Identification

Name
Tobramycin
Accession Number
DB00684  (APRD00582)
Type
Small Molecule
Groups
Approved, Investigational
Description

An aminoglycoside, broad-spectrum antibiotic produced by Streptomyces tenebrarius. It is effective against gram-negative bacteria, especially the pseudomonas species. It is a 10% component of the antibiotic complex, nebramycin, produced by the same species. [PubChem]

Structure
Thumb
Synonyms
  • 3'-Deoxykanamycin b
  • Nebramycin 6
  • Nebramycin factir 6
  • Nebramycin-Faktor 6
  • O-3-Amino-3-deoxy-alpha-D-glucopyranosyl-(1-4)-O-(2,6-diamino-2,3,6-trideoxy-alpha-D-ribohexopyranosyl-(1-4))-2-deoxy-D-streptamine
  • Tobracin (tn)
  • Tobramicina
  • Tobramycin
  • Tobramycine
  • Tobramycinum
  • Tobrex (tn)
External IDs
47663 / Lilly 47663 / SPRC-AB01
Product Ingredients
IngredientUNIICASInChI Key
Tobramycin hydrochloride01IX3OU16895188-93-5CVDADWBWFLWJNQ-TWDWGCDDSA-N
Tobramycin SulfateHJT0RXD7JK49842-07-1ZEUUPKVZFKBXPW-TWDWGCDDSA-N
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
BethkisSolution300 mg/4mLRespiratory (inhalation)Chiesi Pharmaceuticals Inc.2013-04-15Not applicableUs
Kitabis PakSolution300 mg/5mLRespiratory (inhalation)Pari Respiratory Equipment2014-12-02Not applicableUs
Kitabis PakSolution300 mg/5mLRespiratory (inhalation)Catalent Pharma Solutions,Llc2015-02-192018-05-11Us
Nebcin Inj 1.2gm/30mlLiquid1.2 gIntramuscular; IntravenousEli Lilly & Co. Ltd.1986-12-312003-05-12Canada
Nebcin Inj 10mg/mlLiquid10 mgIntramuscular; IntravenousEli Lilly & Co. Ltd.1975-12-312003-05-12Canada
Nebcin Inj 10mg/ml (vantage Vial)Liquid10 mgIntravenousEli Lilly & Co. Ltd.1989-12-311997-05-20Canada
Nebcin Inj 40mg/mlLiquid40 mgIntramuscular; IntravenousEli Lilly & Co. Ltd.1975-12-312003-05-12Canada
Nebcin Inj 60mgLiquid60 mgIntramuscular; IntravenousEli Lilly & Co. Ltd.1978-12-311998-08-04Canada
Nebcin Inj 80mgLiquid80 mgIntramuscular; IntravenousEli Lilly & Co. Ltd.1978-12-311998-08-04Canada
Sandoz Tobramycin 0.3%Solution0.3 %OphthalmicSandoz Canada Incorporated2000-08-21Not applicableCanada
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Aj-tobramycinLiquid40 mgIntramuscular; IntravenousAgila Jamp Canada IncNot applicableNot applicableCanada
Apo-tobramycinSolution0.3 %OphthalmicApotex Corporation2002-09-18Not applicableCanada
Jamp-tobramycinLiquid40 mgIntramuscular; IntravenousJamp Pharma Corporation2014-03-11Not applicableCanada
PMS-tobramycin 0.3% Ophthalmic SolutionLiquid3 mgOphthalmicPharmascience Inc1999-02-18Not applicableCanada
Teva-tobramycinSolution60 mgRespiratory (inhalation)Teva2016-02-03Not applicableCanada
TobramycinSolution3 mg/mLOphthalmicNu Care Pharmaceuticals,inc.1995-01-09Not applicableUs
TobramycinInjection, solution40 mg/mLIntramuscular; IntravenousFresenius Kabi2005-11-23Not applicableUs
TobramycinSolution3 mg/mLOphthalmicRemedy Repack2016-07-192017-03-10Us
TobramycinSolution3 mg/mLOphthalmicRebel Distributors1994-05-25Not applicableUs
TobramycinSolution / drops3 mg/mLOphthalmicRemedy Repack2013-06-132017-01-25Us
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
TobraDexTobramycin (3 mg/mL) + Dexamethasone (1 mg/mL)SuspensionOphthalmicRebel Distributors1988-08-18Not applicableUs
TobraDexTobramycin (3 mg/g) + Dexamethasone (1 mg/g)OintmentOphthalmicAlcon, Inc.1988-10-15Not applicableUs
TobraDexTobramycin (3 mg/g) + Dexamethasone (1 mg/g)OintmentOphthalmicRebel Distributors1988-09-28Not applicableUs
TobraDexTobramycin (3 mg/mL) + Dexamethasone (1 mg/mL)SuspensionOphthalmicA S Medication Solutions1988-09-152017-06-20Us
TobraDexTobramycin (0.3 %) + Dexamethasone (0.1 %)SuspensionOphthalmicNovartis1990-12-31Not applicableCanada
TobradexTobramycin (3 mg/mL) + Dexamethasone (1 mg/mL)SuspensionOphthalmicStat Rx USA1988-09-152018-02-08Us
TobraDexTobramycin (3 mg/mL) + Dexamethasone (1 mg/mL)Suspension / dropsOphthalmicAlcon, Inc.1988-09-15Not applicableUs
TobraDexTobramycin (3 mg/mL) + Dexamethasone (1 mg/mL)SuspensionOphthalmicA S Medication Solutions1988-09-152017-06-20Us
TobraDexTobramycin (0.3 %) + Dexamethasone (0.1 %)OintmentOphthalmicNovartis1990-12-31Not applicableCanada
TobraDexTobramycin (3 mg/g) + Dexamethasone (1 mg/g)OintmentOphthalmicA S Medication Solutions1988-10-152017-06-20Us
International/Other Brands
Aktob (Akorn) / Alveoterol (Tetrafarm) / Amgy (Kobec) / Bactob (Solitaire) / Belbarmicina (Quimica Luar) / Bideon Biotic (Fecofar) / Bioptic (Bausch & Lomb) / Bramitob (Torrex) / Gernebcin (Infectopharm) / Nebcin (Lilly) / Obracin (EuroCept) / Tobracin (Opso Saline) / Tobramaxin (Alcon)
Categories
UNII
VZ8RRZ51VK
CAS number
32986-56-4
Weight
Average: 467.5145
Monoisotopic: 467.259127807
Chemical Formula
C18H37N5O9
InChI Key
NLVFBUXFDBBNBW-PBSUHMDJSA-N
InChI
InChI=1S/C18H37N5O9/c19-3-9-8(25)2-7(22)17(29-9)31-15-5(20)1-6(21)16(14(15)28)32-18-13(27)11(23)12(26)10(4-24)30-18/h5-18,24-28H,1-4,19-23H2/t5-,6+,7+,8-,9+,10+,11-,12+,13+,14-,15+,16-,17+,18+/m0/s1
IUPAC Name
(2S,3R,4S,5S,6R)-4-amino-2-{[(1S,2S,3R,4S,6R)-4,6-diamino-3-{[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxyoxan-2-yl]oxy}-2-hydroxycyclohexyl]oxy}-6-(hydroxymethyl)oxane-3,5-diol
SMILES
NC[C@H]1O[C@H](O[C@@H]2[C@@H](N)C[C@@H](N)[C@H](O[C@H]3O[C@H](CO)[C@@H](O)[C@H](N)[C@H]3O)[C@H]2O)[C@H](N)C[C@@H]1O

Pharmacology

Indication

For the treatment of pseudomonas aeruginosa lung infections. Also being investigated for use in the treatment of sinus infections.

