Tobradex eye drops 5ml

Eye drops Tobradex instruction for use

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Composition

Active components of eye drops are (dosage based on 1 ml of the drug):
    tobramycin - 3 mg;
    dexamethasone - 1 mg.
As auxiliary substances that help active substances to render their pharmaceutical effect to the full, the following are used:
    benzalkonium chloride;
    edetate disodium;
    sodium chloride;
    anhydrous sodium sulfate;
    tyloxapol;
    hydroxyethyl cellulose;
    sulfuric acid and / or sodium hydroxide until the pH is adjusted;
    purified water up to 5 ml.
In turn, ophthalmic ointment Tobradex consists of (the number of active components per 1 g of the drug):
    tobramycin - 3 mg;
    dexamethasone - 1 mg;
    anhydrous chlorobutanol;
    mineral oil;
    white petrolatum.

Form of issue

Pharmaceutical preparation in pharmacy kiosks is supplied in two main types:
    Tobradex eye drops in bottles-droppers, designed for 5 ml of the drug with a special dispenser "Drop Tainer" ("Drop Teiner"). The liquid looks like a suspension of white or almost white color. One bottle is placed in a carton.
    Homogenous ophthalmic ointment Tobradex white or almost white in aluminum tubes, 3.5 g each. A cardboard bundle contains 1 tube.

Pharmacological action

Eye drops Tobradex is a combined pharmaceutical preparation with antibacterial and anti-inflammatory effects, which are provided by the main constituent components of the drug. Such a complex of active substances can significantly reduce the risk of infection and eliminate the main etiological factor of the pathology of the visual apparatus - harmful microorganisms, brought to the surface of the eye.
Tobramycin is a substance possessing the properties of an antibiotic that belongs to the aminoglycoside group and is produced by a streptococcus colony (Streptococcus tenebrarius). A wide range of bactericidal effects covers such harmful microorganisms as:
    Staphylococci, in particular, golden and epidermal staphylococcus aureus (Staphylococcus aures and Staphylococcus epidermidis), including strains that have developed resistance to penicillin (beta-lactamase produced by such a microflora does not affect the strength of the therapeutic effects of the antibiotic);
    Hemolytic types of streptococcus type A and microorganisms of this family that do not possess antigens of aggression to blood cells, for example, the causative agent of typical croupous pneumonia (Streptococcus pneumonia);
    Pseudomonas aeruginosa (Pseudomonas aeruginosa);
    Escherichia coli (E. coli);
    Klebsiella pneumoniae (Klebsiella pneumonia);
    Enterobacter aerogenes (enterobacteria anaerobic);
    Proteus mirabilis and Proteus vulgaris (proteus mirabilis and proteus vulgaris);
    Morganella morganii (morganella morganii);
    Haemophilus influenzae and Haemophilus aegypticus (Haemophilus influenzae and Koch-Weeks bacterium);
    Moraxella lacunata (a stick of Morax-Axenfeld);
    Acinetobacter calcoaceticus;
    Neisseria pneumonia (Neisseria pneumonia).
Dexamethasone, another major constituent of Tobradex ointment, is a steroid of glucocorticoid origin, which has anti-allergic, anti-inflammatory and desensitizing effects. Due to its chemical structure it also has an antiexudative effect, suppressing inflammation in the phase of generation of pathological contents.

Pharmacodynamics and pharmacokinetics

Systemic absorption is low with topical application of the drug.

Indications for use

    prevention of infections in post-operative care (for example, after removal of cataracts or foreign body);
    bacterial infection of the eye apparatus;
    blepharitis - inflammation of the upper or lower eyelid;
    conjunctivitis - inflammation of the conjunctiva of the eye;
    keratitis without damage to the epithelium - pathology of the cornea of ​​the eyeball;
    viral keratitis caused by a pathogen such as Herpes zoster;
    treatment and preventive therapy in traumatological lesions of the eyes.

