of cases: discomfort in the eyes, pain and irritation of the eyes. In 0.1-1% of cases: hypersensitivity and allergic reactions, increase intraocular pressure, keratitis (including punctate), conjunctival hyperemia, itching, erythema of the eyelid, blurred vision, sensation of a foreign body in the eye, swelling of the eyelids and conjunctiva, dry eye syndrome, increased lacrimation. Frequency unknown: development of glaucoma, cataracts, decreased visual acuity, mydriasis, photophobia.
System. In 0.1-1% of cases: headache, dysgeusia, laryngospasm, rhinorrhea. With long-term use (more than 24 days) or an increase in the frequency of instillations of glucocorticosteroids, the following may be observed: an increase in intraocular pressure with the possible subsequent development of steroid glaucoma; posterior subcapsular cataract, slowing of the wound healing process (in diseases that cause thinning of the cornea, its perforation is possible).
Secondary infection. Secondary bacterial infection may occur as a consequence of the local immunosuppressive effect of glucocorticosteroids. Fungal infection of the cornea tends to occur especially often with long-term use of glucocorticosteroids. The appearance of non-healing ulcers on the cornea after long-term treatment glucocorticosteroids may indicate the development of a fungal infection. For acute purulent diseases eyes, glucocorticosteroids can mask or intensify an existing infectious process.

Overdose

Symptoms: conjunctival hyperemia, punctate keratitis, erythema, increased lacrimation, swelling and itching of the eyelids.
Rinse eyes with warm water; treatment is symptomatic.

Interaction with other drugs

When used with other local ophthalmic drugs, the interval between their use should be at least 5 minutes.

Special instructions

The drug contains the preservative benzalkonium chloride, which can be absorbed by contact lenses. Before using the drug contact lenses should be removed and put back no earlier than 20 minutes after using the drug.
When therapy lasts more than 2 weeks, the condition of the cornea should be monitored. If tobramycin is prescribed topically simultaneously with systemic aminoglycoside antibiotics, the general blood picture should be monitored.
If the patient's vision clarity is temporarily reduced after using the drug, it is not recommended to drive a car or engage in activities that require increased attention until it is restored.
Do not touch the tip of the dropper bottle to any surface to avoid contamination of the dropper bottle and its contents.
The bottle must be closed after each use.

Release form

Eye drops.

5 ml in a Droptainer™ dropper bottle made of low-density polyethylene.
1 bottle with instructions for use in a cardboard pack.

Best before date

2 years. Use within 4 weeks after opening the bottle.
Do not use after the expiration date indicated on the package!

Storage conditions

At temperatures from 8 to 27°C in vertical position, out of the reach of children.

Vacation conditions:

according to the recipe.

Manufacturer:

"s.a. Alkon-Kouvrer n.v.”,
B-2870 Puurs, Belgium.

Registrant on site Russian Federation Alkon Pharmaceuticals LLC
Address of Alkon Pharmaceuticals LLC and acceptance of claims:
109004, Moscow, st. Nikoloyamskaya, 54

For the treatment of inflammatory and bacterial diseases eye ophthalmologists often recommend that patients use topically not pure antibiotics, but combined with hormonal or other anti-inflammatory substances. A popular drug of this type is Alcon Tobradex, available in drops and ointment form. How effective and safe is it?

Instructions for use of Tobradex

The product of the Belgian company Alcon-Couvreur is highly valued by ophthalmologists for its rapid action and pronounced effect: on initial stages The symptoms of the disease are relieved within 24 hours, and complete suppression of the activity of pathogenic microorganisms is carried out in 2-3 days. Severe infectious lesions may require 7-10 days of treatment, but only under the supervision of a specialist.

Composition and release form

Mostly for children and adults, doctors prescribe Tobradex eye drops - this is the most common form of this medicinal product, which is a white or transparent suspension. It is sold in 5 ml dropper bottles. The composition looks like this:

Less popular among ophthalmologists is Tobradex ointment, which is available in small aluminum tubes with a volume of 3.5 g. In terms of the concentration of active substances, drops and ointment are identical to each other, and the number of auxiliary agents in the latter dosage form is less. The composition of the ointment looks like this:

Pharmacodynamics and pharmacokinetics

The key active ingredient of Tobradex is tobramycin, an antibiotic belonging to the group of aminoglycosides. When used topically for treatment ophthalmological diseases shows low systemic absorption and is more effective than neomycin. In low concentrations, tobramycin has a bacteriostatic effect (disturbs protein synthesis, inhibiting bacterial activity), and in high concentrations it has a bactericidal effect (impacts the function of cytoplasmic membranes). Tobramycin has a broad spectrum of action and is active against the following bacteria:

escherichia coli.;
proteus spp.;
haemophilus influenzae;
haemophilus aegypticus;
klebsiella pneumonia;
providencia spp.;
enterobacter aerogene;
moraxella lacunata;
morganella morganii;
acinetobacter calcoaceticus;
neisseria spp. (including gonorrhoeae species).

Separately, doctors mention the impact of this antibiotic for staphylococci (especially those with resistance to penicillin and staphylococcus aure s and epidermidis), and streptococci (beta-hemolytic strains of group A, streptococcus pheumonia), excluding representatives of group D. It also shows high effectiveness against Pseudomonas aeruginosa, enterococci , especially in combination with penicillin series or cephalosporin. Dexamethasone is a glucocorticoid steroid that:

suppresses inflammation at the stage of generation of pathological contents;
has antiallergic and desensitizing effects;
reduces the risk of developing an infectious process.

Indications for use

A combination of tobramycin and dexamethasone is used topically in ophthalmic practice to prevent infections after injury or surgical intervention on the eye area. Some doctors prescribe Tobradex for immunosuppressive treatment after corneal transplantation. The main indication for use is the treatment of diseases of the eyes and appendages caused by microorganisms sensitive to tobramycin:

blepharitis;
conjunctivitis;
keratitis (if the epithelium is not damaged);
iridocyclitis;
viral keratitis, caused by herpes zoster.

Directions for use and dosage

Tobradex is introduced into the conjunctival sac, for which the lower eyelid is pulled back with clean hands. Contact lenses are removed before the procedure and put back on no earlier than after 15 minutes. The dosage of Tobradex for all ophthalmological diseases is the same, only the frequency of use changes. The duration of the therapeutic course is determined by the attending physician - according to official instructions it does not exceed a week. A couple of nuances:

Tobradex is discontinued by reducing the frequency of procedures;
dosage forms can be combined - drops can be used during the day, and ointment can be used at night.