Associated Conditions
Pharmacodynamics

Tobramycin, an aminoglycoside antibiotic obtained from cultures of Streptomyces tenebrarius, is used in combination with other antibiotics to treat urinary tract infections, gynecologic infections, peritonitis, endocarditis, pneumonia, bacteremia and sepsis, respiratory infections including those associated with cystic fibrosis, osteomyelitis, and diabetic foot and other soft-tissue infections. It acts primarily by disrupting protein synthesis, leading to altered cell membrane permeability, progressive disruption of the cell envelope, and eventual cell death. Tobramycin has in vitro activity against a wide range of gram-negative organisms including Pseudomonas aeruginosa.

Mechanism of action

Tobramycin binds irreversibly to one of two aminoglycoside binding sites on the 30 S ribosomal subunit, inhibiting bacterial protein synthesis. Tobramycin may also destabilize bacterial memebrane by binding to 16 S 16 S r-RNA. An active transport mechanism for aminoglycoside uptake is necessary in the bacteria in order to attain a significant intracellular concentration of tobramycin.

TargetActionsOrganism
A30S ribosomal protein S12
inhibitor
Escherichia coli (strain K12)
U16S rRNA
inhibitor
Enteric bacteria and other eubacteria
Absorption

The bioavailability of tobramycin may vary because of individual differences in nebulizer performance and airway pathology.

Volume of distribution
Not Available
Protein binding
Not Available
Metabolism
Not Available
Route of elimination
Not Available
Half life

The elimination half-life of tobramycin from serum is approximately 2 hours after intravenous (IV) administration.

Clearance
Not Available
Toxicity

LD50=441mg/kg (s.c. in mice)

