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Inhaled Antibiotic for CF

TOBI® (tobramycin inhalation solution) is an inhaled antibiotic for the treatment of cystic fibrosis (CF). TOBI helps fight the germ Pseudomonas aeruginosa (soo-doh-MOH-nus air-oo-jih-NOH-sa), a leading cause of chronic lung infections among people with CF.

For a person with CF, it’s important to know the basics about TOBI. The information below will help you learn more about TOBI. If you have more questions, ask your CF health care team.

For important patient safety information, please visit and see Patient Product Information and full Prescribing Information.

What is TOBI?

TOBI (tobramycin inhalation solution) is an inhaled antibiotic medication. It is used to treat Pseudomonas aeruginosa infections in people with CF.

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Who should take TOBI?

TOBI is for people with CF age 6 years and older who have Pseudomonas lung infections.

It is not known if TOBI is safe and works in children with CF under age 6 years; in those whose lung function is outside of a certain range; or in those who have Burkholderia cepacia (B. cepacia) infections.

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How does TOBI work?

TOBI controls the growth of Pseudomonas in the lungs.

In people with CF, taking TOBI twice a day has been shown to:

  • Improve lung function
  • Decrease the number of days spent in the hospital
  • Reduce the need for IV (intravenous) antibiotics
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How do I or my child take TOBI?

TOBI can be taken at home, school or work.

It is inhaled using a PARI LC® PLUS Reusable Nebulizer and a DeVilbiss® Pulmo-Aide® air compressor. This is the type of nebulizer used in clinical studies of TOBI.

It is important that your nebulizer and compressor function properly before starting TOBI.

Note: Please refer to the compressor and nebulizer manufacturers’ instructions for care and use information. If you have more questions, you can ask your CF care center.

For more details on how to take TOBI, read the directions that came with TOBI from your pharmacy.

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How often should TOBI be inhaled?

TOBI should be taken for 28 days followed by 28 days of not taking it. This cycle is then repeated: 28 days taking TOBI and then 28 days not taking it.

TOBI should be taken twice a day and as close to 12 hours apart. You should not take TOBI less than 6 hours after your earlier dose.

Taking TOBI requires about 15–20 minutes to nebulize. If it takes longer, talk with your CF care center. Your nebulizer and compressor may not be working well.

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What do I do if a dose is missed?

Never double a dose to make up what was missed.

TOBI should be inhaled twice a day as close to 12 hours apart as possible and not less than 6 hours apart. A missed dose can be taken later than planned as long as it is at least 6 hours before the next dose. After that, you should get back on schedule.

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Should I or my child stop taking TOBI if feeling better?

No. You should take TOBI for the full 28 days and repeat the cycle as discussed with your CF doctor.

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In what order should inhaled medicines be taken?

If you are taking several inhaled medications, the recommended order is as follows: 

1. Bronchodilator, for example, albuterol.
2. Mucolytics, for example, dornase alfa (Pulmozyme®) or hypertonic saline.
3. Airway clearance, such as chest physiotherapy.
4. TOBI.

Ask your CF health care team what order of treatments is best for you or your child.

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Can TOBI be mixed with other inhaled medications?

No. TOBI should not be mixed with any other medicine, including dornase alfa (Pulmozyme) or hypertonic saline.

You should not add water or saline to TOBI.

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Should TOBI be taken with or without food?

Inhaled TOBI can be taken before or after eating. However, if it causes coughing, you may wish to take TOBI before eating or 2 hours after eating.

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Is TOBI safe for use in children?

The safety and efficacy of TOBI have not been studied in children with CF younger than age 6.

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How should TOBI be stored?

  • TOBI should be kept in the refrigerator (36–46° F or 2–8° C).
  • Do not use TOBI if it has been stored at room temperature (up to 77° F or 25° C) for more than 28 days.
  • Avoid exposing TOBI ampules to intense light.
  • You should not use TOBI if it is cloudy or if there are particles in the solution.
  • You should not use TOBI beyond the expiration date stamped on the ampule.
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How long can TOBI be left unrefrigerated?

When you don’t have a refrigerator available (for example, when you are traveling), you may store opened or unopened TOBI foil pouches at room temperature (up to 77° F or 25° C) for up to 28 days.

Unrefrigerated TOBI, which is normally slightly yellow, may darken with age; however, the color change does not indicate any change in the quality of the product.

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Where can I buy TOBI? 

TOBI is available from any pharmacy. If your pharmacy does not have TOBI, you can ask that it be ordered.

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Is TOBI covered by insurance?

You should contact your health insurance plan to find out if TOBI is covered.

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What if I cannot afford TOBI or don’t have insurance?

Novartis, the maker of TOBI, is committed to providing access to the treatment through the TOBI Patient Assistance Program (PAP) and the TOBI CARE Patient Support Program.

  • TOBI PAP helps people with CF who have financial hardship and have no third-party insurance get coverage for their medicine. For more information and to find out if you can get help, call 1-877-TOBI-423 (1-877-862-4423).

  • TOBI CARE Patient Support Program is a one-stop resource to help you through the TOBI reimbursement process. For more information, call 1-877-999-TOBI (1-877-999-8624) between 8 a.m. and 8 p.m., E.S.T., Monday through Friday. 

Learn more about chronic medications for CF lung health

You can learn more about chronic medications for CF lung health, including TOBI, on the CF Foundation’s website:

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Updated 6/28/13

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