Details of the Drug

General Information of Drug (ID: DMUI0CH)

Drug Name
Tobramycin
Synonyms
Aktob; Brulamycin; Distobram; Gotabiotic; NEBRAMYCIN; Nebcin; Nebicin; Obracin; Obramycin; Sybryx; TOY; Tenebrimycin;Tenemycin; Tobacin; Tobi; Tobracin; Tobradex; Tobradistin; Tobralex; Tobramaxin; Tobramicin; Tobramicina; Tobramitsetin; Tobramycetin; Tobramycine; Tobramycinum; Tobrased; Tobrasone; Tobrex; Deoxykanamycin B; Nebramycin VI; TOBRAMYCIN SULFATE; Tobramycin for Inhalation; Tobramycin solution for inhalation; A 12253A; Lilly 47663; NF 6; Nebramycin 6; Nebramycin factir 6; Nebramycin factor 6; Nebcin (Sulfate); SPRC-AB01; TobraDex (TN); Tobracin (TN); Tobramicina [INN-Spanish]; Tobramycin, Free Base; Tobramycine [INN-French]; Tobramycinum [INN-Latin]; Tobrex (TN); Tobramycin (JP15/USP); Tobramycin[USAN:BAN:INN:JAN]; TOA-(1-6)2TB-(4-1)TOC; TOA-(1-6)TOB-(4-1)TOC; 1-Epitobramycin; 3'-Deoxykanamycin B
Indication
Disease Entry ICD 11 Status REF
Bacteremia 1A73 Approved [1]
Bacterial infection 1A00-1C4Z Approved [2]
Blepharoconjunctivitis N.A. Approved [1]
Corneal abrasion NA06.4 Approved [1]
Dacryocystitis N.A. Approved [1]
Demodex blepharitis 1G07 Approved [1]
Neonatal sepsis N.A. Approved [1]
Peritonitis N.A. Approved [1]
Rosacea ED90.0 Approved [1]
Staphylococcal pneumonia N.A. Approved [1]
Staphylococcus aureus infection N.A. Approved [1]
⏷ Show the Full List of Indication(s)
Therapeutic Class
Antibiotics
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 3 Molecular Weight (mw) 467.5
Logarithm of the Partition Coefficient (xlogp) -6.2
Rotatable Bond Count (rotbonds) 6
Hydrogen Bond Donor Count (hbonddonor) 10
Hydrogen Bond Acceptor Count (hbondacc) 14
ADMET Property
Absorption Cmax
The maximum plasma concentration (Cmax) of drug is 1.02 +/- 0.53 mg/L [3]
Absorption Tmax
The time to maximum plasma concentration (Tmax) is 1 h [3]
BDDCS Class
Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 3: high solubility and low permeability [4]
Clearance
The clearance of drug is 14.5 L/h in cystic fibrosis patients aged 6-58 years [3]
Elimination
93% of drug is excreted from urine in the unchanged form [4]
Half-life
The concentration or amount of drug in body reduced by one-half in 3 hours [3]
Metabolism
The drug is not metabolised [3]
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 19.25036 micromolar/kg/day [5]
Unbound Fraction
The unbound fraction of drug in plasma is 1% [6]
Vd
The volume of distribution (Vd) of drug is 85.1 L [3]
Water Solubility
The ability of drug to dissolve in water is measured as 1000 mg/mL [4]
Adverse Drug Reaction (ADR)
ADR Term Variation Related DOT DOT ID REF
Drug toxicity Not Available PLA2G1B OT1GG9FK [7]
Drug toxicity Not Available PLCB1 OT9HYT7A [7]
Nephropathy toxic Not Available LYZ OTD7H0G6 [7]
Nephropathy toxic Not Available LDHA OTN7K4XB [7]
Nephropathy toxic Not Available nag1 OTQCIZOD [7]
Chemical Identifiers
Formula
C18H37N5O9
IUPAC Name
(2S,3R,4S,5S,6R)-4-amino-2-[(1S,2S,3R,4S,6R)-4,6-diamino-3-[(2R,3R,5S,6R)-3-amino-6-(aminomethyl)-5-hydroxyoxan-2-yl]oxy-2-hydroxycyclohexyl]oxy-6-(hydroxymethyl)oxane-3,5-diol
Canonical SMILES
C1[C@@H]([C@H]([C@@H]([C@H]([C@@H]1N)O[C@@H]2[C@@H]([C@H]([C@@H]([C@H](O2)CO)O)N)O)O)O[C@@H]3[C@@H](C[C@@H]([C@H](O3)CN)O)N)N
InChI
InChI=1S/C18H37N5O9/c19-3-9-8(25)2-7(22)17(29-9)31-15-5(20)1-6(21)16(14(15)28)32-18-13(27)11(23)12(26)10(4-24)30-18/h5-18,24-28H,1-4,19-23H2/t5-,6+,7+,8-,9+,10+,11-,12+,13+,14-,15+,16-,17+,18+/m0/s1
InChIKey
NLVFBUXFDBBNBW-PBSUHMDJSA-N
Cross-matching ID
PubChem CID
36294
ChEBI ID
CHEBI:28864
CAS Number
32986-56-4
DrugBank ID
DB00684
TTD ID
D07BCT
INTEDE ID
DR1606
Combinatorial Drugs (CBD) Click to Jump to the Detailed CBD Information of This Drug
Repurposed Drugs (RPD) Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Bacterial 30S ribosomal RNA (Bact 30S rRNA) TTOVFH2 NOUNIPROTAC Modulator [8]