Affected organisms
  • Enteric bacteria and other eubacteria
Pathways
PathwayCategory
Tobramycin Action PathwayDrug action
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
(4R)-limonene(4R)-limonene may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
AceclofenacAceclofenac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
AcemetacinAcemetacin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Experimental, Investigational
AcetyldigitoxinThe serum concentration of Acetyldigitoxin can be decreased when it is combined with Tobramycin.Approved
AcetyldigoxinThe serum concentration of Acetyldigoxin can be decreased when it is combined with Tobramycin.Experimental
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Vet Approved
AdapaleneAdapalene may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
AlclofenacAlclofenac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Withdrawn
AlcuroniumTobramycin may increase the respiratory depressant activities of Alcuronium.Experimental
Alendronic acidTobramycin may increase the hypocalcemic activities of Alendronic acid.Approved
AlminoprofenAlminoprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
AmdinocillinThe serum concentration of Tobramycin can be decreased when it is combined with Amdinocillin.Investigational, Withdrawn
AmikacinThe risk or severity of adverse effects can be increased when Amikacin is combined with Tobramycin.Approved, Investigational, Vet Approved
AmoxicillinThe serum concentration of Tobramycin can be decreased when it is combined with Amoxicillin.Approved, Vet Approved
Amphotericin BAmphotericin B may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
AmpicillinThe serum concentration of Tobramycin can be decreased when it is combined with Ampicillin.Approved, Vet Approved
AndrographolideAndrographolide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
AnisodamineAnisodamine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
AntipyrineAntipyrine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
ApocyninApocynin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
ApremilastApremilast may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
AspoxicillinThe serum concentration of Tobramycin can be decreased when it is combined with Aspoxicillin.Experimental
AtracuriumTobramycin may increase the respiratory depressant activities of Atracurium.Approved, Experimental, Investigational
Atracurium besylateTobramycin may increase the respiratory depressant activities of Atracurium besylate.Approved
AtropineThe therapeutic efficacy of Atropine can be decreased when used in combination with Tobramycin.Approved, Vet Approved
AzapropazoneAzapropazone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Withdrawn
AzelastineAzelastine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
AzidocillinThe serum concentration of Tobramycin can be decreased when it is combined with Azidocillin.Approved
AzlocillinThe serum concentration of Tobramycin can be decreased when it is combined with Azlocillin.Approved
AzosemideThe serum concentration of Tobramycin can be increased when it is combined with Azosemide.Investigational
BacampicillinThe serum concentration of Tobramycin can be decreased when it is combined with Bacampicillin.Approved, Investigational
BacitracinThe risk or severity of nephrotoxicity can be increased when Tobramycin is combined with Bacitracin.Approved, Vet Approved
BalsalazideBalsalazide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
BendazacBendazac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
BenorilateBenorilate may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
BenoxaprofenBenoxaprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Withdrawn
BenzatropineThe therapeutic efficacy of Benzatropine can be decreased when used in combination with Tobramycin.Approved
BenzphetamineThe risk or severity of adverse effects can be increased when Benzphetamine is combined with Tobramycin.Approved, Illicit
BenzydamineBenzydamine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
Benzyl alcoholThe risk or severity of adverse effects can be increased when Benzyl alcohol is combined with Tobramycin.Approved
BenzylpenicillinThe serum concentration of Tobramycin can be decreased when it is combined with Benzylpenicillin.Approved, Vet Approved
Benzylpenicilloyl PolylysineThe serum concentration of Tobramycin can be decreased when it is combined with Benzylpenicilloyl Polylysine.Approved
BevoniumBevonium may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
Botulinum Toxin Type ATobramycin may increase the neuromuscular blocking activities of Botulinum Toxin Type A.Approved, Investigational
Botulinum Toxin Type BTobramycin may increase the neuromuscular blocking activities of Botulinum Toxin Type B.Approved, Investigational
BromfenacBromfenac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
BrompheniramineThe risk or severity of adverse effects can be increased when Brompheniramine is combined with Tobramycin.Approved
BucillamineBucillamine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
BufexamacBufexamac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Experimental
BumadizoneBumadizone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
BumetanideThe serum concentration of Tobramycin can be increased when it is combined with Bumetanide.Approved
BupropionThe risk or severity of adverse effects can be increased when Bupropion is combined with Tobramycin.Approved
CapreomycinCapreomycin may increase the neuromuscular blocking activities of Tobramycin.Approved
CarbamazepineThe risk or severity of adverse effects can be increased when Carbamazepine is combined with Tobramycin.Approved, Investigational
Carbaspirin calciumCarbaspirin calcium may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental, Investigational
CarbenicillinThe serum concentration of Tobramycin can be decreased when it is combined with Carbenicillin.Approved, Investigational
Carbenicillin indanylThe serum concentration of Tobramycin can be decreased when it is combined with Carbenicillin indanyl.Approved, Investigational
CarboplatinTobramycin may increase the ototoxic activities of Carboplatin.Approved
CarfecillinThe serum concentration of Tobramycin can be decreased when it is combined with Carfecillin.Experimental
CarprofenCarprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Vet Approved, Withdrawn
CastanospermineCastanospermine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
CefaclorCefaclor may increase the nephrotoxic activities of Tobramycin.Approved
CefamandoleCefamandole may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CefbuperazoneCefbuperazone may increase the nephrotoxic activities of Tobramycin.Experimental
CefcapeneCefcapene may increase the nephrotoxic activities of Tobramycin.Experimental
CefdinirCefdinir may increase the nephrotoxic activities of Tobramycin.Approved
CefditorenCefditoren may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CefepimeCefepime may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CefetametCefetamet may increase the nephrotoxic activities of Tobramycin.Experimental
CefiximeCefixime may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CefmenoximeCefmenoxime may increase the nephrotoxic activities of Tobramycin.Approved
CefmetazoleCefmetazole may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CefminoxCefminox may increase the nephrotoxic activities of Tobramycin.Approved
CefodizimeCefodizime may increase the nephrotoxic activities of Tobramycin.Experimental
CefonicidCefonicid may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CefoperazoneCefoperazone may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CeforanideCeforanide may increase the nephrotoxic activities of Tobramycin.Approved
CefotaximeCefotaxime may increase the nephrotoxic activities of Tobramycin.Approved
CefotetanCefotetan may increase the nephrotoxic activities of Tobramycin.Approved
CefotiamCefotiam may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CefoxitinCefoxitin may increase the nephrotoxic activities of Tobramycin.Approved
CefozopranCefozopran may increase the nephrotoxic activities of Tobramycin.Experimental
CefpiramideCefpiramide may increase the nephrotoxic activities of Tobramycin.Approved
CefpiromeCefpirome may increase the nephrotoxic activities of Tobramycin.Approved
CefpodoximeCefpodoxime may increase the nephrotoxic activities of Tobramycin.Approved, Vet Approved
CefprozilCefprozil may increase the nephrotoxic activities of Tobramycin.Approved
CefsulodinCefsulodin may increase the nephrotoxic activities of Tobramycin.Experimental
CeftazidimeCeftazidime may increase the nephrotoxic activities of Tobramycin.Approved
CeftibutenCeftibuten may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CeftizoximeCeftizoxime may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
CeftriaxoneCeftriaxone may increase the nephrotoxic activities of Tobramycin.Approved
CefuroximeCefuroxime may increase the nephrotoxic activities of Tobramycin.Approved
CelecoxibCelecoxib may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
CetirizineThe risk or severity of adverse effects can be increased when Cetirizine is combined with Tobramycin.Approved
ChloroquineChloroquine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational, Vet Approved
ChlorphenamineThe risk or severity of adverse effects can be increased when Chlorphenamine is combined with Tobramycin.Approved
ChlorthalidoneThe serum concentration of Tobramycin can be increased when it is combined with Chlorthalidone.Approved
Choline magnesium trisalicylateCholine magnesium trisalicylate may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
CisatracuriumTobramycin may increase the respiratory depressant activities of Cisatracurium.Approved
CisplatinCisplatin may increase the nephrotoxic activities of Tobramycin.Approved
ClemastineThe risk or severity of adverse effects can be increased when Clemastine is combined with Tobramycin.Approved, Investigational
ClindamycinThe risk or severity of adverse effects can be increased when Clindamycin is combined with Tobramycin.Approved, Vet Approved
Clodronic AcidTobramycin may increase the hypocalcemic activities of Clodronic Acid.Approved, Investigational, Vet Approved
ClonixinClonixin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
CloxacillinThe serum concentration of Tobramycin can be decreased when it is combined with Cloxacillin.Approved, Investigational, Vet Approved
CodeineThe risk or severity of adverse effects can be increased when Codeine is combined with Tobramycin.Approved, Illicit
ColistimethateTobramycin may increase the nephrotoxic activities of Colistimethate.Approved, Vet Approved
CurcuminCurcumin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
CyclacillinThe serum concentration of Tobramycin can be decreased when it is combined with Cyclacillin.Approved
CyclobenzaprineThe risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Tobramycin.Approved
CyclosporineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Cyclosporine.Approved, Investigational, Vet Approved
CymarinThe serum concentration of Cymarin can be decreased when it is combined with Tobramycin.Experimental
DecamethoniumTobramycin may increase the respiratory depressant activities of Decamethonium.Approved
DeslanosideThe serum concentration of Deslanoside can be decreased when it is combined with Tobramycin.Approved
DesvenlafaxineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Desvenlafaxine.Approved, Investigational
DexbrompheniramineThe risk or severity of adverse effects can be increased when Dexbrompheniramine is combined with Tobramycin.Approved
DiclofenacThe risk or severity of nephrotoxicity can be increased when Diclofenac is combined with Tobramycin.Approved, Vet Approved
DicloxacillinThe serum concentration of Tobramycin can be decreased when it is combined with Dicloxacillin.Approved, Investigational, Vet Approved
DifenpiramideDifenpiramide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
DiflunisalDiflunisal may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
DigitoxinThe serum concentration of Digitoxin can be decreased when it is combined with Tobramycin.Approved, Investigational
DigoxinThe serum concentration of Digoxin can be decreased when it is combined with Tobramycin.Approved
Digoxin Immune Fab (Ovine)The serum concentration of Digoxin Immune Fab (Ovine) can be decreased when it is combined with Tobramycin.Approved
DimenhydrinateThe risk or severity of adverse effects can be increased when Dimenhydrinate is combined with Tobramycin.Approved
