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This document outlines essential safety information and warnings regarding the use of Tobramycin (Tobi). It is crucial to understand the potential risks and precautions involved while using this medication. If you have any questions or concerns, please consult your healthcare provider.

• Breathing Difficulties: Tobramycin may cause bronchospasm, leading to breathing difficulties or wheezing. If you experience these symptoms, contact your healthcare provider. It is advisable to have a rescue inhaler on hand, especially when starting the medication.

• Hearing Impairment: Tobramycin can lead to hearing issues, including loss, dizziness, or vertigo. Initial signs may include ringing in the ears. Notify your healthcare provider immediately if these symptoms occur. Regular hearing checks may be necessary, particularly if you have a history of ear problems.

• Kidney Impairment: While rare with Tobramycin due to its primary action in the lungs, kidney injury can occur if blood levels of the medication become elevated. Those with existing kidney issues should have regular monitoring. Be alert to reduced urine output or swelling in the legs and feet, and report these to your provider.

• Muscle Weakness: There is a risk of muscle weakness with Tobramycin, notably in individuals with neuromuscular conditions like myasthenia gravis or Parkinson's disease. Severe cases can impact breathing. Immediate medical attention is required if muscle weakness develops.

• Pregnancy Risks: Use of Tobramycin during pregnancy can harm the unborn baby, although this is uncommon since the drug is localized mainly to the lungs. If you are pregnant or planning pregnancy, discuss the potential risks and benefits with your healthcare provider.

Please adhere to these guidelines to ensure safe use of Tobramycin and promptly address any concerns with your healthcare provider.

When taking this medication, some individuals may experience common side effects, such as hoarseness, mouth or throat pain, and respiratory issues like cough, shortness of breath, wheezing, or rattling lung sounds. These effects are often mild, but if they persist or worsen, it's important to consult your healthcare provider for guidance.

Other side effects that have been reported include a stuffy nose, throat or airway irritation, chest muscle pain, changes in taste, nausea, vomiting, diarrhea, bleeding, changes in blood cell counts, high blood sugar, headache, infection, fever, and rash. While these are less frequent, they should be discussed with your healthcare provider, especially if they are severe or concerning.

Serious side effects are rare but require immediate medical attention. These include difficulty breathing, wheezing, hearing loss, dizziness, ringing in the ears, muscle weakness, and signs of kidney injury such as reduced urine output or swollen feet and legs. Additionally, a severe allergic reaction is uncommon but possible, characterized by a rash, itching or swelling, particularly of the face, tongue, or throat, and severe dizziness or trouble breathing. Seek urgent medical care if you experience any of these symptoms.

When using Tobramycin, it's important to be aware of potential interactions with other medications that can affect hearing, potentially increasing the risk of hearing loss. Such medications include amikacin, gentamicin, and mannitol.

Additionally, Tobramycin may have interactions with a variety of other medications. It's crucial to inform your doctor and pharmacist about all the medications and supplements you are currently taking, including prescription, over-the-counter, vitamins, and herbal products.

Certain drugs should generally not be used in combination with Tobramycin. For example, Ataluren is typically not recommended to be used with this medication. In some cases, though, your doctor might decide to adjust the doses if both are necessary.

There are also medications that are usually not recommended to be used with Tobramycin unless necessary. These include Alcuronium, Atracurium, Cholera Vaccine (Live), Cidofovir, Cisatracurium, Colistimethate Sodium, Decamethonium, Doxacurium, Ethacrynic Acid, Fazadinium, Foscarnet, Furosemide, Gallamine, Hexafluorenium, Lysine, Mannitol, Metocurine, Mivacurium, Pancuronium, Pipecuronium, Rapacuronium, Rocuronium, Succinylcholine, Tubocurarine, Vancomycin, and Vecuronium. If these are prescribed together, your healthcare provider may need to adjust how you use them.

Furthermore, using Tobramycin with Cisplatin or Cyclosporine might increase the risk of side effects, but sometimes this combination is necessary. In such cases, your doctor will carefully manage your treatment plan by adjusting dosages or monitoring usage closely. Always follow your healthcare provider's guidance to ensure safe and effective treatment.