The organs of vision are an integral part of the existence of every person. When they get sick, the quality of life deteriorates significantly, and a lot of additional problems appear. That is why it is so important to take care of your health. And at the slightest indisposition to address to doctors. For diseases of bacterial origin, Tobradex drops are often prescribed. Analogues of this drug and the features of their use will be presented to your attention today. You will learn the differences and similarities of medicines, their pros and cons.

Characteristics of the drug: composition, cost and purpose of use

The medicine "Tobradex" - eye drops. Analogues of this medicine can now be chosen from numerous drugs. Manufacturers use a variety of ingredients to make medicines. So, the active substance of the drug "Tobradex" is a combination of tobramycin and dexamethasone. It costs a bottle of 5 milliliters of about 450 rubles. Agree, it's expensive. It is this reason that becomes one of the first that prompts the patient to find an analogue of Tobradex.

The combination of antibacterial and anti-inflammatory effect of the drug can cure diseases such as conjunctivitis, blepharitis, keratitis and other bacterial pathologies. The medicine is also used for prophylactic purposes. Its use is actual after surgical interventions and before them.

The drug "Tobradex" is injected into the conjunctival sac in 1-2 doses during the day. The frequency of application varies from 4 to 6 times. On the first day, it is permissible to use the drug every 2 hours. The duration of therapy is always determined individually, it depends on many factors.

Why is a substitute needed?

If, for some reason, Tobradex (eye) drops are not suitable for you, an ophthalmologist will help you choose analogues. The doctor must first find out why you refuse to use the claimed remedy. The reason for replacing the drug is the presence of contraindications to the use. The antibiotic should not be used for viral lesions of the cornea, fungal diseases of the organs of vision, as well as after removal of a foreign body from the eye. Some primary sources indicate that children under one year of age should not use Tobradex. Instructions for use of analogues recommends choosing safer and more modern ones for small patients. Let's take a look at some of the alternatives and find out how they differ.

Popular "Tobrex": a drug prescribed more often than others

The analogue of "Tobradex", which must be mentioned first of all, is the drug "Tobrex". It contains tobramycin in the same amount as the claimed drug. The drops are distinguished by the absence of a second substance that can have an anti-inflammatory and antihistamine effect. The solution "Tobrex" has an antibacterial effect, it acts against many pathogenic microorganisms. It costs 5 milliliters of drops about 200 rubles. It is important that this medicine is often used in children of the first year of life. It is contraindicated only with hypersensitivity to the components.

Drops of "Dexon"

This analogue of "Tobradex" is distinguished from the main drug by the absence of another substance. It does not contain the antibiotic tobramycin, but it does contain neomycin. At the same time, the same corticosteroid, dexamethasone, is present here. The drug has an anti-inflammatory, antihistamine, antimicrobial effect. The solution is used for acute and chronic bacterial eye diseases. According to the manufacturer, there is no guarantee that the drug is safe for children. Therefore, it can be used in pediatrics only as directed by a doctor.

"Betagenot": a universal drug

If the patient has hypersensitivity to the components of the previously declared drug, then an alternative based on other substances should be chosen. Such an analogue of "Tobradex" is called "Betagenot". It contains two active ingredients: gentamicin and betamethasone. Drops have an action similar to Tobradex: anti-allergic, antibacterial and anti-inflammatory. A medicine is prescribed for allergic and infectious eye diseases. Do not use medication for glaucoma, trachoma, viral lesions of the organs of vision. The versatility of drops is due to the fact that they can be used in otology and otolaryngology.

Garazon: an inexpensive alternative

Has the drug "Tobradex" (eye drops) cheap analogues. This is the tool "Garazon". It costs no more than 130 rubles per pack. The composition of the drug contains, as in the previous case, gentamicin and betamethasone. This medicine can be used for the eyes and ears for infections caused by microorganisms susceptible to it. Do not apply drops in pediatrics until the child reaches the age of six years. Treatment with "Garazon" should not exceed seven days.

"Dexotobropt": an absolute substitute

An analogue of Tobradex, which can be called structural, is called Dexotobropt. It contains the same substances in the same amount as the claimed medication. Dexamethasone together with tobramycin have a complex effect on the affected organs of vision. The result of therapy is an anti-inflammatory and antimicrobial effect. Along with its predecessor, this medicine is used for 10 days, but no more. The corticosteroid component can be addictive. The drugs are distinguished by the fact that Dexotobropt is not used in children under 18 years of age. If it is necessary to use such funds in children, it is worth giving preference to safer and more proven drops.

"Sofradex": a medicine based on three components

The drug "Tobradex" has cheap analogues, but "Sofradex" is quite difficult to call such. The drug is produced in vials of 5 milliliters, and costs at least 300 rubles. The drops contain three components that have an antimicrobial, antibacterial and anti-inflammatory effect: dexamethasone, farmycetin, gramicidin. Medicine is prescribed by doctors for otitis media, as well as bacterial lesions of the eyes and eyelids. This medicine is prohibited for use by pregnant women and infants. Do not use the drug for glaucoma, viral lesions of the organs of vision and violation of the integrity of the corneal epithelium. Long-term use or non-compliance with doses can lead to an increase in intraocular pressure.

