Medications

Tobi® inhalation solution   

This product is manufactured by Novartis using the ingredient tobramycin sulfate.

This product is taken via nebulizer.

Why is it prescribed?

Inhaled tobramycin sulfate can prevent worsening of and maintain stable status of patients with cystic fibrosis and chronic lung infections.


  • Tobi® Inhalation Solution treats a bacteria that commonly infects the lungs of patients with Cystic Fibrosis. Because this bacteria can damage the lungs, it is important that it is treated.
  • Tobi® Inhalation Solution comes in a single dose, ready-to-use ampoule. Each box of Tobi® contains a 28 day supply of medicine.
  • Tobi® is specifically formulated for inhalation using a Pari LC Plus reusable nebulizer and a DeVilbiss Pulmo-Aide air compressor.  Follow supplied instructions carefully.
  • You should store Tobi® ampoules in a refrigerator (2-8°C). However, when you don’t have a refrigerator available (e.g., when transporting), you may store the foil pouches (opened or unopened) at room temperature (up to 25°C) for up to 28 days. 

  • Avoid exposing the ampoules to intense light.

  • Unrefrigerated Tobi®, which is normally slightly yellow, may darken with age; however, the colour change does not indicate any change in the quality of the product. 

  • You should not use Tobi® if it is cloudy, if there are particles in the solution, or if it has been stored at room temperature for more than 28 days. You should not use TOBI beyond the expiration date stamped on the ampoule


Alternatives

Other products that have the same ingredient as Tobi® inhalation solution are •Sandoz-Tobramycin inhalation solution •Teva-Tobramycin inhalation solution •Tobi® Podhaler® •

See other products used in the treatment of •cystic fibrosis •

The recommended dosage for both adults and pediatric patients 6 years of age and older is 1 single-use ampul, 300mg, administered twice a day for 28 days. The doses should be taken as close to 12 hours apart as possible. The doses should not be taken less than 6 hours apart.
After 28 days of therapy, patients should stop Tobi® Inhalation Solution for the next 28 days, and then resume therapy for the next 28 days.


Tobramycin is an aminoglycoside antibiotic. It is used in the management of cystic fibrosis patients with chronic lung infections.


The most common side effects of inhaled tobramycin include:

  • cough
  • worsening of lung problems or cystic fibrosis
  • productive cough
  • shortness of breath
  • fever
  • sore throat
  • changes in your voice (hoarseness)
  • coughing up blood
  • headache
  • altered taste

Inhaled tobramycin can cause serious side effects, including:

  • hearing loss or ringing in the ears (ototoxicity). Tell your healthcare provider right away if you have hearing loss or you hear noises in your ears such as ringing or hissing. Tell your healthcare provider if you develop vertigo, difficulty with balance or dizziness.
  • worsening kidney problems (nephrotoxicity) - especially in people with known or suspected kidney problems. 
  • worsening muscle weakness - in people who already have problems with muscle weakness
  • severe breathing problems (bronchospasm). Tell your healthcare provider right away if you get any of these symptoms of bronchospasm:
    • shortness of breath with wheezing
    • coughing and chest tightness​

 


Do not use if allergic to aminoglycosides.

Tell your doctor before using inhaled tobramycin if you have:

  • Unusual difficulty in breathing with wheezing or coughing or chest tightness

  • Blood in your sputum (the substance you cough up)

  • Muscle weakness that lasts or becomes worse with time.

  • kidney problems

  • dizziness

  • Hearing problems

You should not take the following medicines while you are taking inhaled tobramycin:

  • Furosemide or ethacrynic acid

  • Urea or intravenous mannitol

  • Other medicines which may harm your kidneys or hearing

Use in pregnancy: Use only if risk outweighs benefit. Consult your docotor or pharmacist before use.

Use in breastfeeding: Use only if risk outweighs benefit. Consult your docotor or pharmacist before use.


Page Last Updated: 05/10/2016