Your Patients Need Tobradex — Here's How to Help Them Get It

You've prescribed Tobradex (Tobramycin 0.3%/Dexamethasone 0.1%) for a patient who needs it — perhaps after cataract surgery, for bacterial conjunctivitis with inflammation, or another steroid-responsive condition with a bacterial component. But increasingly, patients return to report they couldn't fill the prescription.

This guide offers a practical, workflow-oriented approach to improving Tobradex access for your patients. From real-time availability tools to prescribing strategies and alternative options, these five steps can reduce friction and improve outcomes.

Current Availability: What's Happening with Tobradex

Tobradex is not listed on the FDA or ASHP drug shortage databases as of early 2026. However, pharmacy-level availability remains inconsistent:

• Chain pharmacies frequently report stock-outs for specialty ophthalmic products
• The brand-name product ($200–$350) is less commonly stocked than the generic ($28–$55)
• Tobradex ointment and Tobradex ST may have different availability than the standard suspension
• Geographic variation is significant — availability differs by region and pharmacy type

For a comprehensive overview of the supply situation, see our provider briefing: Tobradex Shortage: What Providers and Prescribers Need to Know in 2026.

Why Patients Can't Find Tobradex

Understanding the barriers your patients face helps you prescribe more effectively:

1. Limited pharmacy inventory: Specialty eye drops are low-volume items; pharmacies stock minimal quantities
2. Brand vs. generic confusion: Prescriptions written for brand-name Tobradex with "DAW" cannot be filled with the more widely available generic
3. Insurance restrictions: Prior authorization requirements and formulary exclusions create delays
4. Cost shock: Patients without coverage may see a $200+ price tag and abandon the prescription
5. Wholesaler allocation limits: When supply is tight, pharmacies may be limited in how much they can order

What Providers Can Do: 5 Actionable Steps

Step 1: Prescribe Generic Unless Clinically Necessary

Generic Tobramycin/Dexamethasone ophthalmic suspension is AB-rated and therapeutically equivalent to brand-name Tobradex. It is:

• More widely stocked at retail pharmacies
• Significantly more affordable ($28–$55 vs. $200–$350)
• Covered by most insurance plans with low copays

Avoid "dispense as written" designations unless there is a documented clinical reason for the brand-name product.

Step 2: Use Medfinder to Identify In-Stock Pharmacies

Medfinder for Providers allows you to check real-time pharmacy availability before sending a prescription. This means you can:

• Send e-prescriptions directly to pharmacies confirmed to have stock
• Provide patients with specific pharmacy recommendations
• Reduce failed fill attempts and patient frustration

Integrating a quick Medfinder check into your prescribing workflow takes seconds and can save your patients hours.

Step 3: Consider Alternative Formulations

If the standard Tobradex suspension is unavailable, these alternatives may be in stock:

• Tobradex ointment (3.5 g): Same active ingredients; appropriate for nighttime use or when longer contact time is needed
• Tobradex ST: Lower dexamethasone concentration (0.05%); may be preferred when a less potent steroid is clinically appropriate
• Separate prescriptions: Generic Tobramycin drops ($10–$25) + Prednisolone Acetate 1% ($15–$35) can replicate the combination therapy

Step 4: Proactively Address Cost Barriers

Many patients abandon prescriptions due to cost. Help them by:

• Recommending discount cards (GoodRx, SingleCare) for generic — can reduce cost to as low as $28
• Mentioning manufacturer assistance: Novartis Patient Assistance Foundation for qualifying uninsured patients
• Noting that Alcon offers payment assistance programs at myalcon.com
• Directing patients to our savings guide: How to Save Money on Tobradex

For a provider-specific cost resource, see: How to Help Patients Save Money on Tobradex: A Provider's Guide.

Step 5: Have a Backup Plan Ready

Before the patient leaves your office, consider having a contingency. If their first-choice pharmacy doesn't have Tobradex:

• Provide a second pharmacy recommendation
• Write an alternative medication on the chart to expedite a callback if needed
• Instruct patients to call your office if they can't fill within 24 hours

Alternative Medications to Consider

When Tobradex truly isn't available in any formulation, these alternatives can serve as substitutes depending on the clinical scenario:

• Maxitrol (Neomycin/Polymyxin B/Dexamethasone): Broader antibacterial coverage; higher neomycin allergy risk. Generic: $15–$40
• Zylet (Tobramycin/Loteprednol): Softer steroid, lower IOP risk. Brand: $200–$400+
• Pred-G (Gentamicin/Prednisolone): Alternative aminoglycoside/steroid combo. Generic: $20–$50
• Vigamox + Prednisolone Acetate: Fluoroquinolone plus steroid — separate drops, broader Gram-negative coverage

Share this comparison with patients: Alternatives to Tobradex If You Can't Fill Your Prescription.

Workflow Tips for Your Practice

Here are a few operational suggestions to minimize Tobradex-related friction:

• Pre-check availability: Make a Medfinder search part of your standard prescribing workflow for specialty medications
• Stock patient handouts: Print or digitally share links to Medfinder and our patient guides
• Use e-prescribing strategically: Send to confirmed in-stock pharmacies rather than the patient's default
• Track patterns: If you notice recurring availability issues, consider reaching out to local pharmacies to discuss stocking levels
• Educate staff: Ensure your clinical team knows about generic equivalence, discount card options, and how to direct patients to Medfinder

Final Thoughts

Helping patients access Tobradex doesn't require heroic effort — it requires a few smart adjustments to your prescribing workflow. Prescribe generic when possible, check availability with Medfinder, address cost proactively, and have alternatives ready. These small steps make a meaningful difference in patient outcomes and satisfaction.

For the latest on Tobradex supply, see our shortage update: Tobradex Shortage Update: What Patients Need to Know in 2026.