"Albucid": a safe medicine

Do you consider Tobradex (eye drops) very expensive? Cheap analogues can be found, but they may not be as effective as the claimed medicine. One of the inexpensive substitutes is the drug "Sulfacyl Sodium". It is also called the medicine "Albucid". The composition contains the active substance sulfacetamide. This tool is available in different volumes, which is a difference from previously declared analogue drugs. You can buy 3 milliliters of the treatment solution for only 100 rubles. Even when applied topically, the active substance of the drug can be absorbed into the systemic circulation through the inflamed membranes. The medicine has a bactericidal effect. It is effective against gram-positive and gram-negative microorganisms. It is contraindicated to use this remedy in case of hypersensitivity to it. The experience of using in pediatrics proves the safety of this medication. Drops are prescribed for children of all ages, including infants.

Analogue of "Tobradex": how to make a choice?

How to choose a really suitable tool from all those presented earlier? To begin with, you should contact an ophthalmologist, as well as study the information that the instruction provides about the drug "Tobradex" (eye drops). Analogues based on the same composition are selected if for some reason you cannot purchase the prescribed Tobradex (not available at the pharmacy, the cost is too high, and so on). The drug suitable in this case would be Dexotobropt.

Often, a replacement medication is needed if you are allergic to the prescribed remedy or intolerant to it. If there are contraindications to the use of certain substances, then you need to choose analogues that differ in composition. As it became known, one of the safe and affordable is Albucid. In second place in popularity among drugs prescribed by ophthalmologists is Tobrex. The remaining funds are prescribed taking into account the individual characteristics of the consumer.

It is worth noting that the drug "Tobradex" can be produced in the form of an ointment. This form is used less frequently than drops. If you need an alternative, you can choose, for example, tetracycline ointment. If you need to choose more serious analogues, be sure to consult a doctor.

A few final words

Most bacterial eye diseases are accompanied by a thick purulent secretion, tearing, burning and pain. You can find out which pathogen caused the pathology with the help of a laboratory test. A preliminary analysis will show the sensitivity of microorganisms to a particular substance, as a result of which you will be prescribed a certain (effective) medicine. Such therapy is considered the only true one. Therefore, you should not guess on the coffee grounds and worry whether a certain drug will suit you or not. Good health and clear vision, do not get sick!

Tobradex is a combination drug used topically in ophthalmology, which has anti-inflammatory and antimicrobial effects.

It has such an effect due to the content of a glucocorticosteroid (dexamethasone) and a broad-spectrum antibiotic (toramycin).

The tool is used to treat inflammatory eye diseases, as well as to prevent the development of a secondary infection after surgery.

Instructions for use

Beneficial features

Tobradex is an effective drug intended for the treatment of bacterial inflammation of the organs of vision, containing in its composition a glucocorticosteroid and a broad-spectrum antibiotic. The mechanism of action is determined by the properties of these components.

Dexamethasone exhibits anti-allergic, anti-inflammatory and desensitizing effect, tobramycin has antimicrobial activity against a variety of gram-positive and gram-negative bacteria.

The drug does not cause a slowdown in the recovery of the cornea of ​​\u200b\u200bthe eyes, so it is prescribed for use in the postoperative period.

Indications for use

Tobradex is prescribed for the treatment of inflammatory eye diseases accompanied by bacterial infections, including keratitis, conjunctivitis and blepharitis, as well as for the prevention of postoperative and post-traumatic bacterial infections of the anterior parts of the eye.

Interaction with other drugs

When using Tobradex eye drops simultaneously with other ophthalmic agents, it is necessary to observe an interval of at least 15 minutes between their use.

Before using the product, contact lenses should be removed, and they can be put on again 20 minutes after instillation of the drops into the conjunctival sac.

It is necessary to avoid the simultaneous use of Tobradex drops with local and systemic drugs that have neurotoxic, nephrotoxic and ototoxic effects, since mutual enhancement of these effects is possible.

The drug should not be used in combination with systemic aminoglycosides.

Release form, composition, storage and dispensing

Tobradex eye drops are in a sterile 5 ml plastic bottle with a convenient dropper. It is a clear, colorless and odorless solution. When selling a medicine in pharmacies, a prescription is not required.

What is the medicine

The drops are based on the action of the antibiotic tobramycin.

The drug also contains the following components:

• tyloxapol;
• sulfate and sodium hydroxide;
• boric acid;
• benzalkonium chloride;
• purified water.

In accordance with the instructions, it is recommended to store the medication at an air temperature not exceeding 25 degrees Celsius in a dark place protected from light. An opened vial of eye drops should be used within a month.

Method of application and dosage

Tobradex is intended for instillation into the conjunctival sac. Before using the drug, wash your hands and shake the bottle of eye drops.

The required dose of the drug is introduced into the conjunctival sac, gently pulling the lower eyelid and slightly tilting the head back. Immediately after instillation of the drug, you need to close your eye and gently press your finger on its inner corner.