Eye drops

The suspension is injected into the conjunctival sac, after which pressure should be applied to the inner corner of the eye. The frequency of use is determined by the form of the disease and the severity of its manifestations. On the first day, doctors consider it advisable to instill Tobradex every 2 hours in the amount of 2 drops. If necessary, this schedule can be extended to 48 hours. The basic regimen is 2 drops with an interval of 4-6 hours between procedures.

Ointment

General principle applications for everyone dosage forms Tobradex is the same - the ointment is also injected into the conjunctival sac, but it should be measured literally using a ruler: single dose is 1.25-1.5 cm. Before the procedure, you must wash your hands. After placing the ointment behind the lower eyelid, the eyes need to be opened and closed 2-3 times to distribute it. The interval between procedures is 6 hours, so the maximum number of procedures per day is 4.

Special instructions

The tip of the dropper bottle does not touch the eye during instillation, and the suspension itself is shaken before use. After each use, the bottle and tube should be tightly closed. With long-term treatment with Tobradex after the procedure, a decrease in visual acuity may be observed, so it is advisable to refrain from administering vehicles.

During pregnancy

There have been no studies on the safety of using this drug in pregnant or breastfeeding women. Tobramycin has low systemic absorption when applied topically, but it accumulates in the fetal kidneys and can cause congenital bilateral deafness. The official instructions set relative contraindication and allows the use of Tobradex during pregnancy and lactation if the attending physician considers it necessary, having assessed the potential benefits and harms of the drug.

For children

Drops and ointment are not used in children less than a year old, and at the age of 2-12 years - only under the supervision of a doctor. Some sources report that Tobradex for children can be prescribed with constant monitoring of the child’s condition in the hospital, in the absence of alternatives. There have been no clinical studies regarding the safety of this drug for children, so the issue should be discussed with your doctor.

Drug interactions

If complex therapy of ophthalmological diseases is planned, Tobradex is administered with other local medications at intervals of 15 minutes. and more. The exact duration and treatment regimen should be indicated by the doctor. Separately, you should take into account:

necessity constant monitoring blood tests during the use of Tobradex with systemic aminoglycosides;
increased nephrotoxic, neurotoxic and ototoxic side effects when taking drugs that have them.

Side effects

When using Tobradex externally, only local allergic reactions predominantly occur, among which the most obvious are itching, burning, and the feeling of a foreign body in the eye. Less common are redness or swelling of the conjunctiva and dry eyes. The official instructions for the drug Tobradex do not exclude:

decreased visual acuity;
pupil dilation;
photophobia;
increased intraocular pressure;
tearfulness;
damage optic nerve;
headaches;
dizziness;
nausea;
vomit;
mucous discharge from the nose;
spasms of the larynx;
skin itching and rashes.

Overdose

swelling of the eyelids;
prolonged itching in the area where the drug is applied;
rhinorrhea and lacrimation;
hyperemia of the eye mucosa;
increased arterial inflow of the conjunctiva;
development of a secondary infection (mainly fungal, on the cornea).

If symptoms of overdose appear, Tobradex should be discontinued - some of the unpleasant moments will disappear on their own after a few hours. If necessary, carry out symptomatic treatment: rinse eyes with warm water clean water, select medications that relieve emerging adverse reactions. Pharmaceutical antagonist local action does not exist for Tobradex.

Contraindications

Even if the systemic penetration of an antibiotic with a glucocorticosteroid is low, Tobradex is prohibited from being used against the background of intolerance to any of the components of the drug, hypersensitivity or idiosyncrasy to them. If eye diseases are caused by viruses, especially herpes simplex, the causative agent of smallpox, Tobradex is also not used. Additionally, the list of contraindications according to the official instructions includes:

Koch's bacillus infection - mycobacterial eye infection;
carrying out conservative treatment against the background of removal of a foreign body of the cornea;
purulent eye pathologies;
tuberculous eye lesions;
damage to the shell of the eyeballs by fungal microflora;
thinning of the cornea (congenital/acquired) - treatment can only be carried out under the supervision of a doctor;
glaucoma.

Terms of sale and storage

Tobradex is dispensed from pharmacies only after presenting a prescription from a doctor. Storage is carried out in a dark place with an air temperature of 8 to 27 degrees. The shelf life of sealed packages is 2 years, after opening both drops and ointment should be used within 4 weeks and then thrown away.

Analogs

The closest drug in the form of drops from the same manufacturer in terms of the principle of action (but not in composition) is Tobrex: it is based only on an antibiotic, therefore it has less anti-inflammatory activity. If you are looking for complete analogue Tobradex, which contains tobramycin and dexamethasone, consider:

Tobrazon - identical dosages of active substances, but a lower price (up to 200 rubles), since the production is Indian.
DexaTobropt is also a pure analogue, but from Romania, with increased sentence storage (3 years).

Tobradex price

Taking into account short term storage and small volume, doctors and patients classify this medicine as expensive: for 5 ml of drops you will have to pay from 400 to 600 rubles, depending on pricing policy specific pharmacy. The ointment is cheaper - in the range of 300-350 rubles, but it is rarely found on sale. An approximate picture of Tobradex prices for Moscow pharmacies is as follows.

Tobradex is combination drug with antimicrobial and anti-inflammatory effects. Eye drops are used topically for the treatment and prevention of various infectious and inflammatory complications, including in the postoperative period.

Composition and release form

Tobradex is available in the form eye drops, 1 ml of which contains the following active substances:

tobramycin – 3 mg;
dexamethasone 1 mg.

Auxiliary components are presented:

benzalkonium chloride 0.1 mg;
edetate disodium 0.1 mg;
hydroxyethylcellulose – 2.5 mg;
sodium chloride 3 mg;
special purified water 1 ml.

To bring the pH to neutral values, add to the solution small quantities sulfuric acid or sodium hydroxide.

Tobradex is a white suspension, 5 ml of which is placed in a special polyethylene dropper “Droptainer TM”. The bottle itself, along with paper instructions, is packed in a cardboard box.

Pharmacological action

Tobradex is a combination medicine related to antibiotics (aminoglycoside) and glucocorticosteroid hormones.

Its action is associated with the activity of its constituent components.