Drug-Metabolizing Enzyme (DME)
DME Name DME ID UniProt ID MOA REF
RNA cytidine acetyltransferase (hALP) DEZV4AP NAT10_HUMAN Substrate [9]
Aminoglycoside phosphotransferase (aph-Ib) DE5WGIM A0A075C7U3_CAMJU Substrate [10]
Aminoglycoside O-phosphotransferase (aphA6) DEWPAJD KKA6_ACIBA Substrate [11]
Aminoglycoside N-acetyltransferase (aacC2) DEJADS9 AAC6_ACIBA Substrate [11]
Kanamycin/gentamycin-resistance enzyme (aacA) DECXWN8 J3S7E2_CAMCO Substrate [10]

Drug Off-Target (DOT)
DOT Name DOT ID UniProt ID Interaction REF
1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-1 (PLCB1) OT9HYT7A PLCB1_HUMAN Drug Response [7]
Beta-2-microglobulin (B2M) OTDWN6NX B2MG_HUMAN Gene/Protein Processing [12]
Beta-hexosaminidase (nag1) OTQCIZOD P87258_TRIHA Drug Response [7]
Growth arrest and DNA damage-inducible protein GADD45 alpha (GADD45A) OTDRV63V GA45A_HUMAN Gene/Protein Processing [13]
Heme oxygenase 1 (HMOX1) OTC1W6UX HMOX1_HUMAN Gene/Protein Processing [13]
L-lactate dehydrogenase A chain (LDHA) OTN7K4XB LDHA_HUMAN Drug Response [7]
Lysozyme C (LYZ) OTD7H0G6 LYSC_HUMAN Drug Response [7]
mRNA decay activator protein ZFP36 OTJYLJ02 TTP_HUMAN Gene/Protein Processing [13]
Phospholipase A2 (PLA2G1B) OT1GG9FK PA21B_HUMAN Drug Response [7]
Survival motor neuron protein (SMN2) OT54RLO1 SMN_HUMAN Gene/Protein Processing [14]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Tobramycin
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
Cefotetan DM07TX3 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefotetan. Bacterial infection [1A00-1C4Z] [15]
Kanamycin DM2DMPO Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Kanamycin. Bacterial infection [1A00-1C4Z] [16]
Ceftizoxime DM3VOGS Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Ceftizoxime. Bacterial infection [1A00-1C4Z] [15]
Cefoperazone DM53PV8 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefoperazone. Bacterial infection [1A00-1C4Z] [15]
Cefprozil DM7DSYP Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefprozil. Bacterial infection [1A00-1C4Z] [15]
Ceftriaxone DMCEW64 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Ceftriaxone. Bacterial infection [1A00-1C4Z] [15]
Streptomycin DME1LQN Moderate Increased risk of ototoxicity by the combination of Tobramycin and Streptomycin. Bacterial infection [1A00-1C4Z] [16]
Cefepime DMHVWIK Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefepime. Bacterial infection [1A00-1C4Z] [15]
Cefpodoxime DMJUNY5 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefpodoxime. Bacterial infection [1A00-1C4Z] [15]
Gentamicin DMKINJO Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Gentamicin. Bacterial infection [1A00-1C4Z] [16]
Rabeprazole DMMZXIW Moderate Increased risk of hypomagnesemia by the combination of Tobramycin and Rabeprazole. Bacterial infection [1A00-1C4Z] [17]
Cefazolin DMPDYFR Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefazolin. Bacterial infection [1A00-1C4Z] [15]
Netilmicin DMRD1QK Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Netilmicin. Bacterial infection [1A00-1C4Z] [16]
Cefonicid DMTX2BH Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefonicid. Bacterial infection [1A00-1C4Z] [15]
Cefoxitin DMY8NC4 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefoxitin. Bacterial infection [1A00-1C4Z] [15]
⏷ Show the Full List of 15 DDI Information of This Drug
Coadministration of a Drug Treating the Disease Different from Tobramycin (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Remdesivir DMBFZ6L Moderate Decreased renal excretion of Tobramycin caused by Remdesivir mediated nephrotoxicity. 1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019] [16]
Cefuroxime DMSIMD8 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefuroxime. Acute bronchitis [CA42] [15]