Using drops, it is necessary to avoid contact of the dropper tip with the mucous membrane of the eye, eyelashes and skin. After instillation of the drug, the bottle must be carefully closed with a cap.

The duration of use of the drug and the dose of active substances is determined by the doctor. Usually, 1-2 drops of the drug are applied to the affected eye every 5-6 hours.

If the next dose of the drug was missed, the drops should be applied as soon as possible. If less than one hour remains before the planned use of the next dose of the drug, the forgotten dose is skipped. Doubling the dose is not recommended.

Contraindications

1. Contraindications to the use of the drug are viral, tuberculous and fungal eye infections, hypersensitivity to the components of the drug, pregnancy and lactation.
2. Tobradex eye drops are not used to treat patients less than one year of age.
3. The drug is not advisable to use for uncomplicated removal of a foreign body from the eye.
4. When prescribing the drug to patients with thinning of the cornea or glaucoma, care should be taken.

Side effects

When using the drug, there may be a feeling of discomfort immediately after instillation (mucosal hyperemia, slight burning), as well as the development of allergic reactions. Very rarely, the use of Tobradex drops is accompanied by an increase in intraocular pressure, the development of a secondary infection, and clouding of the lens.

Local allergic reactions: burning, itching, dryness of the eyelids and eyes, hyperemia, sensation of a foreign body in the eye, decreased visual acuity, conjunctival edema, increased intraocular pressure, lacrimation, keratitis. In isolated cases, the development of photophobia, glaucoma, cataracts, mydriasis was noted.

Allergic reactions: erythema, pruritus, rash, swelling of the face.

Other side effects include: headache, dizziness, bitter taste in the mouth, nausea, vomiting, laryngospasm, rhinorrhea.

Patients with thinning of the sclera, especially with prolonged use, may develop perforation. When using Tobradex, the development of a secondary infection cannot be ruled out.

Overdose

There is no data on an overdose of this drug. When using the drug Tobradex in high doses, it is possible to increase the severity of side effects.

When using high doses of drops, rinse your eyes with plenty of water and consult a doctor.

Special instructions and precautions

Price

In Russian pharmacies, the average cost of Tobradex is 340 rubles. In pharmacies of Ukraine, the price of this drug is about 150 hryvnia.

Analogues

Medicines that are analogues of the drug can be conditionally divided into two groups. The first group consists of eye drops, the active substance of which is tobramycin. The second group includes ophthalmic agents based on other components, but with a similar effect.

According to the mechanism of action on microbes and composition, the following drugs are similar to Tobradex:

• Brulamycin;
• Bramitob;
• Dilaterol;
• Tobropt;
• Tobracin.
• Nebtsin;
• Tobrin;
• Tobramycin-Gobbi;

The basis of these drugs is one active ingredient - tobromycin sulfate.

An alternative to Tobradex eye drops are drugs that treat bacterial eye diseases based on another active ingredient. These funds include:

• Brakson;
• Futaron;

Reviews

The drug Tobradex enjoys a positive reputation in the forums dedicated to pharmaceuticals and ophthalmology. The therapeutic effect of this remedy is described by the majority of patients who took it as favorable.

The medicinal effect of the drug relieves discomfort and pain, restores vision. Judging by the reviews, Tobradex helps to get rid of chronic inflammation of the eyelids (blepharitis). Also, the medication effectively eliminates conjunctivitis, helps in the treatment of barley.

Numerous reviews about the drug make it possible to assert that there are no side effects when using it. However, people who wear contact lenses note dryness of the eyeball after applying the drops.

Separately, it should be noted that many parents speak positively of Tobradex drops as a remedy that effectively eliminates inflammatory processes in children of different ages. When instilled into the eyes, children do not feel discomfort.

Examples

№1 . For the past three months, I have had severe vision problems. It seemed that the longer I sit at the computer, the more my eyes become inflamed and watery.

I didn’t want to go to the doctor at all, because, being an allergic person, I was tired of hearing the same thing: “How can I treat you with your drug intolerance?” Doctors can also be understood, but still I wanted to be advised at least once on some new drug.

In general, I sat at home until the moment when my eyes practically stopped seeing from half a meter, tears flowed constantly, and the vessels burst almost every day. Turning to the clinic, I found out that we have a new ophthalmologist. On examination, I was diagnosed with inflammation.

I picked up the prescription sheet and went straight to the pharmacy. I wanted to start seeing normally as soon as possible, because the work does not wait, and it’s scary to go out into the street with such eyes.

The cost, of course, did not please me very much - I paid 250 rubles for a bottle of Tobradex drops. But after a day, the effect was noticeable. And literally three days later I already saw 100%, and the redness of the eyes disappeared.

№2 . Throughout my conscious life I have been wearing contact lenses, so every spring my chronic conjunctivitis worsens. Since it takes about a week to forget about lenses to treat this ailment, this means that you can delete the whole week from your life. This is exactly what happened to me until the doctor recommended Tobradex to me. This remedy copes well with all types of conjunctivitis - bacterial, viral, allergic, chronic - because it is a combination drug.

