Nebcin (Injection)

Tobramycin injection is used to treat serious bacterial infections in various parts of the body.

Tobramycin is part of a group of medicines called aminoglycoside antibiotics. It works by killing bacteria or stopping their growth. However, this medicine does not work for colds, flu, or other virus infections.

Tobramycin injection is typically used for serious bacterial infections when other medicines may not be effective. However, it can also cause serious side effects, including damage to your hearing, balance, and kidneys. These side effects may be more likely to happen in elderly patients and newborn infants. You and your doctor should discuss the benefits and risks of this medicine.

This medicine should be given only by or under the close supervision of your doctor.

Your doctor will closely monitor you or your child while receiving this medicine. This helps the doctor determine if the medicine is effective and if you or your child should keep using it. Blood, urine, hearing, and nerve tests may be necessary to check for side effects. Your doctor should also keep an eye on electrolytes (like calcium, magnesium, and potassium) in the blood.

If you or your child's symptoms do not get better in a few days, or if they get worse, contact your doctor.

Using this medicine during pregnancy can harm your unborn baby. Use effective birth control to prevent pregnancy. If you think you might be pregnant while using this medicine, inform your doctor immediately.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and needs immediate medical help. Call your doctor right away if you or your child experience blistering, peeling, or loosening of the skin; itching; hives; hoarseness; shortness of breath; sores, ulcers, or white spots in the mouth or on the lips; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after receiving this medicine.

Stop using this medicine and contact your doctor right away if you or your child experience sudden hearing loss or decrease in hearing, possibly with dizziness and ringing in the ears. Inform your doctor if you or your child have dizziness or lightheadedness; a feeling of constant movement of self or surroundings; or a sensation of spinning. These could be signs of hearing or balance issues.

Contact your doctor immediately if you or your child have blood in the urine, changes in how often or how much urine is produced, breathing difficulties, drowsiness, increased thirst, loss of appetite, nausea or vomiting, swelling of the feet or lower legs, or weakness. These may indicate a serious kidney issue.

This medicine may cause nerve problems. Contact your doctor promptly if you or your child experience numbness, skin tingling, muscle twitching, or seizures.

Make sure your doctor is aware that you or your child are using this medicine before having any surgeries or procedures that need numbing medicine (like anesthetics or neuromuscular blocking agents). Using tobramycin injection with numbing medicines may increase the risk of breathing difficulties, drowsiness, inability to breathe without help, or unusual tiredness or weakness.

Do not take other medicines unless you have discussed them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor need to consider the risks and the benefits. Here are some important things to think about for this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies, including to foods, dyes, preservatives, or animals. For over-the-counter products, carefully read the label or package ingredients.

Pediatric

Studies have not shown any specific problems in children that would limit the use of tobramycin injection. However, this medicine should be used carefully in premature and newborn infants.

Geriatric

Studies have not shown any specific problems in older adults that would limit the use of tobramycin injection. However, older patients are more likely to experience unwanted effects and have kidney problems, which may require caution and a dose adjustment for those receiving tobramycin injection.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication while breastfeeding. Consider the potential benefits and risks before taking this medication during breastfeeding.

Interactions with Medicines

Some medicines should not be used together, while others can be used together even if there might be an interaction. In these cases, your doctor may adjust the dose or take other precautions. When receiving this medicine, it is very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are significant but may not include all possible interactions.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Ataluren

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both medicines.

• Alcuronium
• Aspirin
• Atracurium
• Cholera Vaccine, Live
• Cidofovir
• Cisatracurium
• Colistimethate Sodium
• Decamethonium
• Doxacurium
• Emtricitabine
• Ethacrynic Acid
• Fazadinium
• Foscarnet
• Furosemide
• Gallamine
• Hexafluorenium
• Lysine
• Mannitol
• Metocurine
• Mivacurium
• Pancuronium
• Pipecuronium
• Rapacuronium
• Rocuronium
• Succinylcholine
• Tacrolimus
• Tenofovir Alafenamide
• Tubocurarine
• Vancomycin
• Vecuronium

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both medicines.

• Cisplatin
• Cyclosporine

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around the time of eating food or certain types of food because interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect how you can use this medicine. Make sure to tell your doctor if you have any other medical issues, especially:

• Asthma or
• History of sulfite allergy—This medicine contains sodium bisulfite which may cause an allergic reaction in these cases.

• Extensive burns or
• Cystic fibrosis—Use with caution. Your doctor may need to adjust your dose if you have these conditions.

• Kidney disease—Higher blood levels of tobramycin may occur, increasing the risk of serious side effects.

• Severe kidney disease or
• Muscle problems or
• Myasthenia gravis (severe muscle weakness) or
• Nerve problems or
• Parkinson's disease—Use with caution. This may worsen these conditions.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may happen, if they do occur, they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

• Black, tarry stools
• Bleeding gums
• Blood in the urine or stools
• Chills
• Cloudy urine
• Clumsiness
• Continuing ringing, buzzing, or other unexplained noise in the ears
• Cough
• Cracks in the skin
• Decrease in the amount of urine
• Dizziness or lightheadedness
• Feeling of constant movement of self or surroundings
• Feeling of fullness in the ears
• Fever
• Loss of balance
• Loss of heat from the body
• Loss or change in hearing
• Nausea
• Pale skin
• Pinpoint red spots on the skin
• Red, swollen skin
• Scaly skin
• Sensation of spinning
• Shortness of breath
• Sore throat
• Trouble hearing
• Troubled breathing with exertion
• Ulcers, sores, or white spots in the mouth
• Unsteadiness
• Unusual bleeding or bruising
• Unusual tiredness or weakness
• Vomiting

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Inability to breathe without assistance

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your healthcare professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your healthcare professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

Incidence not known

• Confusion about identity, place, and time
• Diarrhea
• Headache
• Hives or welts
• Itching
• Pain at the injection site
• Redness of the skin
• Skin rash
• Unusual drowsiness, dullness, tiredness, weakness, or feeling sluggish

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Nebcin

Available Dosage Forms:

• Solution

Therapeutic Class: Antibiotic

Chemical Class: Aminoglycoside

A nurse or other trained health professional will give you this medicine. This medicine is given as a shot into a muscle or into a vein. This medicine should not be given into the eyes.

To help clear up your infection completely, keep using this medicine for the full time of treatment, even if you begin to feel better after a few days. Also, this medicine works best when there is a constant amount in the blood. To help keep the amount constant, you must receive this medicine on a regular schedule.

To keep your kidneys working well and help prevent kidney problems, drink extra fluids so you will pass more urine while you are receiving this medicine.