DiphenhydramineThe risk or severity of adverse effects can be increased when Diphenhydramine is combined with Tobramycin.Approved, Investigational
Domoic AcidTobramycin may increase the respiratory depressant activities of Domoic Acid.Experimental
DotarizineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Dotarizine.Investigational
DoxacuriumTobramycin may increase the respiratory depressant activities of Doxacurium chloride.Approved
DoxylamineDoxylamine may increase the central nervous system depressant (CNS depressant) activities of Tobramycin.Approved, Vet Approved
DroxicamDroxicam may decrease the excretion rate of Tobramycin which could result in a higher serum level.Withdrawn
DuvelisibDuvelisib may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
E-6201E-6201 may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
EperisoneThe risk or severity of adverse effects can be increased when Eperisone is combined with Tobramycin.Approved, Investigational
EpicillinThe serum concentration of Tobramycin can be decreased when it is combined with Epicillin.Experimental
EpirizoleEpirizole may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
Etacrynic acidThe serum concentration of Tobramycin can be increased when it is combined with Etacrynic acid.Approved, Investigational
EtanerceptEtanercept may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
EthanolTobramycin may increase the central nervous system depressant (CNS depressant) activities of Ethanol.Approved
EthenzamideEthenzamide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
EthosuximideThe risk or severity of adverse effects can be increased when Ethosuximide is combined with Tobramycin.Approved
Etidronic acidTobramycin may increase the hypocalcemic activities of Etidronic acid.Approved
EtodolacEtodolac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational, Vet Approved
EtofenamateEtofenamate may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
EtomidateThe risk or severity of adverse effects can be increased when Etomidate is combined with Tobramycin.Approved
EtoricoxibEtoricoxib may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
Evening primrose oilEvening primrose oil may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational, Nutraceutical
ExisulindExisulind may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
FelbinacFelbinac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
FenbufenFenbufen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
FenoprofenFenoprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
FentanylThe risk or severity of adverse effects can be increased when Fentanyl is combined with Tobramycin.Approved, Illicit, Investigational, Vet Approved
FentiazacFentiazac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
FeprazoneFeprazone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
Ferulic acidFerulic acid may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
FloctafenineFloctafenine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Withdrawn
FlomoxefFlomoxef may increase the nephrotoxic activities of Tobramycin.Investigational
FlucloxacillinThe serum concentration of Tobramycin can be decreased when it is combined with Flucloxacillin.Approved, Investigational
FlunarizineThe risk or severity of adverse effects can be increased when Flunarizine is combined with Tobramycin.Approved
FlunixinFlunixin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Vet Approved
FlunoxaprofenFlunoxaprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
FluoxetineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Fluoxetine.Approved, Vet Approved
FlurbiprofenFlurbiprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
FluspirileneThe risk or severity of adverse effects can be increased when Fluspirilene is combined with Tobramycin.Approved, Investigational
Fluticasone propionateThe risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Tobramycin.Approved
FluvoxamineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Fluvoxamine.Approved, Investigational
FoscarnetFoscarnet may increase the nephrotoxic activities of Tobramycin.Approved
FurosemideThe serum concentration of Tobramycin can be increased when it is combined with Furosemide.Approved, Vet Approved
GabapentinThe risk or severity of adverse effects can be increased when Gabapentin is combined with Tobramycin.Approved, Investigational
GallamineTobramycin may increase the respiratory depressant activities of Gallamine.Experimental
Gallamine TriethiodideTobramycin may increase the respiratory depressant activities of Gallamine Triethiodide.Approved
GitoformateThe serum concentration of Gitoformate can be decreased when it is combined with Tobramycin.Experimental
GuacetisalGuacetisal may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
GuanfacineThe risk or severity of adverse effects can be increased when Guanfacine is combined with Tobramycin.Approved, Investigational
HigenamineHigenamine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
HydrocodoneTobramycin may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.Approved, Illicit
HydroflumethiazideThe serum concentration of Tobramycin can be increased when it is combined with Hydroflumethiazide.Approved, Investigational
HydroxyzineHydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Tobramycin.Approved
HyoscyamineThe therapeutic efficacy of Hyoscyamine can be decreased when used in combination with Tobramycin.Approved
IbandronateThe risk or severity of nephrotoxicity and hypocalcemia can be increased when Tobramycin is combined with Ibandronate.Approved, Investigational
IbuprofenThe risk or severity of nephrotoxicity can be increased when Ibuprofen is combined with Tobramycin.Approved
IbuproxamIbuproxam may decrease the excretion rate of Tobramycin which could result in a higher serum level.Withdrawn
IcatibantIcatibant may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
Imidazole salicylateImidazole salicylate may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
IndobufenIndobufen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
IndomethacinIndomethacin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
IndoprofenIndoprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Withdrawn
IpratropiumThe therapeutic efficacy of Ipratropium can be decreased when used in combination with Tobramycin.Approved
IsoxicamIsoxicam may decrease the excretion rate of Tobramycin which could result in a higher serum level.Withdrawn
KebuzoneKebuzone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
KetoprofenKetoprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Vet Approved
KetorolacThe risk or severity of nephrotoxicity can be increased when Ketorolac is combined with Tobramycin.Approved
LamotrigineThe risk or severity of adverse effects can be increased when Lamotrigine is combined with Tobramycin.Approved, Investigational
Lanatoside CThe serum concentration of Lanatoside C can be decreased when it is combined with Tobramycin.Experimental
LatamoxefLatamoxef may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
LeflunomideLeflunomide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
LevetiracetamThe risk or severity of adverse effects can be increased when Levetiracetam is combined with Tobramycin.Approved, Investigational
LevodopaThe risk or severity of adverse effects can be increased when Levodopa is combined with Tobramycin.Approved
LisofyllineLisofylline may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
LonazolacLonazolac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
LoracarbefLoracarbef may increase the nephrotoxic activities of Tobramycin.Investigational, Withdrawn
LoratadineThe risk or severity of adverse effects can be increased when Loratadine is combined with Tobramycin.Approved, Investigational
LornoxicamLornoxicam may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
LoxoprofenLoxoprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
LumiracoxibLumiracoxib may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
Magnesium carbonateThe risk or severity of adverse effects can be increased when Tobramycin is combined with Magnesium carbonate.Approved, Investigational
Magnesium citrateThe risk or severity of adverse effects can be increased when Tobramycin is combined with Magnesium citrate.Approved
Magnesium hydroxideThe risk or severity of adverse effects can be increased when Tobramycin is combined with Magnesium hydroxide.Approved, Investigational
Magnesium salicylateMagnesium salicylate may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
Magnesium sulfateThe therapeutic efficacy of Tobramycin can be increased when used in combination with Magnesium sulfate.Approved, Investigational, Vet Approved
Magnesium TrisilicateThe risk or severity of adverse effects can be increased when Tobramycin is combined with Magnesium Trisilicate.Approved
MannitolMannitol may increase the nephrotoxic activities of Tobramycin.Approved, Investigational
MasoprocolMasoprocol may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
MecamylamineTobramycin may increase the neuromuscular blocking activities of Mecamylamine.Approved, Investigational
MeclizineThe risk or severity of adverse effects can be increased when Meclizine is combined with Tobramycin.Approved
Meclofenamic acidMeclofenamic acid may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Vet Approved
Mefenamic acidMefenamic acid may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
MeloxicamMeloxicam may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Vet Approved
MesalazineMesalazine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
MetamizoleMetamizole may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational, Withdrawn
MetampicillinThe serum concentration of Tobramycin can be decreased when it is combined with Metampicillin.Experimental
MethsuximideThe risk or severity of adverse effects can be increased when Methsuximide is combined with Tobramycin.Approved
MethyclothiazideThe serum concentration of Tobramycin can be increased when it is combined with Methyclothiazide.Approved
MeticillinThe serum concentration of Tobramycin can be decreased when it is combined with Meticillin.Approved, Investigational
MetildigoxinThe serum concentration of Metildigoxin can be decreased when it is combined with Tobramycin.Experimental
MetocurineTobramycin may increase the respiratory depressant activities of Metocurine.Approved
Metocurine IodideTobramycin may increase the respiratory depressant activities of Metocurine Iodide.Approved, Withdrawn
MezlocillinThe serum concentration of Tobramycin can be decreased when it is combined with Mezlocillin.Approved, Investigational
MivacuriumTobramycin may increase the respiratory depressant activities of Mivacurium.Approved
MizoribineMizoribine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
MofebutazoneMofebutazone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
Mycophenolate mofetilMycophenolate mofetil may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
Mycophenolic acidMycophenolic acid may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
NabumetoneNabumetone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
NafamostatNafamostat may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
NafcillinThe serum concentration of Tobramycin can be decreased when it is combined with Nafcillin.Approved, Investigational
NaftifineNaftifine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
NaproxenThe risk or severity of nephrotoxicity can be increased when Naproxen is combined with Tobramycin.Approved, Vet Approved
NeomycinThe risk or severity of adverse effects can be increased when Tobramycin is combined with Neomycin.Approved, Vet Approved
NeosaxitoxinTobramycin may increase the respiratory depressant activities of Neosaxitoxin.Investigational
NepafenacNepafenac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
NicotineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Nicotine.Approved
NifenazoneNifenazone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
Niflumic AcidNiflumic Acid may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
NimesulideThe risk or severity of nephrotoxicity can be increased when Nimesulide is combined with Tobramycin.Approved, Investigational, Withdrawn
NitroaspirinNitroaspirin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
OleandrinThe serum concentration of Oleandrin can be decreased when it is combined with Tobramycin.Experimental, Investigational
OlopatadineOlopatadine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
