Tobradex
In brief
- Tobradex is a prescription-only medicine (POM) in the UK.
- Tobradex is used to treat steroid‑responsive ocular inflammation with suspected or confirmed bacterial infection and for post‑surgical prophylaxis; it combines tobramycin (an aminoglycoside antibiotic that inhibits bacterial protein synthesis at the 30S ribosomal subunit) with dexamethasone (a corticosteroid that reduces inflammation via glucocorticoid receptor‑mediated suppression of inflammatory mediators).
- Usual dosage for adults and children ≥2 years is 1–2 drops in the affected eye(s) every 4–6 hours, which may be increased to every 2 hours initially in severe cases; typical course is 5–14 days, with review if treatment extends (longer courses only under specialist advice).
- Administered topically as an ophthalmic suspension (eye drops).
- Symptom relief may begin within hours; noticeable clinical improvement is often seen within 24–48 hours, although full resolution can take several days depending on the condition.
- The effect of a single dose generally lasts about 4–6 hours (hence the usual dosing interval); the recommended treatment course is typically 5–14 days depending on the indication.
- There is no specific alcohol interaction with topical Tobradex; alcohol does not alter the effect of the eye drops, though avoid excessive alcohol if you are systemically unwell and follow any additional advice from your clinician.
- The most common side effect is eye irritation (burning, stinging, redness); other effects can include eyelid itching or swelling, increased intraocular pressure with prolonged steroid use, and risk of secondary infection if used long term.
- Would you like to try Tobradex without a prescription?
Basic Tobradex information
- INN (international nonproprietary name): Tobramycin/dexamethasone.
- Brand names available in the United Kingdom: Tobradex
- ATC code: S01CA01 (corticosteroids and antiinfectives in combination for ophthalmological use)
- Forms and dosages: Eye drops (ophthalmic suspension): tobramycin 3 mg/mL plus dexamethasone 1 mg/mL, 5 mL bottle
- Manufacturers in the United Kingdom: Novartis Pharmaceuticals UK Ltd
- Registration status in the United Kingdom: Licensed by the MHRA
- OTC / Rx classification: Prescription-only medicine (POM)
Legal status and availability in the UK
Tobradex is a prescription-only medicine (POM) in the UK.
In our online pharmacy, Tobradex is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.
What Tobradex is
Core composition and classification
What exactly is Tobradex?
Tobradex is a fixed-dose ophthalmic combination of tobramycin and dexamethasone for treating and preventing eye inflammation with suspected or confirmed bacterial infection.
INN: tobramycin/dexamethasone.
ATC classification: S01CA01 — corticosteroids and antiinfectives in combination for ophthalmological use.
Packaging, formulations and strengths
Strength and pack size
Tobradex is most commonly available as an ophthalmic suspension containing tobramycin 3 mg/mL and dexamethasone 1 mg/mL.
The typical UK pack is a 5 mL dropper bottle.
| Formulation | Administration | Common packaging |
|---|---|---|
| Ophthalmic suspension (drops) | Topical eye drops | 5 mL |
Indications and who it suits
Clinical and practical suitability
Who is Tobradex appropriate for?
It is indicated for steroid-responsive ocular inflammation where bacterial infection is known or suspected, and for post-surgical prophylaxis.
Adults and children aged 2 years and older typically receive the same topical dosing, while use in children under 2 years is not routinely recommended.
Contact lens wearers should remove lenses before instillation and wait the time advised by their prescriber before reinserting lenses.
Patients with a history of steroid response, glaucoma, or active viral or fungal eye infections are not suitable without specialist advice.
- Adults and children ≥2 years: Usually suitable when indicated.
- Children <2 years: Not routinely recommended; specialist decision only.
- Refer back if history of steroid-induced intraocular pressure rise, or suspected viral/fungal infection.
Practical how-to: administration and routines
Step-by-step instillation and missed dose
How should patients put in the drops and what if they miss one?
- Wash hands and remove contact lenses if worn.
- Tilt the head back and gently pull down the lower eyelid to make a small pocket.
- Hold the dropper above the eye and instil 1–2 drops into the affected eye(s).
- Avoid touching the tip to the eye or eyelid to prevent contamination.
- Close the eye gently for 1–2 minutes and press the inner corner of the eye for a short time to reduce systemic absorption.
- Replace the cap and store as advised.
| Phase | Typical dosing |
|---|---|
| Initial intensive | Every 2 hours if prescribed |
| Maintenance | 1–2 drops every 4–6 hours |
Missed dose: apply as soon as remembered unless the next dose is due; do not double up.
Accidental overdose from topical use poses low systemic risk; rinse eyes with water if necessary.
Contraindications and monitoring requirements
Absolute and relative contraindications; follow-up
Who must not use Tobradex?
Absolute contraindications include herpetic keratitis, viral conjunctival or corneal infections, fungal eye infections, tuberculous eye disease, active untreated non-bacterial eye infections, and hypersensitivity to tobramycin, dexamethasone or excipients.
