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tobramycin

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Brand names: Tobi, Nebcin

Aminoglycoside Antibiotic Rx

Tobramycin is an antibiotic medicine. It fights serious bacterial infections in your body.

Drug Shortage Alert

tobramycin is currently listed as to be discontinued by the FDA. Affected manufacturer: Teva Pharmaceuticals USA, Inc..

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Drug Pricing (NADAC)

Generic Price

$1.01/unit

Generic Available

Yes (30 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Tobramycin treats serious infections caused by bacteria.

Common side effects

Nausea, Vomiting, Diarrhea

Key warnings

Tobramycin can potentially damage your hearing and kidneys.

How It Works

Tobramycin belongs to a class of drugs called aminoglycoside antibiotics. It works by stopping the growth of bacteria. This helps your body fight off the infection.

How to Take It

Tobramycin is given as an injection into a muscle or vein. The usual dose for adults with serious infections is 3 mg/kg per day, divided into 3 equal doses every 8 hours. For life-threatening infections, the dose may be increased to 5 mg/kg per day, divided into 3 or 4 equal doses. Your doctor will adjust the dose based on your weight and kidney function.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or breastfeeding. Tobramycin may harm your unborn baby. It is not known if tobramycin passes into breast milk.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store tobramycin at room temperature between 68° to 77°F (20° to 25°C).

Side Effects (from patient reports)

Based on 13,276 FDA adverse event reports.

Off Label Use
1,939
Death
1,666
Infective Pulmonary Exacerbation Of Cystic Fibrosis
1,559
Pneumonia
1,450
Dyspnoea
1,373
Cystic Fibrosis
1,263
Cough
1,256
Hospitalisation
996
Condition Aggravated
942
Infection
832

FDA Adverse Event Report Analysis

Detailed analysis of 23,287 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2002–2025.

Total Reports

23,287

Death-Related Reports

2,764

Hospitalization Reports

11,066

Top Indication

Cystic Fibrosis

Gender Distribution

Female 11,537 (55%)
Male 9,512 (45%)

Age Distribution

0–17 3,320
18–44 4,990
45–64 2,354
65–74 1,528
75+ 1,279

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 OFF LABEL USE 1,939
2 DEATH 1,667
3 INFECTIVE PULMONARY EXACERBATION OF CYSTIC FIBROSIS 1,559
4 PNEUMONIA 1,453
5 DYSPNOEA 1,373
6 CYSTIC FIBROSIS 1,263
7 COUGH 1,257
8 HOSPITALISATION 996
9 CONDITION AGGRAVATED 942
10 INFECTION 832
11 DRUG INEFFECTIVE 818
12 ACUTE KIDNEY INJURY 721
13 MALAISE 675
14 PYREXIA 672
15 FATIGUE 608

Reactions in Death Reports

DEATH 1,661
OFF LABEL USE 217
DRUG INEFFECTIVE 160
RESPIRATORY FAILURE 155
PNEUMONIA 126
RENAL FAILURE 111
CYSTIC FIBROSIS 95
DYSPNOEA 85
PYREXIA 80
MULTIPLE ORGAN DYSFUNCTION SYNDROME 75

Reactions in Hospitalization Reports

INFECTIVE PULMONARY EXACERBATION OF CYSTIC FIBROSIS 1,310
PNEUMONIA 1,202
CYSTIC FIBROSIS 1,016
HOSPITALISATION 938
DYSPNOEA 801
OFF LABEL USE 743
CONDITION AGGRAVATED 607
INFECTION 550
COUGH 511
PYREXIA 487

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Tobramycin can potentially damage your hearing and kidneys. Tell your doctor if you have kidney problems or hearing loss before starting this medicine. Your doctor will monitor your kidney and hearing function during treatment. Report any dizziness, ringing in the ears, or changes in hearing or kidney function to your doctor right away.

Known Drug Interactions

Nephrotoxic agents Concomitant administration of cidofovir injection and agents with nephrotoxic potential [e.g., intravenous aminoglycosides (e.g., tobramycin, gentamicin, and amikacin), amphotericin B, foscarnet, intravenous pentamidine, vancomycin, and nonsteroidal anti-inflammatory agents] is contraindicated.