Contraindications

    individual hereditary or acquired intolerance, hypersensitivity or idiosyncrasy to the constituent components of the pharmaceutical preparation;
    viral diseases of the visual apparatus (in particular keratitis caused by the herpes simplex virus, chickenpox or natural smallpox);
    mycobacterial infection of the eyes (the causative agent of this disease is the known Koch or Micobacterium tuberculosa);
    conservative treatment after surgical removal of the foreign body of the cornea;
    fungal diseases of the shells of the eyeball;
    purulent pathology of the eye;
    age category of patients up to 1 year.
There are also a number of pathological conditions when the pharmaceutical preparation should be used with caution, only under the supervision of qualified medical personnel, for example, in hospital treatment in the ophthalmology department. These diseases include:
    glaucoma;
    hereditary or acquired thinning of the cornea.

Side effects

Usually, drug therapy passes without obvious complications, since the main active components are well tolerated by the body, however, in some cases of conservative treatment with Tobrаdex, the following side effects can occur:
    allergic reactions - itching, flushing or swelling of the eyelids and conjunctiva, face swelling, rash, erythema;
    increased intraocular pressure;
    foreign body sensation in the eye;
    decreased visual acuity;
    photophobia;
    prolonged mydriasis (prolonged dilatation of the pupil);
    subcapsular cataract located in the posterior part;
    slowing of 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 perforation (the risk increases significantly with a long course of treatment);
    secondary infection (the content of dexamethasone glucocorticoid in the drug in combination with the antibiotic component tobramycin leads to a weakened immunity to the fungal microflora, that is, infestations from this type of microorganisms may develop - a typical symptom is the appearance of long-term non-healing ulcers on the cornea).

Tobradex, instructions for use (Method and dosage)

Instruction for eye drops Tobradex indicates that it is extremely easy to use a pharmaceutical preparation for conservative therapy of diseases of the visual apparatus. Use 1-2 drops every 4 to 6 hours, placing the drug directly into the 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 with appropriate indications.
The preparation in the form of ointment is somewhat more difficult to apply. First of all, because of the unpleasant sensations of a foreign object on the eyeball, such a pharmaceutical form is not so convenient to use. Like drops, eye ointment is introduced into the conjunctival sac. Before use, you should thoroughly wash your hands, so that the antibiotic is not simply wasted on their cleansing from harmful microflora.
The head is deflected back, then the lower eyelid is pulled back and about 1.5 cm of ointment is introduced. Next, you need to open and close your eyes several times, so that the pharmaceutical product is evenly distributed in the conjunctival sac. It should be ensured that the tip of the tube does not touch the skin, eyelashes or mucous membranes of the eye, as in the case of the hands, the medicinal properties of the active components will decrease if this rule is not observed. After using the ointment, the tube is closed tightly.
The duration of conservative therapy is determined by the attending physician, as a rule, a scheme of 3-4 applications per day is applied. Between the application of the ointment should be observed a time interval of at least 6 hours. In case of missed dose, it is replenished as soon as possible, but not less than 1 hour before the next. Do not independently increase the amount of Tevendex used, as this may cause an overdose or other undesirable effects of the treatment.

Overdose

In case of an overdose with Tobradex, the following symptoms may occur:
    increased side effects;
    irritation and hyperemia of the mucous membrane of the eye;
    intense itching;
    abundant lacrimation and rhinorrhea;
    swelling of the eyelids;
    an increase in arterial inflow of the conjunctiva.
There is no specific pharmaceutical antagonist for the drug Tobradex at the moment, therefore, when an overdose of a drug is used, symptomatic treatment is used. So, in order to stop this condition, the eyes are abundantly washed with warm water and medications are prescribed for the undesirable consequences of conservative sanation.