I remove the lenses in the evening, put two drops of medicine in each eye. When instilled, a slight burning sensation appears, but it is quite tolerable. In the morning I do the same procedure, after half an hour I put on new lenses and that's it. Eyes feel great. After that, I instill the drug for three days only at bedtime for prevention.

Conclusion

Tobradex eye drops are an effective antibacterial agent that is widely used in ophthalmology. The drug is prescribed for the treatment of inflammatory processes, infections caused by pathogenic bacteria and microbes.

The main feature of Tobradex eye drops is their absolute safety for the patient's health. They are harmless and do not cause side effects. That is why the remedy is prescribed for the treatment of eye diseases in children.

Video

Associate Professor of the Department of Eye Diseases. | Site Editor-in-Chief

He specializes in emergency, outpatient and elective ophthalmology. Carries out diagnostics and conservative treatment of farsightedness, allergic diseases of the eyelids, myopia. Performs probing, removal of foreign bodies, examination of the fundus with a three-mirror lens, washing of the nasolacrimal canals.

Instructions for medical use

medicinal product

TOBRADEX ®

Tradename

Tobradex ®

International non-proprietary name

Dosage form

Eye drops, suspension, 5 ml

Composition

1 ml of the drug contains

Excipients: benzalkonium chloride, disodium edetate, sodium chloride, anhydrous sodium sulfate, tyloxapol, hydroxyethylcellulose, sulfuric acid and/or sodium hydroxide (for pH correction), purified water.

Description

Suspension from white to almost white.

Pharmacotherapeutic group

Anti-inflammatory drugs in combination with antimicrobials. Glucocorticosteroids in combination with antimicrobials. Dexamethasone in combination with antimicrobials.

ATX code S01CA01

Pharmacological properties

Pharmacokinetics

The systemic effect of dexamethasone after topical application of Tobradex eye drops is low. The maximum plasma concentration lies in the range of 220-888 pg / ml (mean value 555 ± 217 pg / ml) after topical application of the drug Tobradex ® eye drops in each eye 4 times a day for 2 days.

Dexamethasone is excreted by a metabolic reaction. Approximately 60% of the dose is found in the urine as 6-β-hydroxydexamethasone. No unchanged dexamethasone was found in the urine. The plasma half-life is 3-4 hours. Dexamethasone is approximately 77-84% bound to serum albumin. The clearance range is 0.111 to 0.225 L/h/kg and the volume of distribution ranges from 0.576 to 1.15 L/kg. The oral bioavailability of dexamethasone is approximately 70%.

Systemic exposure to tobramycin is negligible with topical application of Tobradex ® eye drops. Tobramycin is excreted into the urine rapidly and extensively by glomerular filtration, mainly as unchanged drug. T 1/2 from plasma is approximately 2 hours with a clearance of 0.04 l / h / kg and a volume of distribution of 0.26 l / kg. Plasma protein binding to tobramycin is less than 10%. The oral bioavailability of tobramycin is low (< 1%).

Pharmacodynamics

Corticosteroids exert anti-inflammatory effects by inhibiting vascular endothelial cell adhesion, cyclooxygenase I and II, and cytokine release. This action culminates in a decrease in the production of pro-inflammatory mediators and inhibition of adhesion of circulating leukocytes to the vascular endothelium, thus preventing adhesion to inflamed eye tissues. Dexamethasone has a pronounced anti-inflammatory activity with reduced mineralocorticoid activity compared to some other steroids and is the most potent anti-inflammatory agent.

Tobramycin is a broad-spectrum antibiotic from the aminoglycoside group, which is active against both gram-positive and gram-negative microorganisms. It has a primary effect on the bacterial cell by inhibiting the polypeptide compound and the synthesis of ribosomes.

The drug Tobramycin ® eye drops is effective against the following pathogens:

Indications for use

Steroid-treatable inflammatory conditions of the eye with bacterial infection of the ocular surface or risk of bacterial infection of the eye for which corticosteroid treatment is indicated:

• inflammatory conditions of the palpebral and bulbar conjunctiva
• inflammatory conditions of the cornea
• inflammatory conditions of the anterior segment of the eye
• chronic uveitis of the anterior segment of the eye
• damage to the cornea by chemicals, radiation or thermal burns, or as a result of the penetration of foreign bodies
• prevention and treatment of inflammation after cataract surgery

Dosage and administration

For application to the eyes.

Shake well before use.

The standard dosage is 1-2 drops into the conjunctival sac of the affected eye every 4-6 hours. During the first 24-48 hours, the dose may be increased to 1-2 drops every 2 hours. As clinical signs improve, the frequency of use should be reduced until complete cessation. It is not recommended to stop treatment prematurely.

In acute infectious diseases, 1-2 drops are instilled every hour until the condition stabilizes, then reduce the frequency to 1-2 drops every 3 hours for the next 3 days; then 1-2 drops every 4 hours for 5-8 days and finally 1-2 drops a day for the last 5-8 days if needed.