Tobramycin belongs to antibacterial drugs wide spectrum of action. It is an aminoglycoside and disrupts the synthesis of certain proteins and also increases the permeability of the cytoplasmic membrane bacterial cell. Its effectiveness extends to gram-negative and gram-positive microbes: staphylococcus (aureus, epidermidis, etc.), as well as types of bacteria that are resistant to methicillin; streptococcus (beta-hemolytic from group A, non-hemolytic, pneumonie); Pseudomonas aeruginosa; Escherichia coli; Klebsiella pneumonia; Enterobacter spp; Proteus mirabilis; Morganella morganii; Citrobacter spp; Haemophilus influenza; Moraxella spp; Acinetobacter spp; Serratia marcescens.

Dexamethasone is a glucocorticosteroid hormone of a synthetic nature that does not have a mineralocorticoid effect. It has a pronounced anti-inflammatory effect, has a desensitizing and antiallergic effect. By inhibiting the release of inflammatory mediators by eosinophil cells, reducing the migration of mast cells, vasodilation and reducing the permeability of the capillary wall, it quite actively inhibits various inflammatory reactions and processes.

When used in combination, these substances help fight infection or prevent its occurrence.

Indications

Tobradex is prescribed for various inflammatory diseases ocular apparatus, when the cause of development is a microflora sensitive to an antibiotic:

conjunctivitis;
blepharitis;
keratoconjunctivitis;
keratitis;
blepharoconjunctivitis;
iridocyclitis.

It is also used to prevent infection in the postoperative period after removal of the lens for cataracts.

Directions for use

Apply Tobradex topically, shaking the solution thoroughly before instillation.

The dose is 1-2 drops every 4-6 hours. In the first 1-2 days, it is possible to increase the frequency of use up to 12 times a day.

At severe course infectious acute process It is allowed to instill 1-2 drops every hour. As the severity of the symptoms of inflammation decreases, the frequency of dosing should also be reduced (3 days - every 2 hours, 5-8 days - every 4 hours).

For preventive purposes in the postoperative period, the drug is prescribed 1 drop 4 times a day. The duration of the prima can be up to 24 days.

Another scheme is also possible, when the drug is started to be instilled a day before the operation (4 times), and then continued for the next 23 days.

If necessary, you can increase the frequency of administration in the first two days after the intervention (up to 12 times a day).

After placing a drop of the drug into the conjunctival sac, lightly press with your finger in the area of the lacrimal sacs (at the inner corner of the eye) for a couple of minutes. This helps reduce the resorption of the drug into the systemic circulation and reduces the likelihood of side effects.

Sometimes Tobradex drops are combined with the same ointment. In this case, the drops are used during the day, and the ointment is applied at night. The overall reception frequency must be maintained.

Contraindications

The use of Tobradex is contraindicated for:

individual intolerance;
viral diseases affecting the eyeball (herpes, keratitis, chickenpox);
the presence of a fungal or bacterial infection of the eyeball;
purulent diseases;
in the period after removal of a foreign body from the area of the corneal layer;
lactation;
under 12 years of age.

Since there is no sufficient clinical material on the use of Tobradex in pregnant women, it can be prescribed in individual cases. A number of experimental studies on animals have found adverse effect high doses of the drug to the fetus (nephrotoxicity, ototoxicity). With prolonged use of high doses, developmental anomalies developed.

In children, Tobradex can be used starting from the age of twelve, and the duration of use should not exceed seven days.

Side effects

When using Tobradex drops, side effects may develop.

Local reactions include:

pain, irritation, discomfort in the area of application occurs in 1-10%;
allergy, hypersensitivity, intraocular hypertension, keratitis, itching, redness of the conjunctiva, erythema of the eyelid, sensation foreign object, blurred vision, swelling of the conjunctiva and eyelids, increased lacrimation, or vice versa, dry eye syndrome is observed in 0.1-1%;
Glaucoma, decreased visual acuity, cataracts, photophobia, and mydriasis occur with an unknown frequency.

Systemic complications include:

headache;
laryngospasm;
dysgeusia;
rhinorrhea.

They develop in 0.1-1% of patients.

In case of frequent or long-term use(more than 24 days) development is possible:

intraocular hypertension;
steroid glaucoma;
subcapsular posterior cataract;
slowing down regeneration processes;
secondary infection resulting from a decrease in local immunity under the influence of the immunosuppressive dexazone.

Fungal infection of the cornea develops with prolonged use of the drug. In this case, corneal ulcers appear that are difficult to heal. In case of purulent processes, the use of the drug can intensify the existing process or mask the symptoms.

Overdose

In case of an overdose of the drug Tobradex, redness of the conjunctiva, increased lacrimation, swelling and itching of the eyelids, punctate keratitis and erythema occur. To reduce symptoms, rinse your eyes with warm water and carry out symptomatic treatment.

Interactions

When using other drugs for topical use together, an interval between instillations of at least 5 minutes should be observed.

Special instructions

Tobradex contains a preservative (benzalkonium chloride) that can be deposited on the surface of contact lenses. Therefore, the lens should be removed before instillation. You can return it to its place after 20 minutes.

If long-term use is necessary, monitor the cornea for ulceration. If additionally assigned systemic antibiotics from the group of glycosides, attention should be paid to general analysis blood.

Since a temporary decrease in vision clarity is possible, it is not recommended to drive a vehicle at this moment.

To prevent contamination of the dropper, do not touch the tip of the bottle to any objects.

An opened bottle must be used within a month. The total shelf life reaches two years.

Price of the drug Tobradex

The cost of the drug "Tobradex" in Moscow pharmacies starts from 250 rubles.

Tobradex is a medicine containing tobramycin, which has an anti-inflammatory effect. Tobradex is prescribed to treat eye diseases in children. Used during the recovery period after surgery. Its main components are tobramycin and dexamethasone.

With the help of Tobradex, microbes (staphylococci, streptococci, etc.) are easily eliminated. And dexamethasone relieves swelling and eliminates allergic reactions.

The medicine is available in the form of drops and ointment. Drops include sodium chloride, sulfuric acid and other components. The ointment contains petroleum jelly and mineral oil. Children under one year of age, preschoolers, and children of primary school age should not be treated with the drug.

