Proper Use

Drug information provided by: Micromedex

Use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

Keep using this medicine for the full treatment time, even if you or your child feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Tobramycin usually comes with patient instructions. Read them carefully before using this medicine. Ask your doctor if you have any questions.

If you are using the inhalation solution:

  • Tobramycin inhalation solution is packaged in small plastic containers called ampules. Each ampule contains one full dose of tobramycin. Do not use an ampule that has already been opened. Also, do not use an ampule of this medicine after the expiration date printed on the package.
  • Tobramycin is especially formulated to be used with a PARI LC PLUS™ nebulizer. Tobi® is used together with a DeVilbiss® Pulmo-Aide® compressor, while Bethkis® is used together with a PARI Vios air compressor. An air compressor is used with a nebulizer to turn the medicine into a fine spray. You will breathe the spray in through your mouth and to your lungs.
  • Use the mouthpiece of the nebulizer to breathe in Bethkis®.
  • You will need to use the nebulizer for about 10 to 15 minutes, or until the medicine in the nebulizer cup is gone. You may hear a sputtering sound when the cup is empty.
  • Clean all the parts of the nebulizer after each use.
  • You may want to rinse your mouth or suck on hard candy if Tobi® inhalation solution leaves a bad taste in your mouth.

If you are using the inhalation capsule:

  • Do not swallow the inhalation capsules.
  • This medicine is especially formulated to be used with the Podhaler™ device.
  • Store the capsules in the blister pack until you are ready to use them.
  • Always use a new Podhaler™ device every 7 days.
  • To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece in your mouth with the device upright.
  • Breathe in slowly and deeply.
  • Hold your breath for about 5 seconds, then breathe out slowly.
  • Check if the capsule is empty after inhaling. If some powder remains in the capsule, repeat inhalation until the capsule is empty.
  • Wipe the mouthpiece with a clean, dry cloth. Make sure that the Podhaler™ stays dry at all times to work the right way.

If you are taking any other medicines for cystic fibrosis, keep taking them as you did before you started using tobramycin, unless otherwise directed by your doctor. However, do not put any other inhaled medicine in the nebulizer at the same time that you use tobramycin. Other inhaled medicines may be used in a clean nebulizer before or after your treatment with tobramycin. It is recommended that Tobi® Podhaler™ is taken last.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For Pseudomonas lung infections:
    • For inhalation dosage form (solution):
      • Adults, teenagers, and children 6 years of age and older—One ampule or container with 300 milligrams (mg) of tobramycin two times a day for 28 days in the nebulizer. Then, stop using this medicine and wait 28 days, and repeat the cycle (28-day on, 28-day off cycle). You should space the doses at least 6 hours apart.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.
    • For inhalation dosage form (capsule):
      • Adults, teenagers, and children 6 years of age and older—Four capsules with 28 milligrams (mg) of tobramycin two times a day for 28 days in the Podhaler™ device. Then, stop using this medicine and wait 28 days, and repeat the cycle (28-day on, 28-day off cycle). You should space the doses at least 6 hours apart.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store in the refrigerator. Do not freeze.

If you can't keep the tobramycin inhalation solution in the refrigerator, store the medicine in the foil pouch at room temperature away from heat or direct light. Do not use the unrefrigerated medicine after 28 days.

Store the Tobi® Podhaler™ capsules at room temperature, away from heat and direct light. Keep the capsules and Podhaler™ device in a dry place.