A sterile, topical ophthalmic suspension combining an aminoglycoside antibiotic (Tobramycin) with a potent corticosteroid (Fluorometholone). It is indicated for steroid-responsive inflammatory ocular conditions where a risk of superficial bacterial infection exists or where such an infection is suspected. The combination provides broad-spectrum antibacterial coverage against common ocular pathogens while suppressing inflammation.
Adult: One drop instilled into the conjunctival sac of the affected eye(s) every 4 to 6 hours. In severe inflammation, may be used hourly initially, tapering frequency as inflammation subsides.
Note: 1. Wash hands before use. 2. Shake the suspension well before each use. 3. Tilt head back, pull lower eyelid down to form a pouch. 4. Instill prescribed number of drops. 5. Close eyes gently for 1-2 minutes, applying gentle pressure to the nasolacrimal duct (inner corner of eye) to minimize systemic absorption. 6. Do not touch dropper tip to any surface to avoid contamination. 7. Wait at least 5-10 minutes before instilling any other eye medication.
Tobramycin binds irreversibly to the 30S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis and causing bacterial cell death. Fluorometholone binds to cytoplasmic glucocorticoid receptors, inducing the synthesis of anti-inflammatory proteins (lipocortins) which inhibit phospholipase A2, thereby reducing the production of prostaglandins, leukotrienes, and other mediators of inflammation, edema, and capillary dilation.
Pregnancy: Category C (US FDA). Animal studies show risk, but no adequate, well-controlled studies in pregnant women. Use only if potential benefit justifies potential risk to the fetus. Systemic corticosteroids are known to cause fetal harm. Use minimal effective dose for shortest duration.
Driving: May cause temporary blurred vision after instillation. Patients should not drive or operate machinery until vision clears.
| Other Aminoglycosides (e.g., Gentamicin eye drops) | Additive risk of ototoxicity and nephrotoxicity if systemically absorbed; potential for local toxicity. | Moderate |
| Systemic Corticosteroids (e.g., Prednisone) | Additive systemic steroid effects, increasing risk of hyperglycemia, adrenal suppression, and Cushingoid state. | Moderate |
| Non-depolarizing Muscle Relaxants (e.g., Tubocurarine) | Tobramycin may potentiate neuromuscular blockade if significant systemic absorption occurs. | Major (theoretical for topical use) |
| Loop Diuretics (e.g., Furosemide) | May increase the risk of ototoxicity and nephrotoxicity of Tobramycin if systemically absorbed. | Moderate (theoretical for topical use) |
| Cholinesterase Inhibitors (e.g., Pilocarpine for glaucoma) | Fluorometholone may reduce the anti-glaucoma effect. | Moderate |
Same composition (Tobramycin (0.3% w/v) + Fluorometholone (0.1% w/v)), different brands: