Toba Eye Drops (Tobramycin)

When antimicrobial treatment is used

Toba is a fast-acting antibiotic widely used in modern clinical practice. It comes as an eye drop solution and is for external use only.

Tobramycin (3 mg/mL) is the water-soluble active ingredient. Tobramycin is a broad-spectrum antibiotic that works against many gram-negative and, less often, gram-positive bacteria.

These antibiotic drops are used to treat infections affecting the surface of the eye and other parts of the eye.

How it works

Toba drops create an effective concentration of the medication at the site of inflammation, on the surface of the eye. After it is applied, the antibiotic acts directly on harmful microorganisms.

Toba has a bactericidal effect. It binds to bacterial ribosomes and interferes with protein synthesis. When bacteria are exposed to the medication, one of the following happens:

• Ribosomes produce defective bacterial proteins.
• Protein synthesis is blocked.

The microorganisms exposed to the antibiotic die. Continued use of the drops helps eliminate bacteria that were not exposed to the medication at first.

Dosage guide

If you hold the open bottle upside down above the eye, the bottle is designed to deliver drops of a consistent size. There is no need to squeeze the sides of the bottle. To release one drop, simply tap or press the bottom of the bottle.

The dosage regimen for Toba eye drops in mild to moderate eye infections:

• Recommended dose range: 1-2 drops
• Dosing frequency: every 4 hours

Dosage regimen in severe eye infections:

• Optimal single dose: 2 drops
• Dosing frequency: every hour

If you need to use different kinds of eye medications, leave at least 5-15 minutes between them.

The length of treatment depends on how the condition progresses. In Canada, the doctor decides how long treatment should continue based on objective findings, including the possible risk of side effects, the severity of symptoms, and how well the medication is working.

Use the full course of treatment prescribed by your doctor, even if your symptoms improve or go away. All microorganisms causing the infection need to be eliminated.

Possible side effects of Toba

This medication has a bactericidal effect, as shown in clinical studies. Along with its beneficial effects, Toba can cause side effects, although not everyone gets them.

Possible side effects include:

• temporary blurred vision
• a feeling that something is under the eyelid
• increased tearing
• eye irritation
• swelling of the eyelids
• redness of the sclera (the white part of the eye)

Most side effects are mild, appear early in treatment, and go away over time.

Eye treatment can cause hypersensitivity reactions in some people. Do not use Toba if you are allergic to:

• any medication containing tobramycin;
• any of the inactive ingredients in Toba.

If signs of a severe reaction or hypersensitivity occur during treatment, stop using it. If you notice a rash on your face or anywhere else on your body, contact your doctor for further instructions.

How to put in the drops

To get the best results, use the drops correctly. Ophthalmologist or pharmacist can advise you based on your specific situation. Read the patient leaflet before starting treatment.

In most cases, the correct technique is:

• Wash your hands with soap and water and dry them with a clean towel.
• Warm the bottle in your hands if the solution is cold.
• If you wear contact lenses, remove them (it is not recommended to wear contact lenses during bacterial eye infections).
• Unscrew the cap from the bottle.
• Lie down or sit in front of a mirror, or sit comfortably in a chair.
• Tilt your head back.
• Hold the bottle upside down about 2-3 cm above the eye, making sure it does not touch your eyelashes, eyelids, or eye.
• Pull down the lower eyelid with one or two fingers.
• Tap or press the base of the bottle so the drop goes into the eye, closer to the outer corner.
• Close your eyes and wait a few minutes.
• Repeat for the other eye if advised.
• Close the bottle and follow the storage instructions.

Toba eye drops for babies

In Canadian clinical practice, data on treating infants under 12 months of age are limited. Toba 0.3% eye drops can be used to treat children aged 1 year and older at the same dosage used in adults.

Young children may be afraid of unfamiliar procedures. To reduce distress, stay calm, act quickly, and prepare ahead of time.

Additional recommendations:

• If stored in the refrigerator, warm the bottle in your hands or place it in warm, clean water before use.
• Children under 6-7 years of age should be laid on a flat surface.
• Make sure the child is calm. Avoid giving the drops if the child resists or cries.
• When pulling down the lower eyelid, do not touch the surface of the eye.
• After using Toba, hold the eyelid for a few seconds to let the liquid spread.
• Some medication may leak out; with the correct technique, the right amount still gets into the eye.
• If the child closes the eye and the solution does not go in, repeat the procedure.
• Do not allow the solution to enter the nose.
• Wipe away any leaked medication with a clean cotton pad.
• Keep the child lying down for a few minutes.
• Stop the child from rubbing their eyes right after use.

Important information you should know

While using Toba, it is best to stop wearing contact lenses for a while. This is a general recommendation rather than a strict contraindication. Avoid wearing lenses during inflammatory eye conditions.

Toba contains substances that can be absorbed by soft contact lenses, which may cause deterioration and discoloration.

If you continue to wear lenses, remove them before using the drops and wait at least 15 minutes before putting them back in.

During use, keep everything clean and avoid contaminating the dropper tip. Never share eye drops with anyone else.

Cold eye drops can be uncomfortable, so warm the bottle in your hands before use.

Driving

This medication usually has little to no effect on activities that require alertness. However, temporary blurred vision may occur after use. Wait until your vision is clear before driving, using tools, operating machinery, or doing anything hazardous.

Pregnancy and breastfeeding

Although systemic absorption is negligible, Toba should be used during pregnancy only when clearly needed.

Using Toba while breastfeeding is not recommended.

Exposure to infants is not expected, but risks cannot be completely ruled out. Your doctor should decide whether breastfeeding should be stopped during treatment, taking into account the benefits for both mother and baby.

Storage

When you are not using the drops, keep the bottle tightly closed and store it according to the leaflet.

Sunlight and high temperatures can damage the ingredients. A humid environment can encourage microbial growth on the bottle.

Recommended storage temperature is up to 25°C. This medication can be kept in the refrigerator but should not be frozen.

Toba sterile solution should be clear or slightly yellowish. If the colour has changed, do not use it.