Bg pattern

VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION

Prescription review online

Prescription review online

A doctor will review your case and decide whether a prescription is medically appropriate.

Talk to a doctor about this medicine

Talk to a doctor about this medicine

Discuss your symptoms and possible next steps in a quick online consultation.

This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION

Translated with AI

This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

Show original

Introduction

Leaflet:information for the patient

Vantobra 170 mg solution for inhalation by nebulizer

tobramycin

Read the entire leaflet carefully before starting to use this medicine, as it contains important information for you.

  • Keep this leaflet, as you may need to read it again.
  • If you have any doubts, consult your doctor or pharmacist.
  • This medicine has been prescribed to you only, and you should not give it to others, even if they have the same symptoms as you, as it may harm them.
  • If you experience side effects, consult your doctor or pharmacist, even if they are side effects not listed in this leaflet. See section 4.

Contents of the leaflet

  1. What is Vantobra and what is it used for
  2. What you need to know before starting to use Vantobra
  3. How to use Vantobra
  4. Possible side effects
  5. Storage of Vantobra
  6. Package contents and additional information

1. What is Vantobra and what is it used for

What is Vantobra

Vantobra contains an antibiotic called tobramycin. It belongs to a class of antibiotics known as aminoglycosides.

What is Vantobra used for

Vantobra is used in patients with cystic fibrosis from 6 years of age for the treatment of lung infections caused by a bacterium called Pseudomonas aeruginosa.

Pseudomonas aeruginosais a bacterium that frequently infects the lungs of patients with cystic fibrosis at some point in their lives. If the infection is not treated properly, it will continue to damage the lungs and cause more respiratory problems.

How Vantobra works

When Vantobra is inhaled, the antibiotic can enter the lungs directly to fight the bacteria that cause the infection. This medicine works by altering the production of proteins that bacteria need to build their cell walls. This damages the bacteria and eventually kills them.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before starting to use Vantobra

Do not use Vantobra:

  • if you are allergic (hypersensitive) to tobramycin or to any other aminoglycoside antibiotic or to any of the other components of Vantobra (listed in section 6).

If you are in any of the above circumstances, inform your doctor before using Vantobra.

Warnings and precautions

Consult your doctor if you have ever suffered from any of the following diseases:

  • hearing problems (including ringing in the ears and dizziness)
  • kidney problems
  • chest discomfort
  • blood in the sputum (the substance that is expelled when coughing)
  • persistent or worsening muscle weakness, a symptom often related to disorders such as myasthenia (muscle weakness) or Parkinson's disease.

If you are in any of the above circumstances, inform your doctor before using Vantobra.

If you have hearing or kidney problems, your doctor may take blood samples to monitor the amount of Vantobra present in your body.

If you or members of your maternal family have a disease caused by a mitochondrial mutation (a genetic disease) or hearing loss due to antibiotics, it is recommended that you inform your doctor or pharmacist before taking this medicine. Certain mitochondrial mutations can increase your risk of hearing loss with this product. Your doctor may recommend genetic tests before administering Vantobra.

Inhaling medications can cause chest discomfort due to the narrowing of the airways; this can happen with Vantobra. Your doctor may ask you to use other medications suitable for widening the airways before using Vantobra.

Pseudomonasstrains can become resistant to antibiotic treatment over time. This means that, over time, Vantobra may stop working as it should. If you have doubts about this, consult your doctor.

If you are also taking tobramycin or another aminoglycoside antibiotic administered by injection, this may increase the risk of experiencing side effects. Your doctor will monitor you as necessary.

Children

This medicine is not indicated for use in children under 6 years of age.

Other medicines and Vantobra

Tell your doctor or pharmacist if you are using or have recently used other medicines, including those purchased without a prescription.

Do not take the following medicines while using Vantobra:

  • furosemide, a diuretic (a medicine that increases urine volume)
  • other medicines with diuretic potential, such as urea or mannitol
  • other medicines that can harm your kidneys or hearing:
  • amphotericin B, cephalothin, polymyxins (used to treat microbial infections), cyclosporine, tacrolimus (used to reduce the activity of the immune system). These medicines can harm the kidneys;
  • platinum-based compounds, such as carboplatin and cisplatin (used to treat certain types of cancer). These medicines can harm the kidneys or hearing.

The following medicines may increase the risk of harmful effects if administered when you are already receiving tobramycin or another aminoglycoside antibiotic administered by injection:

  • anticholinesterases, such as neostigmine and pyridostigmine (used to treat muscle weakness) or botulinum toxin. These medicines can cause or worsen muscle weakness.

If you take any of the above medicines, consult your doctor before using Vantobra.

Do not mix or dilute Vantobra with any other medicine in the Tolero handheld nebulizer provided with Vantobra.