Interaction

In the case of complex therapy together with other topical ophthalmic drugs, a gap of at least 5-15 minutes between use of medications should be made, depending on the individual prescriptions of the attending physician.
Before using Tobradex, contact lenses should be removed so that they do not act as an additional barrier preventing penetration of active substances. New lenses can be worn no earlier than 15 minutes after the introduction of the pharmaceutical into the conjunctival sac (these time intervals should be observed regardless of the form of the drug).
Tobradex drops can be administered against a background of systemic treatment with aminoglycosides, however, in this case it is strongly recommended that the overall blood picture is constantly monitored, as one of the constituents of the pharmaceutical preparation is Tobramycin, which by its nature belongs to the group of aminoglycoside antibiotics.
During conservative therapy, Tobradex should avoid the use of medications that have side effects such as ototoxic, nephrotoxic and neurotoxic, since potentiation is possible, thereby increasing the adverse effects of treatment.

Storage conditions

The drug should be stored in a place inaccessible to young children, always in a vertical position and with a temperature regime of 8 to 27 degrees Celsius.
Shelf life - 2 years for sealed cardboard packaging. After autopsies of a vial or a tube - 4 weeks.

special instructions

Before each use of the drug, the container with the suspension should be shaken, so that the constituent components do not stagnate at the bottom under the action of gravity. And after - it is necessary to close the bottle tightly so that Tobradex does not erode.
Do not touch the tip of the dispenser to the eye, first of all, because this can cause unpleasant sensations. Also, this is not recommended because of 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 therapeutic manipulation.
After using the drug Tobradex, temporary blurriness of vision is possible, therefore, one should not drive a car or other potentially dangerous mechanisms until the opportunity to see completely recover. The exact period of resumption of visual abilities should be consulted by your doctor or a qualified pharmacist.

Analogues

Tobradex is a combined preparation that is unique to a certain extent, since it 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. The auxiliary constituents make it possible to use Tobradex with a minimum of side effects from the treatment of the disease of the visual apparatus and even in pediatric practice after 1 year. Because analogues of drops are so few. Similar pharmacological action has the following series of drugs: Tobrex, DexaTobropt, Betagenot, Garazon, Dexon.
Among these medicines, Tobrex should be highlighted. It is most often used as a competing drug in a conservative course of treating ophthalmic problems, because in its composition it has the same aminoglycoside antibiotic (tobramycin) and is supplied to pharmacy kiosks in the form of eye drops. So what's the best way to use Tobrex or Tobradex and can you independently replace their therapeutic effects with each other?
The answer to this question lies in the constituent components of pharmaceuticals. Tobradex, in addition to tobramycin, contains a biologically active substance, such as dexamethasone - a steroid glucocorticoid, which has a wide range of therapeutic effects. Due to this zest, Tobramycin acts as an antiallergic, desensitizing and anti-inflammatory agent. These properties allow you to bravely give priority in the treatment of eye diseases infectious etiology Tobradex.

Children

The drug is used in pediatric hospitals when the child reaches 1 year.

In pregnancy and lactation

The drug is not recommended for use during pregnancy and during breastfeeding. In the treatment of women of childbearing age, pregnancy should be excluded first of all before conservative treatment.

Reviews about drops

Tobradex enjoys a positive reputation in pharmaceutical forums. Its therapeutic effect by the majority of people who used it is described as favorable. The drug allows you to restore the full scope of vision, get rid of the unpleasant sensations and work-limiting pathology in a relatively short period of drug therapy, which, undoubtedly, can not help but serve as a point in favor of the drug.
Also, comments on Tobradex indicate that the manifestations of undesirable consequences of conservative treatment are rare, since the constituent components of the drug are specially selected after long-term clinical studies in such a way that even a sensitive area such as the surface of the eye can cause a minimum of side effects.
Separately, it should be said about Tobradex for children, because in this age group often there are diseases of the visual apparatus of infectious etiology. Children do not hesitate to rub their eyes in conditions that swarm with harmful microorganisms, and Tobradex acts as a kind of magic elixir for moms. Even in young, not yet sufficiently strong young organisms, the drug practically does not cause side effects, proceeding from pharmaceutical forums. This is promoted by the anti-allergenic effect of Dexamethasone, which is one of the main active substances of the pharmaceutical preparation.