Tobradex is used to treat blepharitis and keratitis. It can also be treated. Treatment can be carried out for various eye injuries or after surgical intervention by an ophthalmologist. The instructions state that the drops can be used during the treatment of infections, including chronic inflammation of the cornea. Tobradex is also used after eye damage from radiation, chemistry, after thermal burns children's eyes. If a foreign body gets into the eye, treatment can be carried out with drops. Drops can also be used for preventive measures from the inflammatory process after surgery. When prescribed by a doctor, drops can be instilled into the nose, used to treat a runny nose and adenoids.

Instructions and dosage

Parents are strongly advised to wash their hands with soap before using drops in their child's eyes. The bottle of Tobradex is shaken before use to mix the contents and become a suspension. The child should tilt his head back and pull back his lower eyelid. After instillation, you need to lightly press on the inner corner of the eye.

Parents should not use the drug for children under one year of age, special instructions doctor, the medicine can be used for children after one year.

The medicine is poured one or two drops into the conjunctival sac of the diseased eye. This procedure is performed after 4-6 hours. At acute inflammation the dosage can be increased to one or two drops and the patient is given eye drops every two hours.

If inflammation decreases and swelling occurs, then the dosage of drops is reduced until it stops. But it is very important to cure the disease completely.

In case of acute inflammation, it is necessary to apply drops once an hour until the inflammatory process passes. After the inflammation is relieved, drops are used once every three hours, then the dosage is reduced to one drop every four hours (5–7 days). The course continues with a decrease in dosage; in the last 7 days, it is enough to instill 1 drop in the eyes 1-2 times a day.

After eye surgery, Tobradex is used 1 drop every 6 hours. The course of such therapy is 24 days.

You can start treating your eyes even before surgery; it is recommended to take one drop per day every 6 hours. In case of severe swelling or inflammation, apply a drop every 2-3 hours. This increased dosage is used in the first two courses of treatment. During treatment, the pressure inside the eyes should be constantly checked by an ophthalmologist.

During the instillation procedure, it is necessary to slightly close the eyelids, slightly pressing the nasolacrimal duct, so the drug is better absorbed, and this trick will avoid many side effects.

Do not touch the dosing pipette to your eyes, table, or hands, so as not to introduce dirt into the bottle with drops. If the ophthalmologist prescribed a number of other drugs during treatment eye disease, then you should maintain a time interval between medications of at least 15 minutes. If you did not have time to administer the drug to your child in time, you should not next appointment drip twice as much suspension. In this case, the child is given eye drops earlier than planned, but the interval between two drops must be at least 60 minutes.

After treatment with drops, the bottle is carefully screwed in, its shelf life is 30 days after first opening. During therapy, they should not be used or worn until 15 minutes before treatment with drops. In most cases, the reviews are positive if all recommendations are followed.

During treatment, the dosage of the ointment is a strip of at least 15 mm in length. When treating with ointment, the patient's lower eyelid is pulled back and a pea of medicine is placed, after which the child must blink so that it spreads throughout the mucous membrane.

When applying the ointment, do not touch the eyes, table, hands, skin or other surfaces with the tube. After application, carefully twist the ointment; the tube should not be placed in the refrigerator or freezer. The ointment should absolutely not be frozen, because it loses its medicinal properties. When prescribed by a doctor, you can alternate both forms of the drug, using drops during the day, and in the evening, apply Tobradex ointment to the lower eyelid.

Parents are surprised by doctors' orders to bury eye drops in the nose Indeed, in some cases, pediatricians prescribe treating the nose with this particular drug, for example, for adenoids or a runny nose.

This method of treatment even involves non-surgical treatment of purulent. The treatment is carried out as follows: 5 drops of medicine are instilled into the child’s nose in each nostril for 5 days, after which the doctor decides whether to remove the adenoids or continue to treat the nose with the drug.

Parents often confuse two drugs: Tobradex and Tobrex, but the second drug does not include Tobradex, which relieves inflammation. just like tobradex, it contains tobramycin, which has antibacterial effect. In the same way, Tobrex is used for instillation into the nose for a runny nose and the presence of adenoids. The nasal drop procedure is similar to using Tobradex. Instillation into the nose is carried out with a pipette. Shelf life: 2 years.

Contraindications, side effects

Patients complain of increased pressure inside the eyes, swelling of the tissues, sensation of a foreign object in the eyes, local irritation of the eyes and eyelids, itching. Dry eyes and hyperemia are less common.

Patients complain of an unpleasant taste in the mouth and, migraines, attacks of nausea and vomiting, allergic reactions, swelling of facial tissues, itching.

The medicine is not recommended for use by persons with acute keratitis arising from herpes, or with allergic reactions to the components of the drug. It cannot be used to treat children with chickenpox, viral diseases cornea, fungal diseases of the eye, purulent infections. Doctors do not recommend the drug for use in children under 12 years of age, and the course of drug therapy should not exceed a week. But despite large number side effects listed in the instructions, reviews from parents are positive.

With the help of Tobradex, microbes (staphylococci, streptococci, etc.) are easily eliminated. And dexamethasone relieves swelling and inflammation of the eyes, eliminates allergic reactions.

Tobradex is used to treat blepharitis, barley and keratitis. Conjunctivitis and dacryocystitis can be treated. Treatment can be carried out for various eye injuries or after surgical intervention by an ophthalmologist. The instructions state that the drops can be used during the treatment of infections, including inflammation of the cornea and chronic uveitis. Tobradex is also used after eye damage from radiation, chemicals, and after thermal burns of the eyes in children. If a foreign body gets into the eye, treatment can be carried out with drops. Drops can also be used for preventive measures against the inflammatory process after cataract surgery. When prescribed by a doctor, drops can be instilled into the nose, used to treat a runny nose and adenoids.

Parents should not use the drug for children under one year of age; upon special instructions from the doctor, the medicine can be used for children after one year of age.

The medicine is poured one or two drops into the conjunctival sac of the diseased eye. This procedure is performed after 4-6 hours. In case of acute inflammation, the dosage can be increased to one or two drops and the patient is given eye drops every two hours.

If inflammation decreases and swelling occurs, then the dosage of drops is reduced until it stops. But it is very important to cure the disease completely.

After eye surgery, Tobradex is used 1 drop every 6 hours. The course of such therapy is 24 days.

During the instillation procedure, it is necessary to slightly close the eyelids, slightly pressing the nasolacrimal duct, so the drug is better absorbed, and this trick will avoid many side effects.

