For the ampules, the usual dose for adults and children 6 years of age and older is one ampule (300 mg) inhaled twice a day for 28 days. The doses should be used as close to 12 hours apart as possible, and no less than 6 hours apart. After 28 days, this medication should be stopped for the next 28 days and then restarted for the next 28 days.
Each dose should be given with the hand-held reusable nebulizer provided to you. Do not dilute or mix this medication with other medications in the nebulizer. If you are using other medications that require a nebulizer, use them first, then use this medication.
For the capsules, the usual dose for adults and children 6 years of age and older is the contents of 4 capsules inhaled twice a day for 28 days. The doses should be used as close to 12 hours apart as possible, and no less than 6 hours apart. After 28 days, this medication should be stopped for the next 28 days and then restarted for the next 28 days.
The contents of the capsules should only be inhaled with the device that is provided and should not be swallowed. If you are using other inhaled medications, this medication should be used last. If you are using a short-acting bronchodilator (e.g., salbutamol), use it 15 to 90 minutes before inhaling this medication. Always allow the device and capsules to reach room temperature before using. Children, especially those who are 10 years of age or younger, should be provided assistance for using this medication until they are able to use the device properly without help.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are
taking the medication without consulting your doctor.
The effectiveness of the medication depends on the proper use of the device that delivers the tobramycin. The powder contents of the capsule are intended to be inhaled. Do not swallow the capsules. Have your doctor or pharmacist instruct you in the correct procedure for using the devices used to administer the medication, depending on which form of inhaled tobramycin you are using.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose and there is at least 6 hours until the next dose, take it as soon as possible and continue with your regular schedule. Otherwise, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store the ampules in the refrigerator at 2°C to 8°C, protect them from light, and keep them out of the reach of children. If a refrigerator is not available, you can store the pouches (opened or unopened) at room temperature (up to 25°C) for up to 28 days.
The solution in the ampule is slightly yellow, but may darken with age if not stored in the refrigerator; however, the color change does not indicate any change in the quality of the product as long as it is stored within the recommended storage conditions. Do not use this medication if it appears cloudy or there are particles in the solution.
Store the capsules at room temperature in the original package to protect from them moisture, and keep them out of the reach of children. Only remove the capsules from their packaging immediately before use.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.