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This medication has several important safety considerations and warnings that you should be aware of. The following points outline the potential risks, necessary precautions, and special instructions for certain populations when using this medication. If you have any concerns, please discuss them with your healthcare provider.

• Kidney and Nerve Damage: The medication can lead to serious kidney problems and nerve damage, which may result in permanent hearing loss and balance issues. The risk is heightened for older individuals, those with existing kidney conditions, or those with severe dehydration. High doses or prolonged use of the medication also increase the risk. It is crucial to inform your doctor immediately if you experience ringing or roaring sounds in the ears, hearing loss, dizziness, or a decrease in urine output. Your doctor will monitor your hearing, kidney function, and drug levels to mitigate these risks. Avoid other medications that could elevate your risk of these side effects when taken with tobramycin.

• Nervous System Effects and Hearing Loss: Tobramycin may cause nervous system issues, such as dizziness, numbness, tingling, muscle twitching, and seizures. Risks increase if you are using other medications that can affect hearing, like diuretics. Regular hearing tests may be conducted during treatment. Seek medical attention immediately if you experience changes in hearing, numbness, tingling, or muscle twitching.

• Kidney Issues: Tobramycin can harm kidneys, potentially affecting urine production. Those also taking nephrotoxic medications are at a higher risk. Your healthcare provider will conduct urine and blood tests to monitor kidney function, adjusting the dosage or stopping the medication if necessary. Report symptoms like fatigue, dry and itchy skin, decreased appetite, reduced urination, foamy or bloody urine, or muscle cramps to your provider.

• Risks During Pregnancy: There is a potential for aminoglycoside antibiotics like tobramycin to harm unborn babies, including causing hearing loss. Inform your healthcare provider if you are pregnant before starting treatment to assess whether an alternative antibiotic might be more appropriate.

• Serious Allergic Reactions: Tobramycin can lead to severe allergic reactions, including anaphylaxis and severe skin reactions. Some formulations contain sulfite, which can trigger allergies in sensitive individuals. Contact medical services immediately if you notice hives, peeling skin, difficulty breathing, or swelling of the face, lips, or tongue.

• Diarrhea from C. difficile Infection: Antibiotics, including tobramycin, can increase the risk of Clostridioides difficile infection, leading to potentially life-threatening diarrhea. This happens due to alterations in the normal bacterial balance in the gut.

• Drug-Resistant Bacteria: Your doctor will ensure that tobramycin is used for the correct infection and duration. Misuse or inappropriate use increases the risk of developing drug-resistant infections, which are more challenging to treat.

• Contraindications: Avoid using this medication if you have an allergy to any aminoglycoside antibiotic. Always consult your healthcare provider if you suspect any contraindications to ensure your safety.

Common side effects:

• nausea
• vomiting
• diarrhea
• headache
• low energy

Less common but important to monitor:

• oral thrush
• new yeast infection

Serious side effects:

• hearing problems
• ringing in the ears
• dizziness
• numbness
• tingling
• muscle twitching
• weakness
• severe kidney-related issues
• C. difficile-related diarrhea
• serious allergic reactions

Interactions with high risk of serious adverse effects and should be avoided:

• Ataluren

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• 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
• Vecuronium

Interactions with low risk that usually do not require a change in therapy:

• Cisplatin
• Cyclosporine
• Amikacin
• Amphotericin B
• Polymyxin B
• Cephaloridine
• Ibuprofen