Do not touch the dosing pipette to your eyes, table, or hands, so as not to introduce dirt into the bottle with drops. If the ophthalmologist has prescribed a number of medications for the treatment of an eye disease, then the time interval between medications should be at least 15 minutes. If you did not have time to instill the drug into your child in time, then you cannot drip twice as much suspension at the next dose. In this case, the child is given eye drops earlier than planned, but the interval between two drops must be at least 60 minutes.

After treatment with drops, the bottle is carefully screwed in, its shelf life is 30 days after first opening. During therapy, do not use lenses or do not put them on earlier than 15 minutes before treatment with drops. In most cases, the reviews are positive if all recommendations are followed.

During treatment, the dosage of the ointment is a strip of at least 15 mm in length. When treating with ointment, the patient's lower eyelid is pulled back and a pea of medicine is placed, after which the child must blink so that it spreads throughout the mucous membrane.

When applying the ointment, do not touch the eyes, table, hands, skin or other surfaces with the tube. After application, carefully twist the ointment; the tube should not be placed in the refrigerator or freezer. The ointment should absolutely not be frozen, because it loses its healing properties. When prescribed by a doctor, you can alternate both forms of the drug, using drops during the day, and in the evening, apply Tobradex ointment to the lower eyelid.

Parents are surprised by doctors' orders to put eye drops into the nose. Indeed, in some cases, pediatricians prescribe treating the nose with this particular drug, for example, for adenoids or a runny nose.

This method of treatment even involves non-surgical treatment of purulent adenoiditis in children. The treatment is carried out as follows: 5 drops of medicine are instilled into the child’s nose in each nostril for 5 days, after which the doctor decides whether to remove the adenoids or continue to treat the nose with the drug.

Parents often confuse two drugs: Tobradex and Tobrex, but the second drug does not include dexamethasone, which relieves inflammation. Tobrex, like Tobradex, contains tobramycin, which has an antibacterial effect. In the same way, Tobrex is used for instillation into the nose for a runny nose and the presence of adenoids. The nasal drop procedure is similar to using Tobradex. Instillation into the nose is carried out with a pipette. Shelf life: 2 years.

Patients complain of an unpleasant taste in the mouth and laryngospasms, migraines, attacks of nausea and vomiting, allergic reactions, swelling of facial tissues, itching.

The medicine is not recommended for use by persons with acute keratitis arising from herpes, or with allergic reactions to the components of the drug. It cannot be used to treat children with chickenpox, viral diseases of the cornea, fungal diseases of the eye, or purulent infections. Doctors do not recommend the drug for use in children under 12 years of age, and the course of drug therapy should not exceed a week. But despite the large number of side effects listed in the instructions, reviews from parents are positive.

Read also: complications after chickenpox in children

The medicine has many analogues, one of them is a drug produced in Romania, “DexaTorb”, which is completely similar in composition. Eye drops with hormonal drugs and antibiotics in its composition:

Maxitrol. Country of origin: Belgium. Main components: polymexin B, neomycin, etc.
Garazon has an anti-inflammatory effect for keratitis and blepharitis. Reviews about the effectiveness of the medicine are positive.
Sofradex is an Indian drug based on dexamethasone and framycetin.
Brumicin. Eye drops produced in Hungary, which have an anti-inflammatory effect.

The price of the drug depends on the trade markup of the selling pharmacy, the price of the supplier and the region of the country in which the medicine was purchased. Average price The cost of the drug is 250–350 rubles, and the medicine is stored for 2 years.

INSTRUCTIONS
ON THE USE OF THE DRUG

P N016323/02-230710

Tobradex®

dexamethasone + tobramycin.

Chemical name:

eye drops.

Description: white to almost white suspension.

glucocorticosteroid for local use + aminoglycoside antibiotic.

ATX code: S01CA01.

Pharmacokinetics
When Tobradex® is applied topically, systemic absorption of dexamethasone is low. The maximum concentration (Cmax) of dexamethasone in blood plasma ranges from 220 to 888 pg/ml (about 555 ± 217 pg/ml) after using 1 drop of Tobradex® in each eye 4 times a day for 2 days. About 77-84% of dexamethasone entering the systemic circulation is bound to plasma proteins. T1/2 averages 3-4 hours. It is excreted by metabolism, about 60% in the form of 6-β-hydroxydexamethasone in the urine.
When Tobradex® is applied topically, systemic absorption of tobramycin is low. The concentration of tobramycin in the blood plasma after using 1 drop of Tobradex® in each eye 4 times a day for 2 days was below the detection limit in 9 of 12 patients. The maximum measurable concentration (Cmax) of tobramycin in plasma was 247 ng/ml, which is eight times lower than the concentration threshold associated with nephrotoxicity. It is excreted by the kidneys, mainly unchanged.

Individual hypersensitivity to the components of the drug;
- viral eye diseases (including keratitis caused by Herpes simplex, chicken pox):
- mycobacterial eye infections:
- fungal eye diseases;
- purulent eye diseases;
- condition after removal of a foreign body of the cornea;
- period of breastfeeding;
- children's age up to 12 years.

There is no sufficient experience with the use of the drug during pregnancy. It can be used for the treatment of pregnant women as prescribed by the attending physician, if the expected therapeutic effect for the mother exceeds the risk of developing possible side effects in the fetus.
Teratogenic effect
Animal studies have shown nephrotoxicity and ototoxicity in the fetus when given high doses of tobramycin. Fetal developmental anomalies were identified during chronic administration of high doses of dexamethasone.

Use in children

Tobradex® eye drops can be used in pediatrics for children over 12 years of age.
The duration of treatment should not exceed 7 days!

Locally. Shake the bottle before use!
For children over 12 years of age and adults, instill 1-2 drops into the conjunctival sac every 4-6 hours.
In the first 24-48 hours, the dose can be increased to 1-2 drops into the conjunctival sac every 2 hours, followed by a decrease in the frequency of drug instillations as inflammation decreases.
In case of acute severe infectious process, 1-2 drops into the conjunctival sac every 60 minutes until the severity of the condition decreases. Then reduce the frequency of drug instillations to 1-2 drops into the conjunctival sac every 2 hours for 3 days. Then 1-2 drops into the conjunctival sac every 4 hours for 5-8 days. If necessary, continue instillation: 1-2 drops into the conjunctival sac for 5-8 days.
For the prevention of inflammatory phenomena in the postoperative period: 1 drop into the conjunctival sac 4 times a day, starting from the day of surgery until 24 days. Therapy can be started before surgery: 1 drop into the conjunctival sac 4 times a day 1 day before surgery, 1 drop on the day of surgery, then 1 drop into the conjunctival sac 4 times a day for 23 days. If necessary, the frequency of drug instillations can be increased to 1-2 drops into the conjunctival sac every 2 hours during the first 2 days after surgery.
After using the drug, to reduce the risk of developing systemic side effects, it is recommended to apply light pressure with a finger on the projection area of the lacrimal sacs at the inner corner of the eye for 1-2 minutes after instillation of the drug - this reduces the systemic absorption of the drug.
You can combine the use of ointment and Tobradex® drops: ointment - in the evening before bed, drops - during the day (while maintaining the frequency of use of the drug 3-4 times a day).