After cataract surgery, the dose is 1 drop 4 times a day, for 24 days from the day of the operation. Treatment can be started the day before surgery with 1 drop 4 times a day and continued after surgery, then 4 times a day for up to 23 days. If necessary, the frequency may be increased to 1 drop every 2 hours during the first two days of therapy.

After instillation, it is recommended to lightly cover the eyelids or press the nasolacrimal canal. This may reduce the systemic absorption of the drug administered through the tissues of the eye and thus reduce systemic side effects.

Do not touch the tip of the pipette to the eyes or any other surface to avoid contamination of the contents of the vial.

In the case of joint therapy with other local ophthalmic drugs, the interval between taking the drugs should be about 10-15 minutes.

Application in children:

The use of Tobradex ® eye drops for the treatment of acute inflammation of the eye of bacterial origin for 7 days in children over 8 years of age is as effective and safe as for adult patients.

Side effects

Local

Infrequently:

Increased intraocular pressure

Pinpoint keratitis

Pain in the eye

Itching of the eye, itching of the eyelid

Eyelid erythema

Swelling of the conjunctiva

Eye discomfort, eye irritation

Seldom:

Keratitis

Hypersensitivity

Blurred vision

Dry eyes, foreign body sensation in the eye

- hyperemia of the eye

Systemic

Infrequently:

• laryngospasm
• rhinorrhea

Seldom:

• taste disturbance (unpleasant or bitter taste)

The frequency and severity of the following adverse reactions has not been determined due to insufficient data:

Local: glaucoma, cataract, decreased visual acuity, eyelid edema, mydriasis, photophobia, increased tearing, blurred vision, hyperemia of the eye;

Systemic: headache, dizziness, nausea, vomiting, abdominal discomfort, rash, swelling of the face, itching, erythema.

Contraindications

• hypersensitivity to the active substances or to any of the excipients of the drug
• acute epithelial keratitis of herpes simplex (dendritic keratitis)
• cowpox, chickenpox and a number of viral diseases of the cornea and conjunctiva (with the exception of keratitis caused by herpes zoster)
• fungal diseases of the structures of the eye
• mycobacterial eye infections caused by, but not limited to, acid-fast bacilli listed: Mycobacterium tuberculosis, Mycobacteriumleprae or Mycobacteriumavium
• acute purulent infection of the eye

Children's age up to 8 years

Drug Interactions

No specific drug interaction studies have been conducted with Tobradex ® eye drops.

Systemic absorption of tobramycin and dexamethasone is negligible and therefore the risk of interactions is minimal.

The combined and/or sequential use of an aminoglycoside (tobramycin) and another systemic, oral, or topical drug that has a neurotoxic, ototoxic, or nephrotoxic effect may lead to additional toxicity and, if possible, should be avoided.

special instructions

For topical ophthalmic use. Not for injection.

Prolonged use or increased frequency of use may lead to ocular hypertension and/or glaucoma with subsequent damage to the optic nerve, decreased visual acuity, damage to the visual field, and subsequent formation of subcapsular cataracts. In predisposed patients, an increase in intraocular pressure may be observed even after a single dose. In patients receiving long-term treatment with ophthalmic corticosteroids, intraocular pressure should be carefully monitored.

Long-term use of corticosteroids can reduce resistance to bacterial, viral, and fungal infections of the eye, as well as prevent their detection. Topical corticosteroids may mask the clinical signs of infections, preventing detection of antibiotic failure, or may suppress hypersensitivity reactions to the active ingredients of the drug. Consideration should be given to the possibility of fungal infections in patients with persistent corneal ulceration who have taken or are receiving treatment with topical corticosteroids. If a fungal infection is confirmed, corticosteroid treatment should be discontinued and appropriate treatment instituted.

Sensitivity to topical application of aminoglycosides may cause eyelid itching, edema, and conjunctival erythema in some patients. If hypersensitivity to the drug is observed, the use should be discontinued.

Consideration should be given to the possibility of cross-sensitivity with other aminoglycosides, especially kanamycin, gentamicin and neomycin. Patients with hypersensitivity to topical tobramycin may be susceptible to hypersensitivity to other topical and/or systemic aminoglycosides. The risk of sensitivity increases with repeated use. In the event of hypersensitivity during the use of the drug Tobradex ® eye drops, treatment should be discontinued and another drug used for treatment.

The use of antibiotics such as tobramycin can lead to overgrowth of non-susceptible organisms, including fungi.

Topical use of steroids for diseases that cause thinning of the cornea or sclera is likely to perforate.

Topical ophthalmic corticosteroids may delay the healing of corneal wounds.

With local ophthalmic use of tobramycin in combination with systemic aminoglycoside antibiotics, their total plasma concentration should be monitored.

If multiple courses of treatment are required or clinically indicated, the patient should be assessed by slit lamp biomicroscopy and, if necessary, by fluorescein staining.

Corticosteroids are ineffective in the treatment of Sjögren's keratoconjunctivitis.