Mechanism: Both drugs have the potential to damage your kidneys. Taking them together adds to this risk and can lead to kidney failure.

What to do: Do not use these drugs at the same time. Your doctor must choose a different therapy.

7 DRUG INTERACTIONS • ZOSYN administration can significantly reduce tobramycin concentrations in hemodialysis patients. Monitor tobramycin concentrations in these patients. In vivo inactivation : When aminoglycosides are administered in conjunction with piperacillin to patients with end-stage renal disease requiring hemodialysis, the concentrations of the aminoglycosides (especially tobramycin) may be significantly reduced and should be monitored.

Mechanism: In patients on dialysis, piperacillin can chemically deactivate tobramycin in the blood, making the antibiotic less effective.

What to do: If you are on dialysis, your doctor should monitor your tobramycin blood levels to make sure the dose is still working.

Common Questions

What should I tell my doctor before taking tobramycin?
Tell your doctor if you are allergic to any aminoglycoside antibiotics, have kidney problems, hearing loss, or are pregnant or breastfeeding.
How long will I need to take tobramycin?
The usual treatment lasts 7 to 10 days. Your doctor may extend the treatment if you have a difficult infection.
Can tobramycin interact with other medications?
Yes, tobramycin can interact with other medicines that can harm your kidneys or hearing. Tell your doctor about all the medicines you take.
What tests will be done while I am taking tobramycin?
Your doctor will check your kidney function, hearing, and tobramycin levels in your blood.
What are the signs of kidney problems?
Signs of kidney problems include decreased urination, swelling in your ankles or feet, and fatigue.
What are the signs of hearing problems?
Signs of hearing problems include dizziness, ringing in your ears, and hearing loss.
Can tobramycin cause nerve damage?
Yes, tobramycin can rarely cause nerve damage, leading to numbness, tingling, muscle twitching, or seizures.
What if I have cystic fibrosis?
If you have cystic fibrosis, your doctor will closely monitor your tobramycin levels because you may need a higher dose.
Can tobramycin cause allergic reactions?
Yes, tobramycin can cause allergic reactions, including rash, itching, and hives. Seek medical attention if you have an allergic reaction.
When should I call my doctor?
Call your doctor if you experience any serious side effects, such as changes in hearing or kidney function, or signs of an allergic reaction.
What are the common side effects of tobramycin?
The most commonly reported side effects of tobramycin include Nausea, Vomiting, Diarrhea, Headache, Lethargy. Based on 13,276 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does tobramycin interact with other medications?
Yes, tobramycin has 2 known drug interactions. Notable interactions include cidofovir, piperacillin/tazobactam. Always inform your doctor about all medications you are taking.
What drug class is tobramycin?
tobramycin belongs to the Aminoglycoside Antibiotic drug class. It requires a prescription (Rx). Tobramycin treats serious infections caused by bacteria.
Is tobramycin safe during pregnancy?
Tell your doctor if you are pregnant or breastfeeding. Tobramycin may harm your unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has tobramycin been recalled?
There are 4 recalls associated with tobramycin products. CGMP Deviations: Firm went out of business and could no longer continue stability studies. Check the recalls section below for full details and affected products.
Is tobramycin currently in shortage?
Yes, tobramycin is currently listed as to be discontinued by the FDA. Affected manufacturer: Teva Pharmaceuticals USA, Inc.. Visit the FDA Drug Shortages database for the latest updates.

Active Recalls

Class II April 26, 2023

CGMP Deviations: Firm went out of business and could no longer continue stability studies.

Akorn, Inc.

Class II April 26, 2023

CGMP Deviations: Firm went out of business and could no longer continue stability studies.

Akorn, Inc.

Class II October 13, 2022

CGMP Deviations:

Akorn, Inc.

Class II October 13, 2022

CGMP Deviations:

Akorn, Inc.

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Medication Guides

Related Health & Safety Data

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What the FDA Data Shows for tobramycin

The FDA label for tobramycin (sold under brand names such as Tobi, Nebcin) classifies it as a prescription-only medication in the Aminoglycoside Antibiotic class. Tobramycin treats serious infections caused by bacteria. Official labeling lists 11 commonly reported side effects, including Nausea, Vomiting, Diarrhea.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 13,276 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $1.01.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 4 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: February 27, 2023

All federal data sources used on this page