Local. In 1-10% of cases: discomfort in the eyes, pain and irritation of the eyes. In 0.1-1% of cases: hypersensitivity and allergic reactions, increased intraocular pressure, keratitis (including punctate), conjunctival hyperemia, itching, erythema of the eyelid, blurred vision, sensation of a foreign body in the eye, swelling of the eyelids and conjunctiva, syndrome " dry eye", increased lacrimation. Frequency unknown: development of glaucoma, cataracts, decreased visual acuity, mydriasis, photophobia.
System. In 0.1-1% of cases: headache, dysgeusia, laryngospasm, rhinorrhea. With long-term use (more than 24 days) or an increase in the frequency of instillations of glucocorticosteroids, the following may be observed: an increase in intraocular pressure with the possible subsequent development of steroid glaucoma; posterior subcapsular cataract, slowing of the wound healing process (in diseases that cause thinning of the cornea, its perforation is possible).
Secondary infection. Secondary bacterial infection may occur as a consequence of the local immunosuppressive effect of glucocorticosteroids. Fungal infection of the cornea tends to occur especially often with long-term use of glucocorticosteroids. The appearance of non-healing ulcers on the cornea after long-term treatment with glucocorticosteroids may indicate the development of a fungal infection. In acute purulent diseases of the eye, glucocorticosteroids can mask or intensify the existing infectious process.

Symptoms: conjunctival hyperemia, punctate keratitis, erythema, increased lacrimation, swelling and itching of the eyelids.
Rinse eyes with warm water; treatment is symptomatic.

Interaction with other drugs

When used with other local ophthalmic drugs, the interval between their use should be at least 5 minutes.

The drug contains the preservative benzalkonium chloride, which can be absorbed by contact lenses. Before using the drug, contact lenses should be removed and put back no earlier than 20 minutes after using the drug.
When therapy lasts more than 2 weeks, the condition of the cornea should be monitored. If tobramycin is prescribed topically simultaneously with systemic aminoglycoside antibiotics, the general blood picture should be monitored.
If the patient's vision clarity is temporarily reduced after using the drug, it is not recommended to drive a car or engage in activities that require increased attention until it is restored.
Do not touch the tip of the dropper bottle to any surface to avoid contamination of the dropper bottle and its contents.
The bottle must be closed after each use.

Eye drops.

5 ml in a Droptainer™ dropper bottle made of low-density polyethylene.

1 bottle with instructions for use in a cardboard pack.

2 years. Use within 4 weeks after opening the bottle.
Do not use after the expiration date indicated on the package!

At temperatures from 8 to 27°C in a vertical position, out of the reach of children.

according to the recipe.

"s.a. Alkon-Kouvrer n.v.”,
B-2870 Puurs, Belgium.

The owner of registration on the territory of the Russian Federation is Alkon Pharmaceuticals LLC
Address of Alkon Pharmaceuticals LLC and acceptance of claims:
109004, Moscow, st. Nikoloyamskaya, 54

Combined drug with antimicrobial, anti-inflammatory effect. It contains the antibiotic tobramycin and dexamethasone.

Ingredients: dexamethasone 1 mg, tobramycin 3 mg, sodium chloride, tyloxapol, disodium edetate, hydroxyethylcellulose, purified water, sodium hydroxide, sodium sulfate anhydrous, benzalkonium chloride. Available in 5 ml plastic dropper bottles.

Tobramycin - affects the microorganism cell by disrupting polypeptide compounds and the formation of ribosomes.

Dexamethasone - inhibits the adhesion of endothelial cells, cyclooxygenase I, II, cytokines. Reduces the release of mediators responsible for inflammation.

The drug can be taken by children over 8 years old no more than seven days. Dexamethasone, being a glucocorticosteroid, after long-term use reduces immunity. With an increase in the therapeutic dose of tobramycin, it may be difficult to eliminate them by the kidneys. As a result, toxic substances accumulate.

To prevent systemic side effects, after instillation of the product, it is necessary to lightly press with a finger at the inner edge of the eye, where the lacrimal sac is projected. Thus, the medicine is absorbed into the tissues of the eye without entering the bloodstream. Do not use the medicine more than the dose prescribed in the instructions.

During pregnancy, it is prescribed only in severe cases, due to the ability of tobramycin to pass through the placenta barrier. The drug has a toxic effect on the ears and kidneys of the fetus. Dexamethasone disrupts fetal development. The decision on the advisability of prescribing is made by the attending physician, weighing the risk of side effects against the severity of the disease in the pregnant woman. Nursing mothers should stop feeding while taking the drops.

Increased pressure in the eye (glaucoma).
Punctate keratitis.
Eye pain, burning.
Itching of the eyelid, itching of the eyes.
Redness of the eyelids.
Swelling of the eye.

Hypersensitivity (allergic reactions).
Visual impairment.
Redness of the conjunctiva.

Narrowing of the lumen of the larynx (laryngospasm).
Rhinorrhea.

Rare: failure to heal wounds in the eye, secondary infections, due to decreased immunity and activation of opportunistic human microflora.

Contraindications:

Allergy.
Damage caused by the herpes virus (dendritic keratitis).
Viral eye diseases.
Fungal diseases (mycoses).
Tuberculosis of the eyes.
Eye infections with pus.
Up to 8 years in children.

In terms of their effects and composition, they are similar: Floxal, Stilavit, Azelastine, APE, Dilaterol, Tobramycin-Gobbi, Brulamycin, Tobropt, Nebcin, Bramitob, Tobi, Tobracin-ADS.

Drug price: 300-400 rubles.