Framycetin DMF8DNE Moderate Increased risk of ototoxicity by the combination of Tobramycin and Framycetin. Alcoholic liver disease [DB94] [16]
Inotersen DMJ93CT Major Increased risk of nephrotoxicity by the combination of Tobramycin and Inotersen. Amyloidosis [5D00] [18]
Cefamandole DMNEXZF Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cefamandole. Anaerobic bacterial infection [1A00-1A09] [15]
Etidronic acid DM1XHYJ Moderate Increased risk of hypocalcemia by the combination of Tobramycin and Etidronic acid. Bone paget disease [FB85] [19]
Risedronate DM5FLTY Moderate Increased risk of hypocalcemia by the combination of Tobramycin and Risedronate. Bone paget disease [FB85] [19]
Mannitol DMSCDY9 Major Increased risk of nephrotoxicity by the combination of Tobramycin and Mannitol. Bronchiectasis [CA24] [20]
Iodipamide DMXIQYS Major Increased risk of nephrotoxicity by the combination of Tobramycin and Iodipamide. Cholelithiasis [DC11] [21]
Phenylbutazone DMAYL0T Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Phenylbutazone. Chronic pain [MG30] [22]
Ketoprofen DMRKXPT Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Ketoprofen. Chronic pain [MG30] [22]
Atracurium DM42HXN Major Additive neuromuscular blocking effects by the combination of Tobramycin and Atracurium. Corneal disease [9A76-9A78] [23]
Mivacurium DM473VD Major Additive neuromuscular blocking effects by the combination of Tobramycin and Mivacurium. Corneal disease [9A76-9A78] [23]
Pancuronium DMB0VY8 Major Additive neuromuscular blocking effects by the combination of Tobramycin and Pancuronium. Corneal disease [9A76-9A78] [23]
Tubocurarine DMBZIVP Major Additive neuromuscular blocking effects by the combination of Tobramycin and Tubocurarine. Corneal disease [9A76-9A78] [23]
Methoxyflurane DML0RAE Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Methoxyflurane. Corneal disease [9A76-9A78] [18]
Mycophenolic acid DMRBMAU Moderate Altered absorption of Tobramycin due to GI flora changes caused by Mycophenolic acid. Crohn disease [DD70] [24]
Ethacrynic acid DM60QMR Major Increased risk of ototoxicity by the combination of Tobramycin and Ethacrynic acid. Essential hypertension [BA00] [25]
Mefenamic acid DMK7HFI Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Mefenamic acid. Female pelvic pain [GA34] [22]
Dexlansoprazole DM1DBV5 Moderate Increased risk of hypomagnesemia by the combination of Tobramycin and Dexlansoprazole. Gastro-oesophageal reflux disease [DA22] [17]
Furosemide DMMQ8ZG Major Increased risk of nephrotoxicity by the combination of Tobramycin and Furosemide. Heart failure [BD10-BD1Z] [20]
Bumetanide DMRV7H0 Major Increased risk of ototoxicity by the combination of Tobramycin and Bumetanide. Heart failure [BD10-BD1Z] [20]
Givosiran DM5PFIJ Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Givosiran. Inborn porphyrin/heme metabolism error [5C58] [16]
Exjade DMHPRWG Major Increased risk of nephrotoxicity by the combination of Tobramycin and Exjade. Mineral absorption/transport disorder [5C64] [26]
Neostigmine DM6T2J3 Moderate Additive neuromuscular blocking effects by the combination of Tobramycin and Neostigmine. Myasthenia gravis [8C6Y] [23]
Naproxen DMZ5RGV Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Naproxen. Osteoarthritis [FA00-FA05] [22]
Carboplatin DMG281S Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Carboplatin. Ovarian cancer [2C73] [27]
Aspirin DM672AH Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Aspirin. Pain [MG30-MG3Z] [28]
Etodolac DM6WJO9 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Etodolac. Pain [MG30-MG3Z] [22]
Diflunisal DM7EN8I Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Diflunisal. Pain [MG30-MG3Z] [22]
Ibuprofen DM8VCBE Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Ibuprofen. Pain [MG30-MG3Z] [22]
