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Overview: Tobramycin is an injectable antibiotic that is used to treat certain serious bacterial infections. Serious side effects may include hearing loss, nerve damage, kidney damage, skin reactions, and a type of diarrhea that is difficult to treat. Call your health care provider right away if you get a rash, feel dizzy or off balance, have ringing in your ears or tingling or numbness in your skin, or get watery or bloody diarrhea even up to two months after stopping this medicine. 

Uses

What is tobramycin used for?

Tobramycin is an antibiotic that is commonly used for the following serious infections caused by certain bacteria.

Tobramycin may also be used for other conditions as determined by your health care provider.

Tobramycin may not be the right drug for some of the infections listed above, depending on which germs are causing the infection. Bacteria in some locations may have developed resistance to tobramycin, which will make it not work as well.

Other forms of tobramycin are available. See Tobramycin inhaled and Tobramycin ophthalmic for more information.

How does tobramycin work (mechanism of action)?

Tobramycin kills certain types of bacteria by preventing them from making proteins.

How is tobramycin supplied (dosage forms)?

Brands and other names

  • Nebcin

Dosage forms and strengths

Tobramycin is available in an injectable form that is given by a health care provider.

How should I store tobramycin?

Tobramycin is usually given by a health care provider in a hospital or clinic. If you will store tobramycin at home, follow the instructions given by your health care provider.

Side Effects

What are the most common side effects of tobramycin?

The most common side effects of tobramycin are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Hearing loss (see below)
  • Kidney damage (see below)

There may be other side effects of tobramycin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of tobramycin?

While less common, the most serious side effects of tobramycin are described below, along with what to do if they happen.

Severe Allergic Reactions. Tobramycin may cause allergic reactions, which can be serious. The risk of allergic reactions may be higher if you are allergic to sulfites or have certain medical conditions, such as asthma. Stop using tobramycin and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Hearing Loss. Tobramycin may be linked to hearing loss, which is also called ototoxicity. The risk of hearing loss is higher if tobramycin is used for longer periods of time or at higher doses. The risk is also higher in people with kidney problems. You may be at higher risk of hearing loss if your mother has a history of hearing loss with tobramycin or any similar medicines. Hearing loss may be permanent. Tell your health care provider right away if you have hearing loss, get dizzy, feel off balance, or hear a ringing or roaring sound.

Nerve Damage. Damage to nerves can happen in people who are using tobramycin. The risk of nerve damage is higher if tobramycin is used for longer periods of time or at higher doses. The risk is also higher in people with kidney problems. Nerve damage can also cause muscle-related symptoms such as muscle twitching, paralysis, or breathing problems. Tell your health care provider if you have seizures or symptoms of nerve damage, such as tingling or numbness. 

Kidney Damage. Kidney damage can happen when using tobramycin. The risk of kidney damage is higher if tobramycin is used for longer periods of time or at higher doses. The risk is also higher in people with existing kidney problems. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • A hard time catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Antibiotic-associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or “C. diff,” can happen in your gut with many types of antibiotics, including tobramycin. This can cause a condition known as antibiotic-associated diarrhea and can happen even two months or more after stopping the antibiotic. Call your health care provider right away if you have any of the following symptoms of this condition.

  • Watery diarrhea
  • Diarrhea that does not go away
  • Blood in your stool (poop)
  • Severe stomach cramps
  • Fever that starts after you start or finish the medicine

Severe Skin Reactions. Tobramycin can cause severe skin reactions, called Stevens-Johnson syndrome (SJS), erythema multiforme, and toxic epidermal necrolysis (TEN), that can lead to death if not treated. If you get a rash, stop tobramycin and call your health care provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Warnings & Precautions

Who should not use tobramycin?

Allergies to Ingredients. People who are allergic to any of the following should not use tobramycin.

  • Tobramycin
  • Nebcin
  • Any other medicine known as an aminoglycoside
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific tobramycin products they stock.

What should I know about tobramycin before using it?

Tobramycin is usually given by a health care provider in a hospital or clinic. Do not use tobramycin unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share tobramycin with other people, even if they have the same condition as you. It may harm them.

Tobramycin only treats certain infections caused by bacteria. It will not work for infections caused by viruses, such as the common cold, the flu, or coronavirus. It also will not work for any other infections that are not caused by bacteria. Using tobramycin, or any other antibiotic, when it is not needed may cause the antibiotic to not work for bacterial infections in the future.

People who are 65 or older can have a greater risk of some tobramycin side effects. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using tobramycin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if tobramycin is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Tobramycin may interact with other medicines and supplements. Before using tobramycin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Family History. Certain things about your genes can increase your chance of hearing loss while taking tobramycin. For example, if your mother had hearing problems from tobramycin, or a similar medicine, you may be at higher risk of this side effect. Tell your health care provider about any family history of side effects of this type of antibiotic that you know about.

Pregnancy. Tobramycin may harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use tobramycin while you are pregnant or trying to get pregnant.

Breastfeeding. Tobramycin passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use tobramycin while breastfeeding. If you breastfeed while using tobramycin, monitor your baby for diarrhea or poop with blood in it. If you notice either of these things, tell your health care provider right away.

Interactions

Does tobramycin interact with foods or drinks?

There are no known interactions between tobramycin and foods or drinks.

It is unknown if drinking alcohol will affect tobramycin, but heavy drinking can slow your immune response and make it harder for your body to fight infection. 

Does tobramycin interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using tobramycin.

  • A nonsteroidal anti-inflammatory drug (NSAID), such as aspirin, ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
  • An aminoglycoside antibiotic, such as amikacin, gentamicin, or neomycin, which is a medicine to treat infections
  • A diuretic (also called a water pill), such as ethacrynic acid or furosemide, which is a medicine used to reduce edema (fluid retention) and blood pressure

This may not be a complete list of medicines that can interact with tobramycin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much tobramycin?

If you or someone else has used too much tobramycin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of tobramycin?

It is important to complete your prescribed course of tobramycin, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to tobramycin or other similar medicines.

Tobramycin is usually given by a health care provider in a hospital. Your health care provider will make sure you are receiving tobramycin as scheduled. If you miss an appointment to get your tobramycin dose, call to make another appointment as soon as possible.