I recently treated my son’s conjunctivitis with Tobradex. After 3 days have passed. The drug is completely worth its price.
My daughter got a stye. I first tried to cure traditional medicine. I warmed the potatoes and applied them, but it didn’t help. Afterwards, I took her to an ophthalmologist, who prescribed Tobradex. He helped my daughter well.
We also treated his eye with it. Already on the second day it was good result. Tobradex should not be taken for more than 7 days.
The doctor first prescribed us sulfacyl, but it didn’t help. Then the doctor prescribed Tobradex for us, saying that it was stronger. The drug really helped quickly.
My daughter's eye turned red. At first I thought she rubbed it. But he started to get sick and we went to the clinic, where the doctor prescribed Tobradex. The medicine helps very well.

The active components of eye drops are (dosage per 1 ml of medicine):

tobramycin– 3 mg;
dexamethasone– 1 mg.

As excipients that help the active substances exert their pharmaceutical effect in to the fullest, are used:

benzalkonium chloride;
disodium edetate;
sodium chloride;
anhydrous sodium sulfate;
tyloxapol;
hydroxyethylcellulose;
sulfuric acid and/or sodium hydroxide to adjust pH;
purified water up to 5 ml.

In turn eye ointment Tobradex consists of (amount active ingredients based on 1 g of the drug):

tobramycin– 3 mg;
dexamethasone– 1 mg;
anhydrous chlorobutanol;
mineral oil;
white Vaseline.

The pharmaceutical drug is supplied to pharmacy kiosks in two main forms:

Tobradex eye drops in dropper bottles for 5 ml of medication with a special “Drop Tainer” dispenser. The liquid looks like a white or almost white suspension. One bottle fits in a cardboard package.
Tobradex homogeneous eye ointment is white or almost white in aluminum tubes, 3.5 g each. 1 tube is included in a cardboard box.

Tobradex eye drops are a combined pharmaceutical preparation that has antibacterial And anti-inflammatory effects, which are provided thanks to the main components of the drug. This complex of active substances can significantly reduce the risk infections and liquidate the main etiological factorpathologies of the visual apparatus– harmful microorganisms brought to the surface of the eye.

Tobramycin is a substance that has the properties antibiotic, which belongs to the group aminoglycosides and is produced by a colony of streptococci (Streptococcus tenebrarius). Wide range bactericidal action covers such harmful microorganisms as:

Staphylococcus, in particular Staphylococcus aureus and Staphylococcus epidermidis (Staphylococcus aures and Staphylococcus epidermidis), including strains that have developed resistance to penicillin (beta-lactamase produced by such microflora does not affect the strength of the therapeutic effects of the antibiotic);
Hemolytic species streptococci type A and microorganisms of this family that do not possess antigens of aggression towards blood cells, for example, the causative agent of typical lobar pneumonia (Streptococcus pneumonia);
Pseudomonas aeruginosa ( Pseudomonas aeruginosa);
Escherichia coli ( coli);
Klebsiella pneumoniae (Klebsiella pneumonia);
Enterobacter aerogenes (anaerobic enterobacteria);
Proteus mirabilis and Proteus vulgaris ( Proteus mirabilis And Proteus vulgaris);
Morganella morganii (Morganella morganii);
Haemophilus influenzae and Haemophilus aegypticus ( hemophilus influenzae and Koch-Wicks bacterium);
Moraxella lacunata (Morax-Axenfeld stick);
Acinetobacter calcoaceticus;
Neisseria pneumonia ( neisseria pneumonia).

Dexamethasone, another main component of Tobradex ointment, is a steroid of glucocorticoid origin, which has antiallergic, anti-inflammatory And desensitizing effect. Thanks to its chemical structure It also has an anti-exudative effect, suppressing inflammation in the phase of generation of pathological contents.

Systemic absorption is low when the drug is applied topically.

Contraindications

individual hereditary or acquired intolerance, hypersensitivity or idiosyncrasy to the constituent components of a pharmaceutical product;
viral diseases of the visual apparatus (in particular keratitis caused by herpes virus(Herpes simplex), wind or smallpox);
mycobacterial eye infection (caused by of this disease is well known to everyone Koch's wand or Mycobacterium tuberculosa);
conservative treatment after surgical removal foreign body of the cornea;
fungal diseases membranes of the eyeball;
purulent pathology of the eye;
age category of patients up to 1 year.

There are also a number pathological conditions when the pharmaceutical drug should be used with caution, only under the supervision of qualified medical personnel, for example, during inpatient treatment in the ophthalmology department. These diseases include:

glaucoma;
hereditary or acquired thinning of the cornea.

Side effects

Typically, drug therapy takes place without obvious complications, since the main active ingredients are well tolerated by the body, but in in some cases Conservative treatment with Tobradex may result in the following side effects:

allergic reactions – itching, hyperemia or swelling of the eyelids and conjunctiva, swelling of the face, rash, erythema;
promotion intraocular pressure;
sensation of a foreign body in the eye;
decreased visual acuity;
photophobia;
long mydriasis(prolonged pupil dilation);
subcapsular cataract localized in the posterior part;
slowing down reparative and regenerative mechanisms in open wounds;
dizziness And headache;
bitter taste in the mouth;
abundant rhinorrhea;
laryngospasm;
Patients with hereditary or acquired thinning of the sclera may develop it perforation(the risk increases significantly with a long course of treatment);
secondary infection(the content of the glucocorticosteroid Dexamethasone in the drug in combination with the antibiotic component tobramycin leads to weakened immunity against fungal microflora, that is, invasions from this type of microorganisms can develop - typical symptom is the appearance of long-term non-healing ulcers on the cornea).

The instructions for Tobradex eye drops indicate that it is extremely easy to use the pharmaceutical drug for the conservative treatment of diseases of the visual apparatus. Apply 1-2 drops every 4-6 hours, placing the medicine directly into conjunctival sac. In the first 24-48 hours, the dosage can be increased to 1-2 drops with a time interval of only 2 hours for appropriate indications.

The drug in ointment form is somewhat more difficult to use. First of all, due to the unpleasant sensations of a foreign object on eyeball this pharmaceutical form is not so convenient to use. Like drops, eye ointment is applied to conjunctival sac. Before use, you should wash your hands thoroughly so that the antibiotic is not simply used to cleanse them of harmful microflora.

The head is tilted back, after which the lower eyelid is pulled back and about 1.5 cm of ointment is applied. Next, you need to open and close your eyes several times, so that the pharmaceutical drug is evenly distributed in the conjunctival sac. You need to be careful that the tip of the tube does not touch skin, eyelashes or mucous membrane of the eye, as in the case of the hands, medicinal abilities active components will decrease if not followed this rule. After using the ointment, close the tube tightly.