Esomeprazole DM7BN0X Moderate Increased risk of hypomagnesemia by the combination of Tobramycin and Esomeprazole. Peptic ulcer [DA61] [17]
Choline salicylate DM8P137 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Choline salicylate. Postoperative inflammation [1A00-CA43] [22]
Bromfenac DMKB79O Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Bromfenac. Postoperative inflammation [1A00-CA43] [22]
Everolimus DM8X2EH Major Increased risk of nephrotoxicity by the combination of Tobramycin and Everolimus. Renal cell carcinoma [2C90] [29]
Temsirolimus DMS104F Major Increased risk of nephrotoxicity by the combination of Tobramycin and Temsirolimus. Renal cell carcinoma [2C90] [29]
Salsalate DM13P4C Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Salsalate. Rheumatoid arthritis [FA20] [22]
Meloxicam DM2AR7L Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Meloxicam. Rheumatoid arthritis [FA20] [22]
Oxaprozin DM9UB0P Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Oxaprozin. Rheumatoid arthritis [FA20] [22]
Flurbiprofen DMGN4BY Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Flurbiprofen. Rheumatoid arthritis [FA20] [22]
Sulfasalazine DMICA9H Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Sulfasalazine. Rheumatoid arthritis [FA20] [30]
Salicyclic acid DM2F8XZ Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Salicyclic acid. Seborrhoeic dermatitis [EA81] [28]
Cephapirin DMV2JNY Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Cephapirin. Sepsis [1G40-1G41] [31]
Ifosfamide DMCT3I8 Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Ifosfamide. Solid tumour/cancer [2A00-2F9Z] [16]
Pipecuronium DM5F84A Major Additive neuromuscular blocking effects by the combination of Tobramycin and Pipecuronium. Tonus and reflex abnormality [MB47] [23]
Doxacurium DMKE7L9 Major Additive neuromuscular blocking effects by the combination of Tobramycin and Doxacurium. Tonus and reflex abnormality [MB47] [23]
Vecuronium DMP0UK2 Major Additive neuromuscular blocking effects by the combination of Tobramycin and Vecuronium. Tonus and reflex abnormality [MB47] [23]
Rocuronium DMY9BMK Major Additive neuromuscular blocking effects by the combination of Tobramycin and Rocuronium. Tonus and reflex abnormality [MB47] [23]
Sirolimus DMGW1ID Major Increased risk of nephrotoxicity by the combination of Tobramycin and Sirolimus. Transplant rejection [NE84] [29]
Mycophenolate mofetil DMPQAGE Moderate Altered absorption of Tobramycin due to GI flora changes caused by Mycophenolate mofetil. Transplant rejection [NE84] [24]
Tacrolimus DMZ7XNQ Major Increased risk of nephrotoxicity by the combination of Tobramycin and Tacrolimus. Transplant rejection [NE84] [29]
Olsalazine DMZW9HA Moderate Increased risk of nephrotoxicity by the combination of Tobramycin and Olsalazine. Ulcerative colitis [DD71] [30]
Plazomicin DMKMBES Moderate Increased risk of ototoxicity by the combination of Tobramycin and Plazomicin. Urinary tract infection [GC08] [16]
⏷ Show the Full List of 53 DDI Information of This Drug

References

1 Tobramycin FDA Label
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9 Genetic analysis of bacterial acetyltransferases: identification of amino acids determining the specificities of the aminoglycoside 6'-N-acetyltransferase Ib and IIa proteins. J Bacteriol. 1992 May;174(10):3196-203.
10 Cloning and expression of novel aminoglycoside phosphotransferase genes from Campylobacter and their role in the resistance to six aminoglycosides. Antimicrob Agents Chemother. 2017 Dec 21;62(1). pii: e01682-17.
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14 Translational readthrough by the aminoglycoside geneticin (G418) modulates SMN stability in vitro and improves motor function in SMA mice in vivo. Hum Mol Genet. 2009 Apr 1;18(7):1310-22. doi: 10.1093/hmg/ddp030. Epub 2009 Jan 15.
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