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Overview: Tobramycin/dexamethasone is used for eye infections and inflammation caused by certain bacteria. It combines an antibiotic, tobramycin, to stop bacterial growth, and a steroid, dexamethasone, to relieve swelling. Common side effects include eye or eyelid irritation. Serious side effects are rare, but may include severe allergic reactions and infections with other germs. It comes as an eye drop and an eye ointment. Contact your healthcare provider if your eye condition does not improve with use.

Uses

What is tobramycin/dexamethasone used for?

Tobramycin/dexamethasone is commonly used for eye infections caused by certain bacteria, and to help relieve eye inflammation and swelling from the infection. 

Tobramycin/dexamethasone may not be appropriate for some eye infections, depending on which germs are causing the infection. Some bacteria may have developed resistance to tobramycin, which will make it less effective.

Tobramycin/dexamethasone may also be used for other conditions as determined by your healthcare provider.

How does tobramycin/dexamethasone work (mechanism of action)?

This medicine combines two active ingredients: tobramycin, which is an antibiotic, and dexamethasone, which is a steroid. Tobramycin works by stopping certain bacteria from making proteins they need to grow. Dexamethasone works by calming (suppressing) the immune system to reduce swelling and inflammation.

How is tobramycin/dexamethasone supplied (dosage forms)?

Brands and other names

  • TobraDex
  • TobraDex ST

Dosage forms and strengths

  • 0.3%/0.1% ophthalmic ointment
  • 0.3%/0.05% ophthalmic suspension (eye drops)
  • 0.3%/0.1% ophthalmic suspension (eye drops)

How should I store tobramycin/dexamethasone?

Tobramycin/dexamethasone should be stored at room temperature, between 46 F to 77 F (8 C to 25 C). 

Some products may be able to be stored at slightly lower or higher temperatures. Some products may need to be protected from light. Follow any specific storage instructions that come with your tobramycin/dexamethasone. Ask your pharmacist if you have any questions about how to store it. 

Side Effects

What are the most common side effects of tobramycin/dexamethasone?

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

  • Allergic reactions (see below)
  • Eye irritation or redness
  • Eyelid itching or swelling

There may be other side effects of tobramycin/dexamethasone that are not listed here. Contact your healthcare 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. 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/dexamethasone?

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

Severe Allergic Reactions. Tobramycin/dexamethasone may cause allergic reactions, which can be serious. Stop using tobramycin/dexamethasone 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, blisters, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Another Infection. Using tobramycin/dexamethasone may lead to an infection with other types of germs, such as fungi. Do not use it for longer than prescribed. Call your healthcare provider if your eye infection does not improve or if the following symptoms of an eye infection come back or get worse.

  • Pink or itchy eye
  • Blurry vision
  • Eye discharge or crusting
  • Swollen eyelids
  • Fever

Severe Eye Problems With Prolonged Use. Using tobramycin/dexamethasone for a long time (ten days or more) may cause increased pressure in the eye, which can lead to nerve damage and gradual vision loss (glaucoma). Prolonged use may cause other severe eye problems, including vision changes, cataracts, or a hole (perforation) in part of the eye. Follow your healthcare provider’s instructions carefully and keep all appointments to have your eyes checked. Do not use tobramycin/dexamethasone for longer than prescribed. Tell your healthcare provider right away if you have any eye pain or vision changes, or if your eye condition does not improve after two days. 

Warnings & Precautions

Who should not use tobramycin/dexamethasone?

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

  • Tobramycin
  • Dexamethasone
  • TobraDex
  • TobraDex ST
  • Any of the ingredients in the specific product dispensed

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

Certain Types of Infections. People with the following types of infections should not use tobramycin/dexamethasone, as it could make these infections worse.

  • Herpes simplex keratitis, which is an eye infection caused by herpes simplex virus
  • Most types of active viral infections of the eye, such as those caused by chickenpox (varicella) or poxvirus (vaccinia)
  • Mycobacterial infections of the eye, such as an infection from tuberculosis 
  • Fungal infection of the eye

What should I know about tobramycin/dexamethasone before using it?

Do not use tobramycin/dexamethasone unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

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

Keep tobramycin/dexamethasone out of the reach of children.

Follow the instructions that come with your prescription, so you know how to use your tobramycin/dexamethasone product properly. Be careful not to let the tip touch your eye, fingers, or any other surfaces. Wash your hands before and after use. Tell your healthcare provider if your eye infection gets worse, does not improve, or if you have new eye problems, eye pain, or vision changes.

Do not wear contact lenses during treatment with tobramycin/dexamethasone.

Before each use of tobramycin/dexamethasone eye drops, shake the bottle well.

You may experience temporary blurred vision after using tobramycin/dexamethasone. Do not drive or do other activities that require clear vision until you know how tobramycin/dexamethasone affects you.

What should I tell my healthcare provider before using tobramycin/dexamethasone?

Tell your healthcare 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 determine if tobramycin/dexamethasone is right for you.

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

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

  • Glaucoma
  • A condition that causes thinning of the outer layer (cornea) or white of your eye

Planned Eye Surgery. Using tobramycin/dexamethasone may raise the risk of eye problems after cataract surgery. Tell your healthcare provider if you are planning to have eye surgery. 

Aminoglycoside Allergy. Some people who have had a past allergic reaction to an aminoglycoside medicine, such as amikacin or gentamicin, may also be sensitive to medicines that contain tobramycin. Tell your healthcare provider if you have any allergies to medicines. Your healthcare provider can help you decide if it is safe for you to use tobramycin/dexamethasone.

Pregnancy. It is not known if or how tobramycin/dexamethasone could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if tobramycin/dexamethasone passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use tobramycin/dexamethasone while breastfeeding.

Interactions

Does tobramycin/dexamethasone interact with foods or drinks?

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

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

Does tobramycin/dexamethasone interact with other medicines (drug interactions)?

There are no known interactions between tobramycin/dexamethasone and other medicines. Always tell your healthcare provider about any prescription or OTC medicines, vitamins/minerals, herbal products, and other supplements you are using.

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/dexamethasone?

If you or someone else has used too much tobramycin/dexamethasone, 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/dexamethasone?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.

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