Ocular Inflammation With Presence of Risk of Infection

In a preclinical study, increased viscosity improved ocular retention and bioavailability. The XanGen® formulation of TOBRADEX® ST creates a unique interaction with tears that increases the viscosity of each drop to provide longer ocular retention on the eye and increased ocular bioavailability of the drug without causing visual blurriness.1,2

After 1 week of TOBRADEX® ST dosing, patients had >50% reduction in symptoms. This was demonstrated in a preclinical study utilizing a rabbit model that closely mimics the human eye.3

Eyevance® Pharmaceuticals LLC has been acquired by Santen Pharmaceutical Co., Ltd. TobraDex® ST is a registered trademark of Eyevance Pharmaceuticals. All other trademarks are the property of their respective owners.


  1. TOBRADEX® ST Suspension [package insert]. Fort Worth, TX: Eyevance Pharmaceuticals LLC; 2011.
  2. Scoper SV, Kabat AG, Owen GR, et al. Ocular distribution, bactericidal activity and settling characteristics of TOBRADEX® ST ophthalmic suspension compared with TobraDex® ophthalmic suspension. Adv Ther. 2008;25(2):77-88.
  3. Torkildsen GL, Cockrum P, Meier E, et al. Evaluation of clinical efficacy and safety of tobramycin/dexamethasone ophthalmic suspension 0.3%/0.05% compared to azithromycin ophthalmic solution 1% in the treatment of moderate to severe acute blepharitis/blepharoconjunctivitis. Curr Med Res Opin. 2011;27(1):171-178.

For steroid responsive inflammatory ocular conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe and chronic anterior uveitis, corneal injury from chemical, radiation or thermal burns, or penetration of foreign bodies for which a corticosteroid is indicated and where the risk of superficial bacterial ocular infection is high or where there is an expectation that potentially dangerous numbers of bacteria will be present in the eye.


Most viral diseases of the cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also in mycobacterial infection of the eye and fungal disease of ocular structures. Hypersensitivity to any components of the medication.
・IOP increase
— Prolonged use may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision. IOP should be monitored.
・Aminoglycoside sensitivity — Sensitivity to topically applied aminoglycosides may occur.
・Cataracts — Posterior subcapsular cataract formation may occur.
・Delayed healing — May delay healing and increase the incidence of bleb formation. Perforations of the cornea or sclera have occurred. Slit lamp biomicroscopy, and fluorescein staining should be conducted.
・Bacterial infections — May suppress host response and increase secondary ocular infections. In acute purulent conditions, steroids may mask infection or enhance existing infection. If signs and symptoms fail to improve after 2 days, the patient should be re-evaluated.
・Viral infections — Use with history of herpes simplex requires great caution. The course and severity of many viral infections of the eye (including herpes simplex) may be exacerbated.
・Fungal infections — Fungal infections of the cornea may occur and should be considered in any persistent corneal ulceration.
・Use with systemic aminoglycosides — Total serum concentration of tobramycin should be monitored.

The most frequent adverse reactions (<4%) to topical ocular tobramycin are hypersensitivity and localized ocular toxicity, including eye pain, eyelid pruritus, eyelid edema, and conjunctival hyperemia.
The reactions due to the steroid component are increased intraocular pressure with possible development of glaucoma, and infrequent optic nerve disorder; subcapsular cataract; and impaired healing.
The development of secondary infection has occurred. Fungal infections of the cornea may occur. Secondary bacterial ocular infection following suppression of host responses also occurs.
Non-ocular adverse events (0.5% to 1%) included headache and increased blood pressure.

Please see the Full Prescribing Information.