Tobradex Ointment (Tobramycin 0.3% / Dexamethasone 0.1%)

Topical ophthalmic use only: Not for injection into the eye.

Aminoglycoside sensitivity: Reactions range from local effects to erythema, itching, urticaria, skin rash, anaphylaxis, anaphylactoid reactions, or bullous reactions; discontinue if one occurs, and expect possible cross-sensitivity to other aminoglycosides.

IOP elevation and glaucoma: Prolonged steroid use may produce glaucoma with optic nerve damage and defects in visual acuity and visual fields; monitor IOP routinely, including in pediatric and uncooperative patients where measurement is harder.

Posterior subcapsular cataract: Prolonged steroid use may produce it.

Delayed corneal healing: Ophthalmic ointment may retard corneal wound healing, and delayed wound healing is separately attributed to the steroid component.

Secondary or masked infection: Prolonged use may suppress host response and increase the hazard of secondary ocular infection; in acute purulent conditions and parasitic infections of the eye, steroids may mask infection or enhance existing infection.

Corneal or scleral perforation: Reported with topical steroids in diseases causing thinning of the cornea or sclera.

Fungal and nonsusceptible overgrowth: Consider fungal corneal infection after long-term steroid dosing; prolonged antibiotic use may allow overgrowth of nonsusceptible organisms, including fungi.

Renewal examination: Examine with magnification, such as slit lamp biomicroscopy and where appropriate fluorescein staining, when multiple prescriptions are required or whenever clinical judgment dictates.

Contact lens wear: Lenses should not be worn during treatment, and patients with signs and symptoms of bacterial ocular infection should not wear them.