OlsalazineOlsalazine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
OndansetronThe risk or severity of adverse effects can be increased when Ondansetron is combined with Tobramycin.Approved
OrgoteinOrgotein may decrease the excretion rate of Tobramycin which could result in a higher serum level.Vet Approved
OtiloniumThe therapeutic efficacy of Otilonium can be decreased when used in combination with Tobramycin.Experimental, Investigational
OuabainThe serum concentration of Ouabain can be decreased when it is combined with Tobramycin.Approved
OxacillinThe serum concentration of Tobramycin can be decreased when it is combined with Oxacillin.Approved, Investigational
OxaprozinOxaprozin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
OxycodoneThe risk or severity of adverse effects can be increased when Oxycodone is combined with Tobramycin.Approved, Illicit, Investigational
OxymorphoneThe risk or severity of adverse effects can be increased when Oxymorphone is combined with Tobramycin.Approved, Investigational, Vet Approved
OxyphenbutazoneOxyphenbutazone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Withdrawn
PalmidrolPalmidrol may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental, Nutraceutical
PamidronateTobramycin may increase the hypocalcemic activities of Pamidronate.Approved
PancuroniumTobramycin may increase the respiratory depressant activities of Pancuronium.Approved
ParecoxibParecoxib may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
ParomomycinThe risk or severity of adverse effects can be increased when Tobramycin is combined with Paromomycin.Approved, Investigational
ParoxetineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Paroxetine.Approved, Investigational
ParthenolideParthenolide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
PenamecillinThe serum concentration of Tobramycin can be decreased when it is combined with Penamecillin.Experimental
PenfluridolThe risk or severity of adverse effects can be increased when Penfluridol is combined with Tobramycin.Experimental
PeruvosideThe serum concentration of Peruvoside can be decreased when it is combined with Tobramycin.Experimental
PhenobarbitalThe risk or severity of adverse effects can be increased when Phenobarbital is combined with Tobramycin.Approved, Investigational
PhenoxymethylpenicillinThe serum concentration of Tobramycin can be decreased when it is combined with Phenoxymethylpenicillin.Approved, Vet Approved
PhenylbutazonePhenylbutazone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Vet Approved
Picosulfuric acidThe therapeutic efficacy of Picosulfuric acid can be decreased when used in combination with Tobramycin.Approved
PimecrolimusPimecrolimus may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
PipecuroniumTobramycin may increase the respiratory depressant activities of Pipecuronium.Approved
PiperacillinThe serum concentration of Tobramycin can be decreased when it is combined with Piperacillin.Approved
PiretanideThe serum concentration of Tobramycin can be increased when it is combined with Piretanide.Approved
PirfenidonePirfenidone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
PiroxicamPiroxicam may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
PirprofenPirprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
PivampicillinThe serum concentration of Tobramycin can be decreased when it is combined with Pivampicillin.Approved
PivmecillinamThe serum concentration of Tobramycin can be decreased when it is combined with Pivmecillinam.Approved
Polymyxin B SulfateThe risk or severity of adverse effects can be increased when Tobramycin is combined with Polymyxin B Sulfate.Approved, Vet Approved
PramipexoleTobramycin may increase the sedative activities of Pramipexole.Approved, Investigational
PranoprofenPranoprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental, Investigational
PregabalinThe therapeutic efficacy of Tobramycin can be increased when used in combination with Pregabalin.Approved, Illicit, Investigational
Procaine benzylpenicillinThe serum concentration of Tobramycin can be decreased when it is combined with Procaine benzylpenicillin.Approved, Vet Approved
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Tobramycin.Approved, Vet Approved
ProglumetacinProglumetacin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
PromethazineThe risk or severity of adverse effects can be increased when Promethazine is combined with Tobramycin.Approved, Investigational
PropacetamolPropacetamol may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
PropicillinThe serum concentration of Tobramycin can be decreased when it is combined with Propicillin.Experimental
PropyphenazonePropyphenazone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
ProquazoneProquazone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
ProscillaridinThe serum concentration of Proscillaridin can be decreased when it is combined with Tobramycin.Experimental
PseudoephedrineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Pseudoephedrine.Approved
PTC299PTC299 may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
PyrantelThe therapeutic efficacy of Pyrantel can be increased when used in combination with Tobramycin.Approved, Vet Approved
QuetiapineThe risk or severity of adverse effects can be increased when Quetiapine is combined with Tobramycin.Approved
QuinethazoneThe serum concentration of Tobramycin can be increased when it is combined with Quinethazone.Approved
RapacuroniumTobramycin may increase the respiratory depressant activities of Rapacuronium.Withdrawn
ResveratrolResveratrol may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Experimental, Investigational
RisedronateTobramycin may increase the hypocalcemic activities of Risedronate.Approved, Investigational
RizatriptanThe risk or severity of adverse effects can be increased when Tobramycin is combined with Rizatriptan.Approved
RocuroniumTobramycin may increase the respiratory depressant activities of Rocuronium.Approved
RofecoxibRofecoxib may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational, Withdrawn
RopiniroleTobramycin may increase the sedative activities of Ropinirole.Approved, Investigational
SalicylamideSalicylamide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
Salicylic acidThe risk or severity of nephrotoxicity can be increased when Salicylic acid is combined with Tobramycin.Approved, Investigational, Vet Approved
SalsalateSalsalate may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
ScopolamineThe risk or severity of adverse effects can be increased when Scopolamine is combined with Tobramycin.Approved, Investigational
SemapimodSemapimod may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
SeratrodastSeratrodast may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
SerrapeptaseSerrapeptase may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
SRT501SRT501 may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
SuccinylcholineTobramycin may increase the respiratory depressant activities of Succinylcholine.Approved
SulbenicillinThe serum concentration of Tobramycin can be decreased when it is combined with Sulbenicillin.Experimental
SulfasalazineThe risk or severity of nephrotoxicity can be increased when Sulfasalazine is combined with Tobramycin.Approved
SulindacThe risk or severity of nephrotoxicity can be increased when Sulindac is combined with Tobramycin.Approved, Investigational
SultamicillinThe serum concentration of Tobramycin can be decreased when it is combined with Sultamicillin.Approved, Investigational
SumatriptanThe risk or severity of adverse effects can be increased when Tobramycin is combined with Sumatriptan.Approved, Investigational
SuprofenSuprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Withdrawn
SuxibuzoneSuxibuzone may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
TalampicillinThe serum concentration of Tobramycin can be decreased when it is combined with Talampicillin.Experimental
TarenflurbilTarenflurbil may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
Technetium Tc-99m etidronateTobramycin may increase the hypocalcemic activities of Technetium Tc-99m etidronate.Approved
Technetium Tc-99m medronateTobramycin may increase the hypocalcemic activities of Technetium Tc-99m medronate.Approved
TenidapTenidap may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
Tenofovir disoproxilThe serum concentration of Tobramycin can be increased when it is combined with Tenofovir disoproxil.Approved, Investigational
TenoxicamTenoxicam may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
TepoxalinTepoxalin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Vet Approved
TeriflunomideTeriflunomide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
TetracyclineThe risk or severity of adverse effects can be increased when Tetracycline is combined with Tobramycin.Approved, Vet Approved
TetrahydropalmatineThe risk or severity of adverse effects can be increased when Tetrahydropalmatine is combined with Tobramycin.Investigational
Tiaprofenic acidTiaprofenic acid may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
TicarcillinThe serum concentration of Tobramycin can be decreased when it is combined with Ticarcillin.Approved, Investigational, Vet Approved
Tiludronic acidTobramycin may increase the hypocalcemic activities of Tiludronic acid.Approved, Investigational, Vet Approved
TinoridineTinoridine may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
Tolfenamic AcidThe risk or severity of nephrotoxicity can be increased when Tolfenamic Acid is combined with Tobramycin.Approved, Investigational
TolmetinTolmetin may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved
TopiramateThe risk or severity of adverse effects can be increased when Topiramate is combined with Tobramycin.Approved
TorasemideThe serum concentration of Tobramycin can be increased when it is combined with Torasemide.Approved
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Tobramycin.Approved, Investigational
TribenosideTribenoside may decrease the excretion rate of Tobramycin which could result in a higher serum level.Experimental
TrichlormethiazideThe serum concentration of Tobramycin can be increased when it is combined with Trichlormethiazide.Approved, Vet Approved
TrimethadioneThe risk or severity of adverse effects can be increased when Trimethadione is combined with Tobramycin.Approved
TriptolideTriptolide may decrease the excretion rate of Tobramycin which could result in a higher serum level.Investigational
Trolamine salicylateThe risk or severity of nephrotoxicity can be increased when Trolamine salicylate is combined with Tobramycin.Approved
TrospiumThe therapeutic efficacy of Trospium can be decreased when used in combination with Tobramycin.Approved
TubocurarineTobramycin may increase the respiratory depressant activities of Tubocurarine.Approved
ValdecoxibValdecoxib may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational, Withdrawn
Valproic AcidThe risk or severity of adverse effects can be increased when Valproic Acid is combined with Tobramycin.Approved, Investigational
VancomycinThe risk or severity of adverse effects can be increased when Vancomycin is combined with Tobramycin.Approved
VecuroniumThe therapeutic efficacy of Vecuronium can be increased when used in combination with Tobramycin.Approved
VenlafaxineThe risk or severity of adverse effects can be increased when Tobramycin is combined with Venlafaxine.Approved
VinpocetineThe risk or severity of adverse effects can be increased when Vinpocetine is combined with Tobramycin.Investigational
ZaltoprofenZaltoprofen may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational
ZiconotideThe risk or severity of adverse effects can be increased when Ziconotide is combined with Tobramycin.Approved
ZileutonZileuton may decrease the excretion rate of Tobramycin which could result in a higher serum level.Approved, Investigational, Withdrawn
Zoledronic acidThe risk or severity of nephrotoxicity and hypocalcemia can be increased when Tobramycin is combined with Zoledronic acid.Approved
ZolmitriptanThe risk or severity of adverse effects can be increased when Tobramycin is combined with Zolmitriptan.Approved, Investigational
ZolpidemTobramycin may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.Approved
ZomepiracZomepirac may decrease the excretion rate of Tobramycin which could result in a higher serum level.Withdrawn
ZonisamideThe risk or severity of adverse effects can be increased when Zonisamide is combined with Tobramycin.Approved, Investigational
Food Interactions
Not Available

References

Synthesis Reference

Istvan Bakondi-Kovacs, "Metabolic controlled fermentation process for carbamoyl tobramycin production." U.S. Patent US20020197683, issued December 26, 2002.

US20020197683
General References
Not Available
External Links
Human Metabolome Database
HMDB0014822
KEGG Drug
D00063
KEGG Compound
C00397
PubChem Compound
36294
PubChem Substance
46507662
ChemSpider
33377
BindingDB
50366778
ChEBI
28864
ChEMBL
CHEMBL1747
Therapeutic Targets Database
DAP000110
PharmGKB
PA451704
HET
TOY
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Tobramycin
ATC Codes
S01AA12 — TobramycinJ01GB01 — Tobramycin
AHFS Codes
  • 08:12.02 — Aminoglycosides
  • 52:04.04 — Antibacterials
PDB Entries
1lc4 / 1m4d / 3sg8 / 3vet / 4ebk / 4evy / 4jd6 / 4lfc / 4xje / 5cfs
FDA label
Download (414 KB)
MSDS
Download (73.3 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
0RecruitingTreatmentOsteomyelitis1
1CompletedBasic ScienceCystic Fibrosis (CF)1
1CompletedTreatmentBurkholderia Cepacia Infection / Cystic Fibrosis (CF)1
1CompletedTreatmentCystic Fibrosis (CF)4
1CompletedTreatmentEye Dryness1
1Unknown StatusTreatmentHealthy Volunteers1
1, 2CompletedBasic ScienceInfection NOS / Minor burns1
1, 2CompletedTreatmentBronchiectasis1
1, 2RecruitingTreatmentCystic Fibrosis (CF)1
1, 2Unknown StatusTreatmentCystic Fibrosis (CF)1
2CompletedPreventionCystic Fibrosis (CF) / Pulmonary Disease, Chronic Obstructive1
2CompletedTreatmentChronic Rhinosinusitis1
2CompletedTreatmentCystic Fibrosis (CF)1
2CompletedTreatmentCystic Fibrosis (CF) / Pseudomonas Aeruginosa1
2, 3RecruitingTreatmentNon-CF Bronchiectasis1
3Active Not RecruitingTreatmentCystic Fibrosis (CF)1
3CompletedTreatmentBacterial Infections / Cystic Fibrosis (CF)1
3CompletedTreatmentCataracts1
3CompletedTreatmentConjunctivitis, Bacterial1
3CompletedTreatmentBacterial blepharitis / Conjunctivitis / Corneal Inflammation1
3CompletedTreatmentCystic Fibrosis (CF)7
3CompletedTreatmentEye Infections / Postoperative Complications1
3CompletedTreatmentMultiple Myeloma (MM)1
3CompletedTreatmentOcular Inflammation Associated With Blepharaconjunctivitis1
3CompletedTreatmentPseudomonas Aeruginosa Infection1
3CompletedTreatmentPseudomonas Infections1
3CompletedTreatmentPurulent Bacterial Conjunctivitis1
3CompletedTreatmentTreatment of Early Pulmonary Infections With P. Aeruginosa in Cystic Fibrosis Patients1
3CompletedTreatmentBacterial blepharitis1
3RecruitingPreventionCritical Illness / Sepsis / Shock, Septic / Ventilator-associated Bacterial Pneumonia1
3RecruitingTreatmentAcute maxillary sinusitis caused by M. catarrhalis / Chronic Lung Diseases / Cystic Fibrosis (CF)1
3RecruitingTreatmentCystic Fibrosis (CF)1
3Unknown StatusTreatmentAcute Bacterial Conjunctivitis1
3WithdrawnTreatmentPost-surgical Inflammation1
4Active Not RecruitingTreatmentMeibomian Gland Dysfunction (MGD) / Posterior Blepharitis1
4Active Not RecruitingTreatmentOpen-angle Glaucoma (OAG)1
4CompletedTreatmentBlepharokeratoconjunctivitis1
4CompletedTreatmentChalazion / Hordeolum1
4CompletedTreatmentConjunctivitis1
4CompletedTreatmentCystic Fibrosis (CF)3
4CompletedTreatmentInflammatory Reaction1
4CompletedTreatmentOcular Hypertension / Open-angle Glaucoma (OAG)1
4CompletedTreatmentPneumonia Ventilator Associated1
4RecruitingPreventionSurgical Site Infections1
4RecruitingTreatmentCystic Fibrosis (CF)1
4RecruitingTreatmentVentilator-associated Bacterial Pneumonia1
4Unknown StatusTreatmentBronchiectasis1
4Unknown StatusTreatmentCystic Fibrosis (CF)1
Not AvailableActive Not RecruitingNot AvailablePseudomonas Aeruginosa in Cystic Fibrosis1
Not AvailableCompletedNot AvailableCystic Fibrosis (CF)1
Not AvailableCompletedNot AvailableOcular Hypertension1
Not AvailableCompletedNot AvailableOrthopedic Operations1
Not AvailableCompletedTreatmentCataracts1
Not AvailableCompletedTreatmentChalazion Both Eyes / Chalazion Left Eye, Unspecified Eyelid / Chalazion Right Eye, Unspecified Eyelid / Chalazion Unspecified Eye, Unspecified Eyelid1
Not AvailableCompletedTreatmentChronic Bronchitis / Cystic Fibrosis (CF)1
Not AvailableNot Yet RecruitingTreatmentDry Eye Syndrome (DES)1
Not AvailableRecruitingNot AvailableAcute Bacterial Exacerbation of Chronic Bronchitis (ABECB) / Acute Bacterial Sinusitis (ABS) / Acute Decompensated Heart Failure (ADHF) / Acute Pyelonephritis / Adenovirus / Adjunct to general anesthesia therapy / Adrenal Insufficiency / Airway Swelling / Anaesthesia therapy / Anxiolysis / Arterial Hypotension / Autism, Early Infantile / Autistic Disorder / Bartonellosis / Benzodiazepine Withdrawal / Benzodiazepines / Bipolar Disorder (BD) / Bloodstream Infections / Bone and Joint Infections / Brain Swelling / Bronchospasm / Brucellosis / Cardiac Arrest / Central Nervous System Infections / Cholera / Chronic Bacterial Prostatitis / Community Acquired Pneumonia (CAP) / Complicated Urinary Tract Infections / Convulsions / Cyanide Poisoning / Cytomegalovirus Retinitis / Drug hypersensitivity reaction / Early-onset Schizophrenia Spectrum Disorders / Edema / Epilepsies / Feeling Anxious / Flu caused by Influenza / Gastroparesis / GYNAECOLOGICAL INFECTION / Headaches / Herpes Simplex Virus / High Blood Cholesterol Level / High Blood Pressure (Hypertension) / Hospital-acquired bacterial pneumonia / Hyperlipidemias / Infantile Hemangiomas / Infection NOS / Inflammatory Conditions / Inflammatory Reaction / Influenza Treatment or Prophylaxis / Inhalational Anthrax (Post-Exposure) / Intra-Abdominal Infections / Life-threatening Fungal Infections / Lower Respiratory Tract Infection (LRTI) / Meningitis, Bacterial / Migraines / Muscle Spasms / Nausea / Opioid Addiction / Pain / Plague / Pneumonia / Prophylaxis / Psittacosis / Q Fever / Reflux / Relapsing Fever / Rocky Mountain Spotted Fever / Schizophrenic Disorders / Sedation therapy / Seizures / Sepsis / Skeletal Muscle Spasms / Skin and Subcutaneous Tissue Bacterial Infections / Skin Structures and Soft Tissue Infections / Stable Angina (SA) / Thromboprophylaxis / Thrombosis / Trachoma / Treatment-resistant Schizophrenia / Tularemia / Typhus Fever / Uncomplicated Skin and Skin Structure Infections / Uncomplicated Urinary Tract Infections / Urinary Tract Infections (UTIs) / Vomiting / Withdrawal1
Not AvailableRecruitingDiagnosticCystic Fibrosis (CF)1
Not AvailableRecruitingTreatmentAge-related Cataract1
Not AvailableRecruitingTreatmentBacterial Keratitis1
Not AvailableRecruitingTreatmentCystic Fibrosis (CF)1
Not AvailableRecruitingTreatmentMyopia / Refractive Errors1
Not AvailableUnknown StatusTreatmentBronchiectasis With Chronic Infection With Pseudomonas Aeruginosa1

