Last update Nov. 25, 2019

C18 H37 N5 O9


Safe substance and/or breastfeeding is the best option.

Aminoglycoside antibacterial with actions and uses similar to those of gentamicin.
Administration by intramuscular or intravenous injection, or by inhalation

Excreted into breast milk in non-significant amount (Takase 1975, Uwaydah 1975, Festini 2006) without harm effects observed among breastfed infants of mothers treated with Tobramycin (Festini 2006 y 2004, Bourget 1993).

In addition, a low oral bioavailability renders concentration in the infant's plasma be nil or low.

Be aware of the risk of acute diarrhea by alteration of normal gut flora.

Several experts consider the use of this medication safe during breastfeeding (Hale 2019, Briggs 2017, Rowe 2013, Schaefer 2007, Chin 2001, Niebyl 1992).

When used in eye drops, because of a low dose and topical application with minimal absorption in the serum, it is compatible while breastfeeding.


We do not have alternatives for C18 H37 N5 O9 since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

C18 H37 N5 O9 is Tobramycin in Molecular formula.

Is written in other languages:

C18 H37 N5 O9 is also known as


Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 468 daltons
Protein Binding 1 %
VD 0.3 l/Kg
Tmax 0.5 - 1.5 hours
2 - 3 hours
M/P ratio 0.4 -
Theoretical Dose 0.09 mg/Kg/d
Relative Dose 3 %
Ped.Relat.Dose 1.5 %


  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from Consulted on April 10, 2024 Full text (link to original source)
  2. Middleton PG, Gade EJ, Aguilera C, MacKillop L, Button BM, Coleman C, Johnson B, Albrechtsen C, Edenborough F, Rigau D, Gibson PG, Backer V. ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases. Eur Respir J. 2020 Feb 6;55(2). pii: 1901208. Abstract Full text (link to original source) Full text (in our servers)
  3. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  4. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  5. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  6. Festini F, Ciuti R, Taccetti G, Repetto T, Campana S, De Martino M. Breast-feeding in a woman with cystic fibrosis undergoing antibiotic intravenous treatment. J Matern Fetal Neonatal Med. 2006 Jun;19(6):375-6. Abstract
  7. Festini F. Ciuti R, Repetto T, Taccetti G, Neri A, Campana S, Mergni G, de Martino M. Safety of breast-feeding during an IV tobramycin course for infants of CF women. Pediatr Pulmonol Suppl. 2004;27:288-9. Poster-Abstract 291. 2004
  8. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  9. Bourget P, Quinquis-Desmaris V, Fernandez H. Ceftriaxone distribution and protein binding between maternal blood and milk postpartum. Ann Pharmacother. 1993 Abstract
  10. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992 Dec;8(4):221-3. Review. No abstract available. Abstract
  11. Niebyl JR. Use of antibiotics for ear, nose, and throat disorders in pregnancy and lactation. Am J Otolaryngol. 1992 Jul-Aug;13(4):187-92. Review. No abstract available. Abstract
  12. Uwaydah M, Bibi S, Salman S. Therapeutic efficacy of tobramycin--a clinical and laboratory evaluation. J Antimicrob Chemother. 1975 Abstract
  13. Takasa Z, Shirafuji H, Uchida M et al. Laboratory and clinical studies on tobramycin in the fields of obstetrics and gynecology. Chemotherapy (Tokyo) 1975; 23:1399–1402.

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