Pregnancy of Tobramycin in details
Tobramycin crosses the placenta.
[US Boxed Warning]: Aminoglycosides may cause fetal harm if administered to a pregnant woman. There are several reports of total irreversible bilateral congenital deafness in children whose mothers received another aminoglycoside (streptomycin) during pregnancy. Although serious side effects to the fetus/infant have not been reported following maternal use of all aminoglycosides, a potential for harm exists.
Due to pregnancy-induced physiologic changes, some pharmacokinetic parameters of Tobramycin may be altered (Bourget 1991). Tobramycin injection may be used for the management of cystic fibrosis in pregnant patients with Pseudomonas aeruginosa (inhalation is preferred unless risk of infection is great) (Edenborough 2008) and as an alternative antibiotic for prophylactic use prior to cesarean delivery (Bratzler 2013).
Tobramycin breastfeeding
Parenteral: The manufacturer makes no recommendation regarding use during lactation. Inhalation: A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. Excreted into human milk: Yes Excreted into animal milk: Unknown
Parenteral: Tobramycin has been used without apparent harmful effects in the nursing infant. Inhalation: The effects in the nursing infant are unknown.
Parenteral: Trace amounts of Tobramycin have been measured in milk after intramuscular injection. Due to poor oral bioavailability, systemic toxicity in the nursing infant is unlikely; however, the possibility of bowel flora modification and interference with culture results should be considered. Inhalation: It is unknown whether nebulized Tobramycin would reach sufficient serum concentrations to be excreted in human milk. Due to poor oral bioavailability, systemic toxicity in the nursing infant is unlikely; however, the manufacturer recommends that due to the potential for ototoxicity and nephrotoxicity in nursing infants, a decision should be made to discontinue nursing or discontinue the drug.
See references
References for pregnancy information
- "Product Information. Nebcin (Tobramycin)." Lilly, Eli and Company, Indianapolis, IN.
References for breastfeeding information
- "Product Information. Nebcin (Tobramycin)." Lilly, Eli and Company, Indianapolis, IN.
- Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):
References
- DailyMed. "TOBRAMYCIN SULFATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubMed Health. "Tobramycin (By breathing): This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhe... (accessed September 17, 2018).
- Human Metabolome Database (HMDB). "Tobramycin: The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body.". http://www.hmdb.ca/metabolites/HMDB0... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