Pharmacoeconomics

Manufacturers
  • Alcon laboratories inc
  • Akorn inc
  • Alcon universal ltd
  • Altana inc
  • Bausch and lomb pharmaceuticals inc
  • Novex pharma
  • Falcon pharmaceuticals ltd
  • Novartis pharmaceuticals corp
  • Eli lilly and co
  • Akorn strides llc
  • Apothecon inc div bristol myers squibb
  • App pharmaceuticals llc
  • Astrazeneca lp
  • Baxter healthcare corp anesthesia and critical care
  • Hospira inc
  • Marsam pharmaceuticals llc
  • Teva parenteral medicines inc
  • X gen pharmaceuticals inc
Packagers
  • Advanced Pharmaceutical Services Inc.
  • Akorn Inc.
  • Alcon Laboratories
  • Apotex Inc.
  • APP Pharmaceuticals
  • A-S Medication Solutions LLC
  • Bausch & Lomb Inc.
  • Bristol-Myers Squibb Co.
  • Cardinal Health
  • Clipper Distributing Co. LLC
  • Darby Dental Supply Co. Inc.
  • Dispensing Solutions
  • Diversified Healthcare Services Inc.
  • E.R. Squibb and Sons LLC
  • Eye Care and Cure Corp.
  • Falcon Pharmaceuticals Ltd.
  • H.J. Harkins Co. Inc.
  • Hospira Inc.
  • Innoviant Pharmacy Inc.
  • Keltman Pharmaceuticals Inc.
  • Lake Erie Medical and Surgical Supply
  • Major Pharmaceuticals
  • Medical Ophthalmics
  • Medisca Inc.
  • MWI Veterinary Supply Co.
  • Novartis AG
  • Novex Pharma
  • Nucare Pharmaceuticals Inc.
  • Ocusoft
  • Palmetto Pharmaceuticals Inc.
  • PD-Rx Pharmaceuticals Inc.
  • Pharmedix
  • Physicians Total Care Inc.
  • Preferred Pharmaceuticals Inc.
  • Rebel Distributors Corp.
  • Redpharm Drug
  • Rx Veterinary Products
  • Stat Rx Usa
  • Strides Arcolab Limited
  • Taylor Pharmaceuticals
  • Teva Pharmaceutical Industries Ltd.
  • Vedco Inc.
  • Wilson Ophthalmic Corp.
  • X-Gen Pharmaceuticals
Dosage forms
FormRouteStrength
SolutionRespiratory (inhalation)300 mg/4mL
SolutionRespiratory (inhalation)300 mg/5mL
LiquidIntramuscular; Intravenous1.2 g
LiquidIntravenous10 mg
LiquidIntramuscular; Intravenous60 mg
LiquidIntramuscular; Intravenous80 mg
SolutionOphthalmic0.3 %
SolutionRespiratory (inhalation)60 mg
SolutionOral300 mg/5mL
SolutionRespiratory (inhalation)300 mg
CapsuleOral; Respiratory (inhalation)28 mg/1
CapsuleRespiratory (inhalation)28 mg
OintmentOphthalmic
InjectionIntramuscular; Intravenous40 mg/mL
InjectionIntravenous1200 mg/30mL
Injection, powder, for solutionIntravenous1200 mg/30mL
Injection, powder, lyophilized, for solutionIntravenous1.2 g/30mL
Injection, solutionIntramuscular; Intravenous10 mg/mL
Injection, solutionIntramuscular; Intravenous40 mg/mL
Injection, solutionIntravenous40 mg/mL
SolutionOphthalmic3 mg/mL
SolutionOral3 mg/mL
Solution / dropsOphthalmic3 mg/mL
SuspensionOphthalmic
Suspension / dropsOphthalmic
Powder, for solutionIntravenous1.2 g
Injection, solutionIntravenous.8 mg/mL
SolutionIntramuscular; Intravenous10 mg
SolutionIntramuscular; Intravenous40 mg
LiquidIntramuscular; Intravenous10 mg
LiquidIntramuscular; Intravenous40 mg
LiquidOphthalmic3 mg
OintmentOphthalmic0.3 %
OintmentOphthalmic3 mg/g
Prices
Unit descriptionCostUnit
Tobi (1 Box = 56, 5ml Ampules = 280ml Total) 280ml Plastic Container4461.42USD plastic
Tobramycin 1.2 gm vial338.25USD vial
TobraDex 0.3-0.1% Suspension 10ml Bottle200.43USD bottle
TobraDex 0.3-0.1% Ointment 3.5 gm Tube126.67USD tube
TobraDex 0.3-0.1% Suspension 5ml Bottle98.11USD bottle
Tobrex 0.3% Ointment 3.5 gm Tube80.02USD tube
Tobrex 0.3% Solution 5ml Bottle67.58USD bottle
TobraDex 0.3-0.1% Suspension 2.5ml Bottle54.99USD bottle
Tobramycin sulfate powder53.55USD g
Tobradex eye drops19.27USD ml
Tobi 300 mg/5 ml solution17.58USD ml
Tobramycin Sulfate 0.3% Solution 5ml Bottle15.99USD bottle
Tobrex 0.3% eye drops13.0USD ml
Tobi 60 mg/ml Solution11.4USD ml
Tobramycin Sulfate 40 mg/ml Solution3.6USD ml
Tobramycin 40 mg/ml3.14USD ml
Tobramycin 0.3% eye drops2.99USD ml
Aktob 0.3% eye drops2.85USD ml
Tobrex 0.3 % Ointment2.66USD g
Tobramycin 10 mg/ml2.26USD ml
Tobrex 0.3 % Solution1.88USD ml
Pms-Tobramycin 0.3 % Solution1.05USD ml
Sandoz Tobramycin 0.3 % Solution1.05USD ml
Tobramycin 60 mg/50 ml ns0.19USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5508269No1994-10-192014-10-19Us
US5149694No1992-09-222009-09-22Us
CA2414737No2009-01-062021-06-26Canada
US7795316No2008-08-032028-08-03Us
US8101582No2007-12-192027-12-19Us
US8450287No2007-12-192027-12-19Us
US7368102No2002-12-192022-12-19Us
US8715623No2002-12-192022-12-19Us
US7559325No2005-10-272025-10-27Us
US7442388No2000-05-102020-05-10Us
US7097827No1996-04-162016-04-16Us
US8349294No2000-05-102020-05-10Us
US8069851No2004-09-242024-09-24Us
US7516741No2004-01-112024-01-11Us
US7939502No2002-06-142022-06-14Us
US6987094No2002-09-222022-09-22Us
US7696178No2003-03-172023-03-17Us

