Tobramycin (By breathing)


Tobramycin (toe-bra-MYE-sin)

Treats Pseudomonas lung infections in patients with cystic fibrosis. This medicine is an aminoglycoside antibiotic.

Brand Name(s)


There may be other brand names for this medicine.

When This Medicine Should Not Be Used

Do not use this medicine if you have had an allergic reaction to tobramycin or other similar medicines, such as amikacin, gentamicin, kanamycin, neomycin, netilmicin, streptomycin, or Garamycin®. Do not use this medicine if you are pregnant.

How to Use This Medicine


  • Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
  • Your doctor may give you medicines to use before the tobramycin inhalation liquid. Carefully follow your doctor's instructions about how to use your medicines. Tobramycin inhalation will work better if you use all of your medicines in the right order.
  • This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.You should receive an information sheet that will tell you how to take care of the equipment needed to give the medicine.
  • The medicine is a clear colorless or pale yellow liquid that comes in a plastic vial called an ampule. Do not use the medicine if the liquid is cloudy or if you see particles in it.
  • You will use this medicine with an inhaler device called a nebulizer. The nebulizer turns the medicine into a fine mist that you breathe in through your mouth and to your lungs. Your caregiver will show you how to use your nebulizer.Tobi® is used with a DeVilbiss® Pulmo-Aide® compressor. Bethkis® is used with a PARI Vios air compressor.
  • Do not mix other medicine (such as dornase alfa, Pulmozyme®) with tobramycin in the nebulizer unless your doctor tells you to.
  • Use the mouthpiece of the nebulizer to breathe in the medicine.
  • 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.
  • Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in the refrigerator. Do not use the medicine after the expiration date on the ampule has passed.
  • If you cannot keep the medicine in the refrigerator, store the medicine in the foil pouch at room temperature away from heat or direct light. Do not use medicine stored at room temperature after 28 days.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine. You will also need to throw away old medicine after the expiration date has passed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you use other aminoglycoside antibiotics (such as amikacin, gentamicin, kanamycin, neomycin, netilmicin, streptomycin, Garamycin®) or diuretics (water pills, such as ethacrynic acid, furosemide, mannitol, urea, Edecrin®, Lasix®).

Warnings While Using This Medicine

  • Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
  • Make sure your doctor knows if you are breastfeeding or if you have kidney problems, breathing problems, hearing problems, myasthenia gravis, or Parkinson disease. Tell your doctor if you have had an organ transplant.
  • This medicine may cause hearing loss. Call your doctor right away if you notice any changes in your hearing or have ringing in your ears, headaches, nausea, vomiting, or dizziness.
  • Call your doctor right away if you have any of the following symptoms: blood in the urine, change in how much or how often you urinate, increased thirst, or swelling of the feet or lower legs. These could be symptoms of kidney problems.
  • Call your doctor right away if you have a cough, trouble breathing, or tightness in the chest after you use this medicine.
  • Talk to your doctor right away if any of your medicines do not seem to be working as well as usual. Do not change your doses or stop using your medicines without asking your doctor.
  • Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Change in how much or how often you urinate, bloody urine, swelling in your feet or lower legs
  • Dizziness, hearing loss, ringing in your ears
  • Feeling of constant movement of self or surroundings, problems with balance
  • Increased coughing, noisy breathing, trouble breathing
  • Shakiness, trembling, or problems with muscle control or coordination
  • Worsening muscle weakness

If you notice these less serious side effects, talk with your doctor:

  • Sore throat or hoarseness

If you notice other side effects that you think are caused by this medicine, tell your doctor

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

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: June 18, 2013

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