Pregnancy and lactation

Data regarding the topical ophthalmic use of tobramycin or dexamethasone during pregnancy are absent or very limited. Aminoglycosides cross the placental barrier and therefore the risk to the fetus or newborn should be considered when using aminoglycosides during pregnancy. Tobradex ® eye drops are not recommended for use during pregnancy.

There are no data on the penetration of tobramycin or dexamethasone after topical ophthalmic use into breast milk. However, a risk to the infant cannot be ruled out.

Since most drugs are excreted in breast milk, an informed decision should be made whether to interrupt breastfeeding or discontinue/withhold treatment with Tobradex ® eye drops, taking into account the benefits of breastfeeding for the baby and the benefits of treatment for the woman.

Contact lenses

Tobradex ® eye drops contains the preservative benzalkonium chloride, which may cause eye irritation or discolour soft contact lenses. Contact with soft contact lenses should be avoided. Before using the drug Tobradex eye drops, remove contact lenses from the eyes and wait 15 minutes after using the drug before inserting the lenses again.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

As with other eye drops, temporary blurred vision or other visual disturbances may occur after instillation, which may adversely affect the ability to drive a car or other potentially dangerous machinery. In this case, it is necessary to wait some time before the restoration of vision.

Overdose

There were no cases of overdose.

Clinically noticeable signs and symptoms of an overdose of Tobradex ® eye drops (punctate keratitis, erythema, increased lacrimation, itching and swelling of the eyelid) are similar to side effects observed in some patients.

If the cornea becomes inflamed, doctors prescribe eye drops or Tobradex ointment. The drug has a combined effect. It is recommended as a preventive measure against secondary infections that may develop after surgery.

Pharmacological action and group

The International Nonproprietary Name (INN) of Tobradex is known as Dexamethasone + Tobramycin; these active ingredients are contained in its composition. This medication is prescribed to treat bacterial inflammation of the cornea. The effect of using this tool is based on the properties of the main substances included in it.

Tobramycin has an antimicrobial effect, which makes it possible to more effectively fight gram-negative and gram-positive bacteria, and dexamethasone can have an anti-inflammatory, anti-allergic and antihistamine effect.

Tobradex is not able to provoke a slowdown in the recovery processes in the cornea, for this reason it is used in the postoperative period.

The high efficiency of this pharmaceutical preparation, which has an antibacterial effect, has been proven in the fight against the following bacteria:

• Staphylococci;
• Pseudomonas aeruginosa, intestinal and Pfeifer sticks;
• Klebsiella pneumonia;
• Facultative anaerobic rod-shaped spore-forming bacteria;
• Morgan bacterium;
• Koch's wand, etc.

This antibiotic of the aminoglycoside group has a low rate of systemic absorption during treatment.

Release form and composition

The drug Tobradex is produced in two forms: in the form of eye drops and ointment. The former are produced in the form of a white liquid, resembling a suspension, in vials with a volume of 5 ml. At the end they are equipped with a special nozzle. Eye ointment is available in aluminum tubes of 3.5 g.

Regardless of the form of release, the drug contains the active ingredients mentioned above, and some auxiliary components: sodium chloride, benzalkonium chloride, etc.

Indications for use

The drug is prescribed to patients as a therapeutic and preventive measure for the following inflammatory diseases of the anterior parts of the eye:

1. Keratitis;
2. Swelling of the conjunctiva;
3. Cataract;
4. Prevention of infections in the postoperative period;
5. Inflammation of the edges of the eyelids;
6. Received injuries.

Instructions for use

Before using Tobradex, wash your hands thoroughly with detergent. The vial is shaken several times to make the suspension homogeneous. The head is tilted back a little. Pull the lower eyelid down slightly and drip a couple of drops of the medication into the conjunctiva. After that, the eye is closed and a little pressure is applied with a finger on its inner corner.

If you miss the next dose of the drug, you should not double the next one. You can take the medicine earlier than the scheduled time, observing a gap between two instillations of at least one hour.

If an ointment is used, it is applied to the mucous membrane of the lower eyelid, pulling it down. After the procedure, you need to blink slowly several times.

In the process of applying the composition, it is impossible to touch the skin, mucous membrane of the eye and eyelashes with the tube. After the Tobradex ointment is applied, the cap must be carefully screwed on. If you skip the next dose, then you need to follow the same recommendations as in the case of drops, as described above.

Side effects and contraindications

At the moment, experts have identified the following side effects from the use of the drug:

• Spasm of the larynx;
• The occurrence of an allergic reaction, which manifested itself as a rash, swelling of the conjunctival sac and eyelids, itching;
• Bitter taste in the mouth;
• Increased intraocular pressure;
• Headaches;
• Dryness of the conjunctiva;
• Dizziness is often felt;
• Sharply decreases visual acuity after instillation of eye drops;
• Inflammation of the cornea of ​​​​the eye develops;
• Acute eye pain as a reaction to light;
• The pupils are greatly dilated.