If you are taking different medicines for cystic fibrosis, you will take them in the following order:

  1. Bronchodilator treatment, such as salbutamol
  2. Respiratory physiotherapy
  3. Other inhaled medicines
  4. Vantobra

Consult your doctor about the order.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor before using this medicine.

It is not known if inhaling this medicine during pregnancy can cause side effects. When administered by injection, tobramycin and other aminoglycoside antibiotics can cause harm to the fetus, such as deafness and kidney problems.

If you are breastfeeding, you should consult your doctor before using this medicine.

Driving and using machines

Vantobra is not expected to affect your ability to drive or use machines.

3. How to use Vantobra

Follow your doctor's instructions for administering this medicine exactly. If in doubt, consult your doctor again.

The recommended dose is two ampoules per day (one in the morning and one in the evening) for 28 days.

  • The dose is the same for all people from 6 years of age.
  • Inhale the complete contents of one ampoule through the mouth in the morning and another ampoule in the evening using the Tolero handheld nebulizer.
  • It is recommended that the interval between doses be as close as possible to 12 hours, but in any case, this interval should be at least 6 hours.
  • After using the medicine for 28 days, you will start a 28-day rest period, during which you will not inhale any dose of Vantobra. Then, you will have to start a new cycle after the rest period (as illustrated).
  • It is essential that you continue using the medicine twice a day during the 28 days of treatment and respect the cycle of 28 days with treatment and 28 days without treatment.

Comparative table with arrows indicating “WITH Vantobra” and “WITHOUT Vantobra” showing instructions for use for 28 days

Repeat the cycle

Continue using Vantobra following this same scheme until your doctor tells you otherwise.

If you have any doubts about how long you should continue using Vantobra, consult your doctor or pharmacist.

Preparing Vantobra for inhalation

  • Use Vantobra only with the Tolero handheld nebulizer provided with Vantobra to ensure that you inhale the correct dose. Do not use the Tolero handheld nebulizer with any other medicine.
  • Read the instructions for use included with the Tolero handheld nebulizer before using it.

Medicine administration device with cable and connector, labeled “Tolvaptan for VANTORAN” in black on white

  • Make sure you have an eTrack or eBase controller to connect the Tolero handheld nebulizer to. The corresponding controller can be prescribed by your doctor or purchased separately.
  • Wash your hands well with soap and water.
  • Remove a Vantobra ampoule from the aluminum paper pouch just before inhalation.
  • Keep the rest of the medicine refrigerated in the original box.
  • Place all the parts of the Tolero handheld nebulizer on a clean and dry paper or cloth. Make sure the nebulizer is on a flat and stable surface.
  • Assemble the Tolero handheld nebulizer as indicated in its instructions for use.
  • Hold the ampoule upright and gently tap it before removing the top to avoid spilling. Empty the contents of one ampoule into the medication reservoir of the Tolero handheld nebulizer.
  • Start the treatment sitting upright in a well-ventilated room. Hold the nebulizer in a horizontal position and breathe through your mouth normally. Avoid breathing through your nose. Continue inhaling and exhaling comfortably until the treatment is finished. When all the medicine has been administered, you will hear an acoustic signal indicating that the administration is complete.
  • If for any reason you need to interrupt the treatment before finishing it, hold the On/Off button for one second. To restart the treatment, hold the On/Off button for one second again.
  • The Tolero handheld nebulizer must be cleaned and disinfected as described in its instructions for use.
  • Use a new Tolero handheld nebulizer for each treatment cycle (28 days of active treatment), including the one provided with the medicine.

Do not use an alternative and untested nebulizer system, as this may alter the amount of medicine that reaches the lungs, which in turn may alter the safety and efficacy of the medicine.

If you use more Vantobra than you should

If you inhale too much Vantobra, your voice may become very hoarse. Inform your doctor as soon as possible. If you swallow Vantobra, it is unlikely to cause serious problems, since tobramycin is hardly absorbed in the stomach, but still, you should inform your doctor as soon as possible.

If you forget to use Vantobra

If you forget to use Vantobra and there are at least 6 hours until the next dose, take the dose as soon as you can. Otherwise, wait until the next dose. Do not use a double dose to make up for forgotten doses.

If you interrupt treatment with Vantobra

Do not interrupt treatment with Vantobra unless your doctor tells you to, as the lung infection may not be sufficiently controlled and could worsen.

If you have any other doubts about using this medicine, ask your doctor or pharmacist.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everyone gets them.

Some side effects can be serious

  • chest discomfort with difficulty breathing (rare, may affect up to 1 in 1,000 people)
  • allergic reactions, such as hives and itching (very rare, may affect up to 1 in 10,000 people)

If you experience any of these effects, stop using Vantobra and contact your doctor immediately.

