Nebcin Side Effects
Generic name: tobramycin
Medically reviewed by Drugs.com. Last updated on Jun 24, 2023.
Note: This document contains side effect information about tobramycin. Some dosage forms listed on this page may not apply to the brand name Nebcin.
Applies to tobramycin: injection solution. Other dosage forms:
Warning
Injection route (Solution; Powder for Solution)
Therapy has been associated with potential neurotoxicity, ototoxicity, and nephrotoxicity. Patients with impaired renal function, advanced age, dehydration, and those who receive high dosage or prolonged therapy are at an increased risk of toxicity. Monitor renal and auditory function during therapy and discontinue therapy or adjust dose if there is evidence of ototoxicity or nephrotoxicity. Aminoglycoside-induced ototoxicity is usually irreversible. Serum concentrations of aminoglycosides should be monitored periodically to assure adequate levels and to avoid potentially toxic levels. Concurrent use of other potentially neurotoxic or nephrotoxic agents, or potent diuretics should be avoided. Tobramycin should be used with caution in premature and neonatal infants because of their renal immaturity and the resulting prolongation of serum half-life of the drug. Aminoglycosides can cause fetal harm when administered to a pregnant woman.
Serious side effects of Nebcin
Along with its needed effects, tobramycin (the active ingredient contained in Nebcin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking tobramycin:
Incidence not known
- Black, tarry stools
- bleeding gums
- blood in the urine or stools
- chills
- cloudy urine
- clumsiness
- continuing ringing or buzzing or other unexplained noise in the ears
- cough
- cracks in the skin
- decrease in the amount of urine
- dizziness or lightheadedness
- feeling of constant movement of self or surroundings
- feeling of fullness in the ears
- fever
- loss of balance
- loss of heat from the body
- loss or change in hearing
- nausea
- pale skin
- pinpoint red spots on the skin
- red, swollen skin
- scaly skin
- sensation of spinning
- shortness of breath
- sore throat
- trouble in hearing
- troubled breathing with exertion
- ulcers, sores, or white spots in the mouth
- unsteadiness
- unusual bleeding or bruising
- unusual tiredness or weakness
- vomiting
Get emergency help immediately if any of the following symptoms of overdose occur while taking tobramycin:
Symptoms of overdose
- Inability to breath without assistance
Other side effects of Nebcin
Some side effects of tobramycin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
- Confusion about identity, place, and time
- diarrhea
- headache
- hives or welts
- itching
- pain at the injection site
- redness of the skin
- skin rash
- unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
For Healthcare Professionals
Applies to tobramycin: compounding powder, inhalation capsule, inhalation solution, injectable powder for injection, injectable solution, intravenous solution.
General
Inhalation Capsules: The most commonly reported side effects included cough, lung disorder, productive cough, and dyspnea.
Inhalation/nebulizer solution: The most commonly reported side effects included increased cough, pharyngitis, fever, and increased sputum.
Parenteral formulations: The most commonly reported serious side effects included hypersensitivity reactions, ototoxicity, and nephrotoxicity.[Ref]
Respiratory
Inhalation Capsules:
Very common (10% or more): Cough (up to 48.4%), lung disorder (up to 33.8%), productive cough (up to 18.2%), dyspnea (up to 15.6%), oropharyngeal pain (up to 14%), dysphonia (up to 13.6%), hemoptysis (up to 13%), pharyngolaryngeal pain (up to 10.9%)
Common (1% to 10%): Bronchospasm, epistaxis, forced expiratory volume (FEV1) decreased, nasal congestion, pulmonary function test decreased, rales, throat irritation, upper respiratory tract infection, wheezing
Frequency not reported: Cystic fibrosis exacerbation, pulmonary exacerbation, sputum discolored
Inhalation/nebulizer solution:
Very common (10% or more): Cough increased (up to 50%), pharyngitis (up to 48%), sputum increased (up to 44%), dyspnea (up to 42%), rhinitis (up to 38%), lung disorder (up to 34%), cough (up to 31.1%), hemoptysis (up to 28%), lung function decreased (up to 29%), asthma (up to 28%), sputum discoloration (up to 25%), productive cough (up to 19.6%), sinusitis (up to 14%), upper respiratory tract infection (up to 14%), voice alteration (up to 13%), oropharyngeal pain (up to 10.5%)
Common (1% to 10%): Dysphonia, epistaxis, FEV1 decreased, hyperventilation, hypoxia, laryngitis, lower respiratory tract infection, nasal congestion, nasal polyp, pulmonary function test decreased, rales, respiratory disorder, throat irritation, wheezing
Rare (0.01% to 0.1%): Bronchospasm
Frequency not reported: Pulmonary exacerbation
Parenteral formulations:
Uncommon (0.1% to 1%): Apnea, respiratory depression[Ref]
Other
Ototoxicity, usually irreversible, was typically initially manifested by diminution of high-tone acuity, dizziness, hearing loss, roaring in the ears, tinnitus, and vertigo. Patients receiving inhalation formulations with a history of prolonged treatment and/or receiving concomitant IV treatment with an aminoglycoside have developed hearing loss. Ototoxicity may progress despite discontinuation in some patients.