With thinning of the sclera of the eye in a patient with an acquired or inherited pathology, symptoms of perforation may appear on it, especially if therapy using Tobradex continues for more than the period noted in the instructions.

As a result of weakened immunity and the influence of active substances contained in the eye drops, a secondary infection may develop.

• Intolerance to substances that are part of the medication;
• Viral eye diseases (keratitis, which manifested itself after the defeat of smallpox or herpes);
• Mycobacterial ophthalmic infectious diseases;
• Carrying out conservative therapy after surgery to remove a foreign body from the cornea;
• Fungal ophthalmic diseases;
• Inflammatory purulent diseases.

Tobradex should be used with extreme caution and only under the supervision of a doctor in case of glaucoma and thinning of the cornea of ​​the eye, which was caused by a hereditary pathology or acquired.

Interaction with other drugs

Medical medicine Tobradex can be combined with other eye drops and remedies, for example, Venarus and Okomistin, but before you drip or take any other drug, you need to maintain an interval between the use of drugs for at least five minutes.

Glucocorticosteroid eye ointments should not be used in parallel with Tobradex, since such interaction of drugs will increase the possibility of side effects and the risk of possible overdose. The same goes for drinking with alcohol.

Use in children

Tobradex is allowed to be used for the treatment of children aged at least 12 years. The medicine is contraindicated in newborns and babies under 1 year old.

The duration of the course of treatment with Tobradex eye drops and ointment cannot be more than one week.

Use in pregnancy

Tobradex is not recommended for women who are pregnant. The experience of using the drug during childbearing is limited, for this reason, it is possible to start therapy only in case of extreme need, when the benefit to the expectant mother is significantly greater than the possible risk to the baby.

Caution should be used in women who are breastfeeding. There is no need to stop lactation.

Storage conditions and shelf life

The bottle after it has been opened and used for the first time should be stored for no more than one month. The same applies to ointment. If the packaging of Tobradex for eye treatment is sealed, then it can be kept at home for two years from the date of production.

In both situations, the drug must be stored indoors in a place where children cannot get it.

Analogues

Similar cheap substitutes from Russia include the following medications:

• Tobrex;
• Sofradex;
• Tobrazon.

Before replacing the prescribed remedy with the drugs presented above, the patient must necessarily consult a doctor.

Price and reviews

The cost of Tobradex in pharmacies in the Russian Federation is mainly in the range of 280-340 rubles. However, sometimes it can be purchased at a reduced price, approximately 270-280 rubles.

As for the opinions of patients who had to drip and smear Tobradex as a therapeutic measure, they note the effectiveness of the drug during treatment and subsequent prevention of diseases. However, it is mentioned everywhere that the drug was prescribed by the attending ophthalmologist. We recommend that you seek prescriptions from the services of qualified specialists, and not self-medicate.

Name:

Tobradex (Tobradex)

Pharmacological
action:

Combined drug.
Tobramycin- a broad-spectrum antibiotic from the group of aminoglycosides.
Violates protein synthesis, structure and permeability of the cytoplasmic membrane of a microbial cell.
Active against gram-positive and gram-negative microorganisms: staphylococci (including Staphylococcus aureus, Staphylococcus epidermidis), including methicillin-resistant strains; streptococci, including some group A beta-hemolytic species, non-hemolytic species and some Streptococcus pneumoniae; Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Proteus mirabilis, Morganella morganii, Citrobacter spp., Haemophilus influenzae, Moraxella spp., Acinetobacter spp., Serratia marcescens.
Dexamethasone- synthetic fluorinated GCS, does not have mineralocorticoid activity.
It has a pronounced anti-inflammatory, anti-allergic and desensitizing effect. Dexamethasone actively suppresses inflammatory processes, inhibiting the release of inflammatory mediators by zosinophils, mast cell migration and reducing capillary permeability, vasodilation.
The combination of corticosteroids with an antibiotic (tobramycin) can reduce the risk of an infectious process.

Pharmacokinetics
With topical application of Tobradex, systemic absorption of dexamethasone is low.
Cmax of dexamethasone in plasma ranges from 220 to 888 pg / ml (about 555 ± 217 pg / ml) after using 1 drop of Tobradex in each eye 4 times / day for 2 days.
About 77-84% of dexamethasone entering the systemic circulation binds to plasma proteins. T1 / 2 averages 3-4 hours.
Excreted by metabolism, about 60% as 6-P-hydroxydexamethasone in the urine.
With topical application of Tobradex, systemic absorption of tobramycin is low.
The concentration of tobramycin in blood plasma after using 1 drop of Tobradex in each eye 4 times / day for 2 days was below the detection threshold in 9 of 12 patients.
Cmax of tobramycin in plasma was 247 ng / ml, which is 8 times lower than the concentration threshold associated with nephrotoxicity.
It is excreted by the kidneys, mainly unchanged.

Indications for
application:

For the treatment of patients suffering from inflammatory eye diseases that are accompanied or not accompanied by a superficial bacterial infection, including blepharitis, conjunctivitis and keratitis (without compromising the integrity of the epithelium);
- for the treatment and prevention of infectious and inflammatory eye diseases in patients who have undergone surgical interventions (for example, cataract removal, removal of a foreign body);
- in case of eye injuries for the treatment and prevention of infectious and inflammatory diseases.

