Generic Name: Nebcin Brand Name(s): Generics only. No brands available.

Uses

What is Nebcin® (tobramycin) used for?

Nebcin® is commonly used for treating or preventing bacterial infections of the skin, heart, stomach, brain and spinal cord, lungs, and urinary tract (bladder and kidneys). It is also used in the treatment of cystic fibrosis.

Tobramycin injection is sometimes used together with other antibiotics.

Tobramycin may also be used for other purposes, ask your doctor for more information.

How should I take Nebcin® (tobramycin)?

Tobramycin is injected into a muscle, or into a vein through an IV. You may be shown how to use injections at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Use a disposable needle only once, then throw away in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it).

Drink 6 to 8 full glasses of water each day while you are using tobramycin injection. You may become easily dehydrated while using this medication.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Tobramycin will not treat a viral infection such as the common cold or flu.

How do I store Nebcin® (tobramycin)?

Nebcin® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Nebcin® in the bathroom or the freezer. There may be different brands of Nebcin® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Nebcin® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Nebcin® (tobramycin)?

Your doctor will need to check your hearing and kidney function while you are using tobramycin.

Tobramycin can damage nerves and may cause hearing loss that may be permanent.

Tobramycin can also harm your kidneys, and this effect is increased when you also use certain other medicines harmful to the kidneys.

If you need surgery, tell the surgeon ahead of time that you are using tobramycin injection. You may need to stop using the medicine for a short time.

You should not use this medication if you are allergic to tobramycin or similar antibiotics (amikacin, gentamicin, kanamycin, neomycin, paromomycin, streptomycin).

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Nebcin® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Nebcin®. Nebcin® is pregnancy risk category D, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Tobramycin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

Side effects

What side effects can occur from Nebcin® (tobramycin)?

Common side effects may include:

  • Headache
  • Lack of energy
  • Mild rash or itching
  • Nausea
  • Vomiting
  • Diarrhea
  • Pain (where the medicine was injected)

Tobramycin can damage nerves and may cause hearing loss that may be permanent. Tell your doctor right away if you have:

  • Numbness
  • Tingling
  • Muscle stiffness
  • Uncontrolled twitching
  • Dizziness
  • Spinning sensation
  • Seizure (convulsions)
  • Hearing loss
  • A ringing or roaring sound in your ears (even after you have stopped using tobramycin injection)

Call your doctor at once if you have:

  • Swelling
  • Rapid weight gain
  • Little or no urinating
  • Confusion
  • Loss of appetite
  • Vomiting
  • Pain in your side or lower back
  • Fever
  • Severe skin reaction

Get emergency medical help if you have any of these signs of an allergic reaction including hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Nebcin® (tobramycin)?

Nebcin® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Especially if you are taking:

  • Diuretics including ethacrynic acid, furosemide
  • Cisplatin
  • Injected antibiotics such as amikacin, colistimethate, kanamycin, gentamicin, polymyxin B, streptomycin, vancomycin
  • Certain antibiotics taken by mouth such as neomycin, paromomycin

Does food or alcohol interact with Nebcin® (tobramycin)?

Nebcin® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Nebcin® (tobramycin)?

Nebcin® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

To make sure tobramycin injection is safe for you, tell your doctor if you have:

  • Kidney disease
  • A muscle disorder such as myasthenia gravis
  • Parkinson’s disease
  • Asthma
  • A metabolic disorder such as high or low levels of potassium, calcium, or magnesium in your blood

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Nebcin® (tobramycin).

What is the dose of Nebcin® (tobramycin) for an adult?

Bacterial infections

The recommended dose is 3-6 mg/kg/day IV/IM divided q8hr or 4-7 mg/kg/dose IV/IM qDay.

Renal impairment

The recommended dose is:

  • Clcr >60 ml/min: q8hr
  • Clcr 40-60 ml/min: q12hr
  • Clcr 20-40 ml/min: q24hr
  • Clcr 10-20 ml/min: q48hr
  • Clcr <10 ml/min: q72hr

Following dialysis in ESRD

Monitor (Peak and trough concentrations, renal and auditory function)

Life-threatening infection: The recommended dose is 8-10 mcg/ml.

Serious infection: The recommended dose 6-8 mcg/ml.

UTIs: The recommended dose 4-6 mcg/ml.

Synergy for infections caused by gram-positive organisms: The recommended dose 3-5 mcg/ml.

What is the dose of Nebcin® (tobramycin) for a child?

Cystic Fibrosis

IV/IM: The recommended dose is 2.5-3.3 mg/kg q6-8hr.

Neonates

<30week gestation

  • <28 days old: The recommended dose is 2.5 mg/kg IV/IM qDay.
  • ≥28 days old: The recommended dose is 3 mg/kg IV/IM qDay.

30-36week gestation

  • <14 days old: The recommended dose is 3 mg/kg IV/IM qDay.
  • ≥14 days old: The recommended dose is 5 mg/kg/day IV/IM divided q12hr.

>37week gestation

  • <7 days old: The recommended dose is 5 mg/kg/day IV/IM divided q12hr.
  • ≥7 days old: The recommended dose is 7.5 mg/kg/day IV/IM divided q8hr.

Bacterial Infection

<5 years old: The recommended dose is 2.5 mg/kg/dose IV/IM q8hr.

≥5 years old: The recommended dose is 2-2.5 mg/kg/dose IV/IM q8hr.

Hemodialysis: The recommended dose 1.25-1.75 mg/kg/dose postdialysis.

Monitor (Peak and trough concentrations, renal and auditory function)

Life-threatening infection: The recommended dose is 8-10 mcg/ml.

Serious infection: The recommended dose is 6-8 mcg/ml.

UTIs: The recommended dose is 4-6 mcg/ml.

Synergy for infections caused by gram-positive organisms: The recommended dose is 3-5 mcg/ml.

How is Nebcin® (tobramycin) available?

Nebcin® is available in the following dosage forms and strengths:

  • Injectable solution 10mg/ml
  • Injectable solution 40mg/ml

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Nebcin®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 25, 2017 | Last Modified: March 25, 2017

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