Tinnitus was typically transient, usually resolved without discontinuation of treatment, and was associated with permanent hearing loss in some patients.[Ref]
Inhalation Capsules:
Very common (10% or more): Pyrexia (up to 15.6%)
Common (1% to 10%): Deafness, deafness unilateral, hypoacusis, increased hearing loss, mild to moderate hearing loss, tinnitus
Frequency not reported: Malaise
Inhalation/nebulizer solution:
Very common (10% or more): Fever (up to 46%), asthenia (up to 44%), pain (up to 24%), pyrexia (up to 12.4%)
Common (1% to 10%): Accidental injury, chills, malaise, otitis media, tinnitus
Uncommon (0.1% to 1%): Deafness neurosensory, hypoacusis, mucosal dryness
Rare (0.01% to 0.1%): Hearing loss
Very rare (less than 0.01%): Ear disorder, ear pain
Frequency not reported: Ototoxicity
Parenteral formulations:
Common (1% to 10%): Hearing loss/irreversible hearing loss, high frequency hearing loss, ototoxicity, roaring in the ears, tinnitus
Rare (0.01% to 0.1%): Fever
Frequency not reported: Transient cochlear toxicity[Ref]
Nervous system
Inhalation Capsules:
Very common (10% or more): Headache (up to 11.4%)
Common (1% to 10%): Aphonia, dysgeusia
Inhalation/nebulizer solution:
Very common (10% or more): Headache (up to 34%), dysphonia (up to 13%)
Common (1% to 10%): Dizziness, somnolence, taste perversion
Uncommon (0.1% to 1%): Dysgeusia, vertigo
Rare (0.01% to 0.1%): Aphonia
Parenteral formulations:
Common (1% to 10%): Acute dizziness/dizziness, vertigo, vestibular dysfunction
Uncommon (0.1% to 1%): Exacerbation of impairment of neuromuscular transmission, neuromuscular blocking effects
Rare (0.01% to 0.1%): Acute brain syndrome, lethargy, neurotoxicity
Frequency not reported: Headache[Ref]
Acute brain syndrome occurred in an elderly patient approximately 4 days after starting treatment.[Ref]
Cardiovascular
Inhalation Capsules:
Common (1% to 10%): Chest discomfort
Inhalation/nebulizer solution:
Very common (10% or more): Chest pain (up to 37%)
Common (1% to 10%): Chest discomfort[Ref]
Gastrointestinal
Inhalation Capsules:
Common (1% to 10%): Diarrhea, nausea, vomiting
Inhalation/nebulizer solution:
Very common (10% or more): Abdominal pain (up to 27%)
Common (1% to 10%): Diarrhea, nausea, vomiting
Uncommon (0.1% to 1%): Abdominal pain upper, glossitis, salivary hypersecretion
Rare (0.01% to 0.1%): Mouth ulceration
Parenteral formulations:
Common (1% to 10%): Diarrhea, nausea, vomiting
Rare (0.01% to 0.1%): Stomatitis[Ref]
Renal
Nephrotoxicity, demonstrated by rising BUN, NPN, serum creatinine, cylindruria, oliguria, and proteinuria, primarily occurred in patients with preexisting renal damage and in patients with normal renal function treated for longer periods and/or at higher doses than recommended. Predisposing factors also included advanced age, dehydration, and concomitant use of other potentially nephrotoxic drugs.