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubility1E+003 mg/mlNot Available
logP-5.8Not Available
Predicted Properties
PropertyValueSource
Water Solubility53.7 mg/mLALOGPS
logP-3ALOGPS
logP-6.5ChemAxon
logS-0.94ALOGPS
pKa (Strongest Acidic)12.54ChemAxon
pKa (Strongest Basic)9.83ChemAxon
Physiological Charge5ChemAxon
Hydrogen Acceptor Count14ChemAxon
Hydrogen Donor Count10ChemAxon
Polar Surface Area268.17 Å2ChemAxon
Rotatable Bond Count6ChemAxon
Refractivity106.69 m3·mol-1ChemAxon
Polarizability47.18 Å3ChemAxon
Number of Rings3ChemAxon
Bioavailability0ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption-0.9313
Blood Brain Barrier-0.9794
Caco-2 permeable-0.759
P-glycoprotein substrateSubstrate0.5933
P-glycoprotein inhibitor INon-inhibitor0.7579
P-glycoprotein inhibitor IINon-inhibitor0.9086
Renal organic cation transporterNon-inhibitor0.8412
CYP450 2C9 substrateNon-substrate0.8361
CYP450 2D6 substrateNon-substrate0.8333
CYP450 3A4 substrateNon-substrate0.6662
CYP450 1A2 substrateNon-inhibitor0.9052
CYP450 2C9 inhibitorNon-inhibitor0.9359
CYP450 2D6 inhibitorNon-inhibitor0.923
CYP450 2C19 inhibitorNon-inhibitor0.9117
CYP450 3A4 inhibitorNon-inhibitor0.9728
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9398
Ames testNon AMES toxic0.7537
CarcinogenicityNon-carcinogens0.9469
BiodegradationNot ready biodegradable0.9052
Rat acute toxicity1.7638 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9695
hERG inhibition (predictor II)Non-inhibitor0.7522
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as 4,6-disubstituted 2-deoxystreptamines. These are 2-deoxystreptamine aminoglycosides that a glycosidically linked to a pyranose of furanose unit at the C4- and C6-positions.
Kingdom
Organic compounds
Super Class
Organic oxygen compounds
Class
Organooxygen compounds
Sub Class
Carbohydrates and carbohydrate conjugates
Direct Parent
4,6-disubstituted 2-deoxystreptamines
Alternative Parents
O-glycosyl compounds / Aminocyclitols and derivatives / Cyclohexylamines / Cyclohexanols / Oxanes / Monosaccharides / 1,2-aminoalcohols / Oxacyclic compounds / Acetals / Primary alcohols
show 3 more
Substituents
4,6-disubstituted 2-deoxystreptamine / Glycosyl compound / O-glycosyl compound / Aminocyclitol or derivatives / Cyclohexanol / Cyclohexylamine / Cyclitol or derivatives / Monosaccharide / Oxane / Cyclic alcohol
show 15 more
Molecular Framework
Aliphatic heteromonocyclic compounds
External Descriptors
amino cyclitol glycoside (CHEBI:28864)

Targets

Kind
Protein
Organism
Escherichia coli (strain K12)
Pharmacological action
Yes
Actions
Inhibitor
General Function
Trna binding
Specific Function
With S4 and S5 plays an important role in translational accuracy.Interacts with and stabilizes bases of the 16S rRNA that are involved in tRNA selection in the A site and with the mRNA backbone. Lo...
Gene Name
rpsL
Uniprot ID
P0A7S3
Uniprot Name
30S ribosomal protein S12
Molecular Weight
13736.995 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
  3. Gill AE, Amyes SG: The contribution of a novel ribosomal S12 mutation to aminoglycoside resistance of Escherichia coli mutants. J Chemother. 2004 Aug;16(4):347-9. [PubMed:15332709]
  4. Yang G, Trylska J, Tor Y, McCammon JA: Binding of aminoglycosidic antibiotics to the oligonucleotide A-site model and 30S ribosomal subunit: Poisson-Boltzmann model, thermal denaturation, and fluorescence studies. J Med Chem. 2006 Sep 7;49(18):5478-90. [PubMed:16942021]
2. 16S rRNA
Kind
Nucleotide
Organism
Enteric bacteria and other eubacteria
Pharmacological action
Unknown
Actions
Inhibitor
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed:17139284]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423]
  3. Doi Y, de Oliveira Garcia D, Adams J, Paterson DL: Coproduction of novel 16S rRNA methylase RmtD and metallo-beta-lactamase SPM-1 in a panresistant Pseudomonas aeruginosa isolate from Brazil. Antimicrob Agents Chemother. 2007 Mar;51(3):852-6. Epub 2006 Dec 11. [PubMed:17158944]
  4. Bogaerts P, Galimand M, Bauraing C, Deplano A, Vanhoof R, De Mendonca R, Rodriguez-Villalobos H, Struelens M, Glupczynski Y: Emergence of ArmA and RmtB aminoglycoside resistance 16S rRNA methylases in Belgium. J Antimicrob Chemother. 2007 Mar;59(3):459-64. Epub 2007 Jan 15. [PubMed:17224412]
  5. Chen SY, Lin TH: A molecular dynamics study on binding recognition between several 4,5 and 4,6-linked aminoglycosides with A-site RNA. J Mol Recognit. 2010 Sep-Oct;23(5):423-34. doi: 10.1002/jmr.1008. [PubMed:20029836]

Enzymes

Kind
Protein
Organism
Mycobacterium tuberculosis
Pharmacological action
Unknown
Actions
Substrate
General Function
May catalyze the coenzyme A-dependent acetylation of the 2' hydroxyl or amino group of a broad spectrum of aminoglycosides and confer resistance to aminoglycosides (By similarity). In vitro assays show no significant increase of resistance to aminoglycosides, possibly due to low expression in a heterologous system (PubMed:9159528).
Specific Function
Aminoglycoside 2'-n-acetyltransferase activity
Gene Name
aac
Uniprot ID
P9WQG9
Uniprot Name
Aminoglycoside 2'-N-acetyltransferase
Molecular Weight
20037.53 Da
References
  1. Vetting MW, Hegde SS, Javid-Majd F, Blanchard JS, Roderick SL: Aminoglycoside 2'-N-acetyltransferase from Mycobacterium tuberculosis in complex with coenzyme A and aminoglycoside substrates. Nat Struct Biol. 2002 Sep;9(9):653-8. [PubMed:12161746]

Drug created on June 13, 2005 07:24 / Updated on August 15, 2018 09:43