When Tobradex Isn't Available, You Still Have Options

You need your eye drops. Your doctor prescribed Tobradex for a reason — maybe you're recovering from eye surgery, dealing with bacterial conjunctivitis, or treating another inflammatory eye condition. But if you can't find Tobradex at any pharmacy near you, what are your options?

The good news is that there are several effective alternatives in the same drug class. This guide explains what Tobradex is, how it works, and which alternatives your doctor might consider if Tobradex isn't available. Important: Never switch medications on your own. Always talk to your doctor before making any changes.

What Is Tobradex?

Tobradex is a brand-name prescription eye drop that combines two medications:

• Tobramycin 0.3% — an aminoglycoside antibiotic that kills bacteria
• Dexamethasone 0.1% — a corticosteroid that reduces inflammation, swelling, and redness

It's manufactured by Novartis/Alcon and is available as an ophthalmic suspension (eye drops), an ointment, and a lower-strength version called Tobradex ST. The generic version, Tobramycin/Dexamethasone, contains the same active ingredients and is available at a fraction of the cost.

For more details about this medication, read our full guide: What Is Tobradex? Uses, Dosage, and What You Need to Know.

How Does Tobradex Work?

Tobradex works in two ways at the same time:

1. Fighting infection: Tobramycin kills susceptible bacteria by disrupting their ability to make proteins, which they need to survive and multiply
2. Reducing inflammation: Dexamethasone suppresses the body's inflammatory response, reducing swelling, redness, pain, and discomfort in the eye

This dual action makes Tobradex especially useful after eye surgery or in conditions where both infection and inflammation need to be addressed simultaneously. To learn more about how it works, see our article on Tobradex's mechanism of action.

Alternative 1: Maxitrol (Neomycin/Polymyxin B/Dexamethasone)

Maxitrol is one of the most common alternatives to Tobradex. Like Tobradex, it combines antibiotics with the corticosteroid dexamethasone — but instead of tobramycin alone, Maxitrol uses two antibiotics: neomycin and polymyxin B.

What makes it different:

• Broader antibacterial coverage with two antibiotics instead of one
• Contains neomycin, which has a higher rate of allergic reactions (up to 8% of patients may develop sensitivity)
• Available as eye drops and ointment
• Generic versions are widely available

Cost: Generic Maxitrol typically costs $15 to $40 with a discount card, making it one of the more affordable options.

Best for: Patients who need broad-spectrum coverage and don't have a neomycin allergy.

Alternative 2: Zylet (Tobramycin/Loteprednol)

Zylet pairs the same antibiotic found in Tobradex (tobramycin) with a different steroid: loteprednol. Loteprednol is considered a "softer" corticosteroid that may carry a lower risk of increasing eye pressure (intraocular pressure) compared to dexamethasone.

What makes it different:

• Same antibiotic (tobramycin) but a gentler steroid
• May be preferred for patients at risk of glaucoma or elevated intraocular pressure
• Brand-name only — tends to be more expensive

Cost: Brand-name Zylet can cost $200 to $400+ without insurance. Generic availability is limited.

Best for: Patients concerned about steroid-related side effects like elevated eye pressure.

Alternative 3: Pred-G (Gentamicin/Prednisolone)

Pred-G combines the antibiotic gentamicin with the corticosteroid prednisolone acetate. It's another established combination product that's been used for decades.

What makes it different:

• Uses gentamicin instead of tobramycin — similar coverage but different antibiotic
• Prednisolone is a moderately potent steroid (between loteprednol and dexamethasone in strength)
• Available as drops and ointment

Cost: Generic versions are typically $20 to $50 with a discount card.

Best for: Patients who need a steroid-antibiotic combination and can't access Tobradex or Maxitrol.

Alternative 4: Separate Antibiotic + Steroid Eye Drops

Instead of a single combination product, your doctor may prescribe two separate eye drops:

• An antibiotic eye drop like Vigamox (Moxifloxacin), Besivance (Besifloxacin), or generic Tobramycin
• A steroid eye drop like Prednisolone Acetate 1% or Lotemax (Loteprednol)

What makes it different:

• Allows your doctor to choose the best antibiotic and steroid independently
• More flexibility in dosing — each drop can be adjusted separately
• Requires using two separate bottles, which is less convenient

Cost: Generic Tobramycin drops cost about $10 to $25, and generic Prednisolone Acetate costs about $15 to $35. Together, they may be cheaper than a single combination product.

Best for: Patients who need a customized approach or can't find any combination product.

How to Decide Which Alternative Is Right for You

This is a conversation to have with your eye doctor. Factors they'll consider include:

• The specific bacteria likely causing your infection
• Your risk of elevated eye pressure or glaucoma
• Any drug allergies (especially to neomycin or aminoglycosides)
• Cost and insurance coverage
• Whether you're recovering from surgery (where a potent steroid may be preferred)

If cost is a major concern, read our guide on how to save money on Tobradex — many of the same strategies apply to alternatives as well.

Final Thoughts

Not being able to fill a Tobradex prescription is stressful, especially when you're dealing with an eye condition that needs prompt treatment. But there are real, effective alternatives available. Maxitrol, Zylet, Pred-G, and separate antibiotic/steroid drops can all provide similar therapeutic benefits.

Before trying to find an alternative on your own, use Medfinder to see if Tobradex or its generic is available near you. If it truly isn't, bring this article to your next appointment and ask your doctor which alternative is the best fit for your situation.

For more help locating Tobradex, check out our guide on how to find Tobradex in stock near you.