Mode of application:

Suspension (eye drops) Tobradex
The drug is intended for instillation into the conjunctival sac.
Before using Tobradex, it is recommended to wash your hands thoroughly and shake the vial with the drug until an equilibrium suspension is formed.
The required number of drops is introduced into the conjunctival sac, slightly throwing the head back and gently pulling the lower eyelid.
Immediately after the instillation of the drops, close your eye and gently press your finger on the inner corner of the eye. When using drops, contact of the dropper tip with the skin, eyelashes and mucous membranes of the eye should be avoided.
After applying the drops, carefully close the bottle with a lid.
The duration of the use of the drug Tobradex and the dose of active substances is determined by the doctor. As a rule, 1-2 drops of Tobradex are prescribed in the affected eye every 4-6 hours.
In case of missing the next dose of the drug, drops should be applied as early as possible, if less than 1 hour is left before the planned use of the next dose, the dose that was forgotten is skipped. Doubling the dose is not recommended.

Eye ointment Tobradex
The drug is intended for introduction into the conjunctival sac.
Wash your hands thoroughly before applying the ointment.
To apply the ointment, the head is tilted back somewhat, the lower eyelid is pulled back and about 1.5 cm of ointment is applied.
After applying the ointment, it is recommended to open and close your eyes several times.
Do not allow the tip of the tube to come into contact with the skin, eyelashes and mucous membranes of the eye.
After applying the ointment, carefully close the tube with a cap.
The duration and scheme of application of Tobradex ophthalmic ointment is determined by the doctor. As a rule, the application of the ointment is prescribed 3-4 times a day in the affected eye.
An interval of at least 6 hours between application of the ointment should be observed.
If the next dose is missed, the eye ointment is used as early as possible, but not less than 1 hour before the next dose.
If the missed dose is remembered less than 1 hour before the next dose, only the planned dose is used. Do not double the dose of Tobradex.

Side effects:

Tobradex is generally well tolerated by patients.
Rare cases of the development of such undesirable effects have been reported with the use of eye ointment and Tobradex eye drops:
- local reactions: hyperemia, itching, burning and dryness of the eyes and eyelids, feeling of a foreign body in the eye, increased intraocular pressure, decreased visual acuity, keratitis, conjunctival edema, lacrimation. In isolated cases, the development of cataracts, glaucoma, mydriasis and photophobia was also noted;
- allergic reactions: swelling of the face, pruritus, rash, erythema;
- other: nausea, vomiting, bitter taste in the mouth, dizziness, headache, rhinorrhea, laryngospasm.
In addition, patients with thinning of the sclera may develop perforation (the risk increases with prolonged use).
It is impossible to exclude the development of a secondary infection (caused by microorganisms insensitive to the action of tobramycin) when using the drug Tobradex.

Contraindications:

Do not prescribe to patients with individual intolerance to tobramycin and dexamethasone;
- eye drops should not be administered to patients with hypersensitivity to benzalkonium chloride;
- do not use for the treatment of patients suffering from keratitis and other eye infections caused by the herpes virus, mycobacterium tuberculosis, fungi and other microorganisms insensitive to tobramycin;
- it is not advisable to use the drug for uncomplicated removal of a foreign body from the eye;
- do not apply to the treatment of children under the age of 1 year.
Caution must be observed, prescribing the drug Tobradex to patients with glaucoma, as well as thinning of the cornea.
Patients who operate potentially unsafe machinery and drive a car are advised to avoid these activities during the period of therapy with Tobradex.

Interaction
other medicinal
by other means:

When using drops or ointment Tobradex simultaneously with other local ophthalmic agents, an interval of at least 15 minutes between their use should be observed.
You should also remove contact lenses before using the drug Tobradex, it is recommended to wear lenses no earlier than 15 minutes after the drug is introduced into the conjunctival sac.
The combined use of the drug Tobradex with local and systemic drugs that have ototoxic, nephrotoxic and neurotoxic effects should be avoided, since mutual enhancement of these effects is possible.
Do not use Tobradex in combination with systemic aminoglycosides.

Storage conditions:

The drug Tobradex, regardless of the form of release, should be stored for no more than 2 years after manufacture.
Eye drops and eye ointment should be stored in rooms with a temperature not exceeding 25 ° C.
It is forbidden to freeze the drug.
After the first opening of the tube or vial, Tobradex is valid for 30 days.

1 ml Tobradex eye drops contains:

- excipients: benzalkonium chloride, disodium edetate, sodium chloride, anhydrous sodium sulfate, tyloxapol, hydroxyethylcellulose, sodium hydroxide or sulfuric acid (to maintain pH), purified water.

1 g Tobradex eye ointment contains:
- active ingredients: tobramycin - 3 mg, dexamethasone - 1 mg;
- excipients: anhydrous chlorobutanol, mineral oil, white petrolatum.