Duration conservative therapy determined by the attending physician; as a rule, a regimen of 3-4 applications per day is used. Between applications of the ointment, a time interval of at least 6 hours should be observed. If a dose is missed, it should be filled as soon as possible, but not less than 1 hour before the next one. You should not increase the amount of Tobradex ointment used on your own, as this may cause an overdose or the appearance of other undesirable consequences treatment.

In case of an overdose of Tobradex, the following symptoms may be observed:

increased side effects;
irritation and hyperemia mucous membrane of the eye;
intense itching;
copious lacrimation And rhinorrhea;
swelling of the eyelids;
increased arterial inflow of the conjunctiva.

A specific pharmaceutical antagonist for the drug Tobradex on at the moment does not exist, therefore in case of drug overdose it is used symptomatic treatment. So for cupping purposes this state the eyes are washed generously with warm water and drug therapy is prescribed for the undesirable consequences of conservative sanitation that appear.

In case complex therapy together with other topical ophthalmic drugs, an interval between the use of drugs should be at least 5-15 minutes, depending on the individual prescriptions of the attending physician.

Before using Tobradex, you should remove contact lenses, so that they do not act as an additional barrier preventing the penetration of active substances. You can put on lenses again no earlier than 15 minutes after introducing the pharmaceutical drug into the conjunctival sac (these time intervals must be observed regardless of the form of the drug).

Tobradex drops can be prescribed against the background systemic treatment aminoglycosides however, in this case it is strongly recommended to constantly monitor the big picture blood, since one of the components of the pharmaceutical drug is Tobramycin, which by its nature belongs to the group of aminoglycoside antibiotics.

During conservative therapy with Tobradex, you should avoid the use of drugs that have side effects such as ototoxic, nephrotoxic And neurotoxic, since potentiation is possible, as a result of which there is an increase in the adverse effects of treatment.

The drug is not sold freely at pharmacy kiosks; it can only be purchased upon presentation of the appropriate prescription form certified by the attending physician.

The drug should be kept out of the reach of children younger age place, always in a vertical position and with temperature conditions from 8 to 27 degrees Celsius.

2 years for sealed carton packaging. After opening the bottle or tube – 4 weeks.

Before each use of the drug, the container with the suspension should be shaken so that the components do not stagnate at the bottom under the influence of gravity. And after that, it is necessary to close the bottle tightly so that Tobradex does not erode.

You should not touch the tip of the dispenser to your eye, first of all, because this may cause discomfort. It is also not recommended to do this due to the reflex closure of the eyelids; this reduces the effectiveness of the active components of the drug, creating additional barriers to passage and increasing the duration of the therapeutic manipulation.

After using the drug Tobradex it is possible temporary blurred vision, therefore, you should not drive a car or other potentially dangerous mechanisms until your ability to see is fully restored. The exact period for the restoration of visual abilities should be obtained from your doctor or qualified pharmacist.

Tobradex – combination drug, which to a certain extent is unique, since its composition simultaneously contains such components as a strong antibiotic of the aminoglycoside group and a steroid of glucocorticoid origin, which is not found in every drug. Auxiliary components allow the use of Tobradex with minimum quantity side effects from treatment of diseases of the visual apparatus and even in pediatric practice after 1 year. That’s why analogues of drops are so few. Similar pharmacological action has the following range of drugs: Tobrex, DexaTobropt, Betagenot, Garazon, Dexon.

Among these drugs, special mention should be made Tobrex. It is most often used as a competing drug in the conservative course of treatment of ophthalmic problems, because it contains the same aminoglycoside antibiotic ( tobramycin) and is supplied to pharmacies in the form of eye drops. So what is better to use Tobrex or Tobradex and is it possible to independently replace their therapeutic effects with each other?

The answer to this question lies in the constituent components of pharmaceutical drugs. Tobradex, in addition tobramycin, contains such biologically active substance, How dexamethasone- a steroidal glucocorticoid that has the widest spectrum therapeutic effects. Thanks to this highlight, Tobramycin acts as an antiallergic, desensitizing and anti-inflammatory agent. These properties allow us to confidently give priority in the treatment of eye diseases of infectious etiology to Tobradex.

Dexamethasone + Tobramycin.

Medicine used in pediatric hospitals once the child reaches 1 year of age.

The drug is not recommended for use during pregnancy and during breastfeeding . When treating women childbearing age Before conservative treatment, pregnancy should initially be excluded.

Tobradex enjoys a positive reputation on pharmaceutical forums. Its therapeutic effect is described as favorable by most people who have used it. The drug allows you to restore full vision, get rid of unpleasant and disability-limiting pathology in a relatively short period drug therapy, which, undoubtedly, cannot but serve as a point in favor of the drug.

Also, reviews of Tobradex note that manifestations of undesirable consequences of conservative treatment are observed quite rarely, since the constituent components of the drug are specially selected after long-term clinical studies in such a way that even when exposed to such a sensitive area as the surface of the eye, they cause a minimum of side effects.

Separately, it should be said about Tobradex for children, because in this age category they often occur diseases of the visual apparatus of infectious etiology. Children without hesitation rub their eyes in conditions that are teeming with harmful microorganisms, and Tobradex acts as a kind of magic elixir for mothers. Even in young organisms that are not yet sufficiently strong, the drug practically does not cause side effects, based on pharmaceutical forums. This is facilitated by the anti-allergenic effect of Dexamethasone, which is one of the main active ingredients of the pharmaceutical drug.

The price of Tobradex drops on the pharmaceutical market of the Russian Federation is 140-150 rubles, and the ointment can be purchased for 250-260 rubles.

The price of Tobradex eye drops in Ukraine is somewhat lower; in pharmacy kiosks it ranges from 40 to 70 hryvnia, the cost of ointment is about 50 hryvnia.

Tobradex drops 5 ml Alkon-Kuvrer N.V. S.A.

Tobradex eye drops 5ml dropper bottleAlcon-Couvreur

TobradexAlcon-Couvreur, Belgium

TobradexAlcon-Couvreur (Belgium)

Tobradex eye drops 5ml Alkon-Kovreur (Belgium)

Tobradex h/c 5ml

Tobradex 5 ml eye drops.

Tobradex 3.5 g eye ointment.