Relative contraindications are pre-existing glaucoma, a history of steroid-responsive intraocular pressure rise, and prolonged use due to risks such as secondary infection and cataract formation.
Courses beyond a few weeks require intraocular pressure monitoring and ophthalmology follow-up.
Advise patients to see their prescriber promptly if symptoms suggest a viral or fungal infection, or if vision changes after starting treatment.
Side effects, frequency and escalation
Common reactions and emergency signs
What side effects should patients expect and when is urgent review needed?
Common, usually mild effects include eye discomfort, irritation, transient burning, redness, and occasional eyelid itching or swelling.
With prolonged use there is a risk of secondary infection, raised intraocular pressure and eventual cataract formation.
If severe eye pain, sudden vision loss, intense sensitivity to light, or signs of an allergic reaction occur, stop the drops and seek urgent medical review.
- Common/mild: Stinging, irritation, redness, eyelid pruritus.
- Serious/rare: Severe eye pain, sudden visual changes, intense photophobia, signs of hypersensitivity.
If discharge persists or worsens after 48–72 hours of treatment, contact the prescribing clinician for reassessment.
Pharmacology
Mechanism and ATC
How do the components work?
Tobramycin is an aminoglycoside antibiotic with bactericidal activity against susceptible Gram-negative and some Gram-positive ocular pathogens.
Dexamethasone is a corticosteroid that suppresses inflammation, reducing pain, swelling and tissue damage.
Combined, they treat and reduce inflammation where bacterial infection is suspected or confirmed and are used for post-operative prophylaxis.
ATC: S01CA01.
| Outcome | Summary |
|---|---|
| Infection control | Bactericidal activity from tobramycin against susceptible organisms |
| Inflammation control | Dexamethasone reduces signs and symptoms of inflammation |
Alternatives
Comparison with other eye preparations
What are the main alternatives and how do they compare?
Alternatives include Maxitrol (neomycin + polymyxin B + dexamethasone) and Pred‑G (prednisolone + gentamicin).
Tobradex combines a familiar aminoglycoside antibiotic with dexamethasone and is effective for many bacterial infections with inflammation.
Maxitrol provides a broader antibiotic mix but contains neomycin, which causes sensitivity in some patients.
| Product | Antibiotic | Steroid | Notes |
|---|---|---|---|
| Tobradex | Tobramycin | Dexamethasone | Suitable for many post-op and inflammatory infections |
| Maxitrol | Neomycin + Polymyxin B | Dexamethasone | Broader antibiotic mix; neomycin sensitivity possible |
Choice depends on antibiotic spectrum, steroid potency and patient history such as allergy or steroid sensitivity.
Regulatory and prescribing context in the UK
MHRA and prescription status
What legal and practical prescribing rules apply in the UK?
Tobradex is authorised for ophthalmic use in the UK and is designated a prescription-only medicine under MHRA oversight.
Pharmacies must only dispense Tobradex against a valid prescription, whether paper or electronic via EPS.
Storage and shelf life
Handling and patient advice
How should Tobradex be stored and handled at home?
Store between 2–25°C and protect from light; do not freeze.
Discard the bottle 28 days after opening to reduce contamination risk.
Advise patients to keep the medicine in a cool place during travel and to avoid leaving it in a car on a hot day.
For air travel, keep the bottle in hand luggage to reduce exposure to extreme temperatures.
Delivery across the United Kingdom
| City | Region | Delivery Time |
|---|---|---|
| London | Greater London | 9–21 days |
| Birmingham | West Midlands | 9–21 days |
| Manchester | Greater Manchester | 9–21 days |
| Glasgow | Scotland | 9–21 days |
| Leeds | West Yorkshire | 9–21 days |
| Liverpool | Merseyside | 9–21 days |
| Bristol | South West England | 9–21 days |
| Edinburgh | Scotland | 9–21 days |
| Sheffield | South Yorkshire | 9–21 days |
| Newcastle Upon Tyne | North East England | 9–21 days |
| Nottingham | Nottinghamshire | 9–21 days |
| Cardiff | Wales | 9–21 days |
| Belfast | Northern Ireland | 9–21 days |
Quick FAQs
Short questions patients ask
Can patients reuse the bottle past 28 days?
No; discard 28 days after opening to reduce contamination risk.
Is it safe with contact lenses?
Remove lenses before instillation and follow prescriber’s advice on when to reinsert them.
When should patients return for review?
If symptoms worsen or there is no improvement within 48–72 hours, or if steroids are used for an extended period.
What to tell someone with suspected viral eye infection?
Do not use Tobradex and refer back to the prescriber because steroids can worsen viral or fungal infections.
Final reminder: Tobradex is an MHRA-authorised prescription medicine containing tobramycin and dexamethasone supplied commonly as a 5 mL dropper bottle.
