Adults

Instill one or two drops into the conjunctival sac(s) of the affected eye(s) every 4 to 6 hours. During the initial 24 to 48 hours, the dosage may be increased to one or two drops every 2 hours. Dosage should be gradually decreased as the clinical signs improve.

Elderly

No specific dosage adjustment is required for elderly patients.

Renal_impairment

No specific dosage adjustment is required as systemic absorption is minimal with topical ophthalmic use.

Onset

Anti-inflammatory and antibacterial effects can be observed within hours of administration.

Excretion

Tobramycin is primarily excreted unchanged in urine. Dexamethasone metabolites are excreted in urine.

Half life

Ocular half-life not precisely defined for topical administration, but systemic half-life of tobramycin is approximately 2-3 hours and dexamethasone is 3-4 hours.

Absorption

Minimal systemic absorption after topical ophthalmic administration. Tobramycin penetrates ocular tissues. Dexamethasone penetrates ocular tissues; systemic absorption is low but detectable.

Metabolism

Minimal metabolism of tobramycin. Dexamethasone is metabolized primarily in the liver.

Systemic aminoglycosides

Increased risk of systemic toxicity (e.g., ototoxicity, nephrotoxicity) with significant systemic absorption, although rare with topical ophthalmic use.

Other topical ophthalmic corticosteroids

Increased risk of systemic side effects if significantly absorbed.