Signs of renal failure included elevated serum creatinine and urea, and may be a rare complication in patients with cystic fibrosis.[Ref]
Inhalation/nebulizer solution:
Frequency not reported: Nephrotoxicity
Parenteral formulations:
Common (1% to 10%): Decreased glomerular filtration, elevated urea concentrations, increased blood urea nitrogen (BUN), increased nonprotein nitrogen (NPN), oliguria, reduced creatinine clearance, reduced renal function, renal function changes, reversible nephrotoxicity
Uncommon (0.1% to 1%): Increased serum creatinine
Rare (0.01% to 0.1%): Acute renal failure, interstitial nephritis[Ref]
Musculoskeletal
Inhalation Capsules:
Common (1% to 10%): Musculoskeletal chest pain
Inhalation/nebulizer solution:
Common (1% to 10%): Back pain, musculoskeletal chest pain, myalgia
Parenteral formulations:
Uncommon (0.1% to 1%): Skeletal muscle weakness[Ref]
Dermatologic
Inhalation Capsules:
Common (1% to 10%): Rash
Inhalation/nebulizer solution:
Common (1% to 10%): Rash
Very rare (less than 0.01%): Pruritus, urticaria
Parenteral formulations:
Uncommon (0.1% to 1%): Itching, maculopapular rash, urticaria
Rare (0.01% to 0.1%): Exfoliative dermatitis, rash[Ref]
Genitourinary
Parenteral formulations:
Common (1% to 10%): Cylindruria, increased proteinuria[Ref]
Immunologic
Inhalation/nebulizer solution:
Common (1% to 10%): Flu syndrome
Uncommon (0.1% to 1%): Fungal infection, oral candidiasis[Ref]
Metabolic
Patients have developed a complex metabolic syndrome lasting approximately 2 to 8 weeks after administration of this drug; this syndrome was marked by hypoalbuminemia, hypocalcemia, hypokalemia, hypomagnesemia, hypophosphatemia, hypouricemia, and increased AST, ALT, serum bilirubin, and alkaline phosphatase.[Ref]
Inhalation Capsules:
Common (1% to 10%): Blood glucose increased
Inhalation/nebulizer solution:
Uncommon (0.1% to 1%): Blood glucose increased
Rare (0.01% to 0.1%): Anorexia
Postmarketing reports: Decreased appetite
Parenteral formulations:
Rare (0.01% to 0.1%): Hypoalbuminemia, hypocalcemia, hypokalemia, hypomagnesemia, hypophosphatemia, hypouricemia, metabolic syndrome
Frequency not reported: Increased serum lactate dehydrogenase[Ref]
Hematologic
Inhalation/nebulizer solution:
Common (1% to 10%): Lymphadenopathy
Parenteral formulations:
Rare (0.01% to 0.1%): Anemia, chemotaxis inhibition, decreased platelet counts, decreased white cell counts, eosinophilia, granulocytopenia, inhibition of microbicidal activity of phagocytes, thrombocytopenia
Frequency not reported: Leukocytosis, leukopenia[Ref]
Hepatic
Inhalation/nebulizer solution:
Uncommon (0.1% to 1%): Transaminases increased
Parenteral formulations:
Rare (0.01% to 0.1%): Increased alkaline phosphatase, increased ALT, increased AST, increased serum bilirubin[Ref]
Hypersensitivity
Hypersensitivity reactions included anaphylaxis, angioedema, exfoliative dermatitis, and stomatitis.[Ref]
Inhalation/nebulizer solution:
Very rare (less than 0.01%): Hypersensitivity
Parenteral formulations:
Rare (0.01% to 0.1%): Anaphylaxis, angioedema, hypersensitivity reactions[Ref]
Local
Parenteral formulations:
Rare (0.01% to 0.1%): Pain (IM administration), thrombophlebitis (IV administration)[Ref]
Psychiatric
Parenteral formulations:
Frequency not reported: Delirium, disorientation, mental confusion[Ref]
Delirium was reversible after treatment was discontinued.[Ref]
More about Nebcin (tobramycin)
- Check interactions
- Compare alternatives
- Side effects
- Dosage information
- During pregnancy
- Drug class: aminoglycosides
- Breastfeeding
Patient resources
Other brands
Kitabis Pak, Tobi, Bethkis, TOBI Podhaler
Professional resources
Other brands
Kitabis Pak, Tobi, Bethkis, TOBI Podhaler
Related treatment guides
References
1. Product Information. Nebcin (tobramycin). Lilly, Eli and Company. 2001;PROD.
2. Product Information. Tobi (tobramycin). PathoGenesis. 2022.
3. Cerner Multum, Inc. UK Summary of Product Characteristics.
4. Cerner Multum, Inc. Australian Product Information.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.