People with cystic fibrosis have various symptoms of this disease. These symptoms may continue to occur while using Vantobra, but they should not be as frequent or worse than before.

If your underlying lung disease seems to worsen while taking Vantobra, inform your doctor immediately.

Other side effects may be:

Uncommon (may affect up to 1 in 100 people)

  • difficulty breathing
  • voice alteration (hoarseness)
  • increased frequency of coughing
  • sore throat

Rare (may affect up to 1 in 1,000 people)

  • Laryngitis (inflammation of the vocal cords that can cause voice alteration, sore throat, and difficulty swallowing)
  • Loss of voice
  • Headache, weakness
  • Nasal bleeding, nasal discharge
  • Ringing in the ears (usually transient), hearing loss, dizziness
  • Coughing up blood, producing more sputum than usual, chest discomfort, asthma, fever
  • Taste disturbances, feeling unwell (nausea), mouth ulcers, discomfort (vomiting), decreased appetite
  • Rash
  • Chest pain or generalized pain
  • Worsening of lung function test results

Very rare (may affect up to 1 in 10,000 people)

  • Fungal infections in the mouth or throat, such as thrush
  • Inflammation of the lymph nodes
  • Drowsiness
  • Ear pain, ear problems
  • Hyperventilation, low oxygen levels in the blood, sinusitis
  • Diarrhea, pain in or around the stomach
  • Red-colored pustules, papules on the skin
  • Hives, itching
  • Back pain
  • General discomfort

Reporting side effects

If you experience any side effects, consult your doctor or pharmacist, even if they are possible side effects not listed in this leaflet. You can also report them directly through the national reporting system included in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Vantobra

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiration date that appears on the ampoule, on the pouch, or on the box after "EXP". The expiration date is the last day of the month indicated.

Store in a refrigerator (between 2°C and 8°C). If you do not have a refrigerator (for example, when transporting the medicine), you can store the box with the medicine (even if the pouches are open) below 25°C for a maximum of 4 weeks. If the medicine is stored at room temperature for more than 4 weeks, it will be discarded according to local regulations.

Do not use this medicine if it appears cloudy or particles are observed in the solution.

Never store an open ampoule.Once an ampoule is opened, it must be used immediately, and the remaining product will be discarded.

Medicines should not be thrown away in the trash. Ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. Package contents and additional information

Composition of Vantobra

  • The active ingredient is tobramycin. One ampoule contains 170 mg of tobramycin as a single dose.
  • The other components (excipients) are: sodium chloride, calcium chloride, magnesium sulfate, water for injectable preparations, sulfuric acid, and sodium hydroxide to adjust the pH.

Appearance of Vantobra and package contents

Vantobra solution for inhalation by nebulizer is supplied in a ready-to-use ampoule.

Vantobra is a clear to yellowish solution, which may vary to dark yellow. This does not affect the action of Vantobra as long as the storage instructions have been followed.

The ampoules are packaged in pouches, and each pouch contains 8 ampoules, which corresponds to four days of treatment.

Vantobra is available together with a Tolero handheld nebulizer. It is presented in a box that contains two boxes inside, one with the medicine (56 ampoules with solution for inhalation by nebulizer in 7 pouches) and another that contains the Tolero handheld nebulizer. One package is sufficient for a 28-day treatment cycle.

Marketing authorization holder and manufacturer

PARI Pharma GmbH

Moosstrasse 3

D-82319 Starnberg

Germany

Tel.: +49 (0) 89 – 74 28 46 - 10

Fax: +49 (0) 89 – 74 28 46 30

E-mail: [email protected]

Date of the last revision of this leaflet:

Other sources of information

Detailed information about this medicine is available on the European Medicines Agency website: http://www.ema.europa.eu. There are also links to other websites about rare diseases and orphan medicines.

Online doctors for VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION

Discuss questions about VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

0.0 (0)
Doctor

Joao Silva

General medicine 6 years exp.

Dr. João Silva is a physician with training and experience in the field of General and Family Medicine, dedicated to providing healthcare focused on the well-being and quality of life of his patients. Throughout his professional career, he has developed broad clinical competencies, striving to maintain a medical practice based on scientific evidence and continuous knowledge updates.

Between 2013 and 2019, he completed the Integrated Master's Degree in Medicine at the Abel Salazar Institute of Biomedical Sciences in Porto, where he acquired a solid academic and clinical education.

Subsequently, between January 2021 and December 2021, he completed the General Internship at the Entre Douro e Vouga Hospital Center in Santa Maria da Feira, where he had the opportunity to work in different hospital settings and deepen his competencies in several areas of medicine.

From January 2022 until March 2026, he works as a Resident Physician in General and Family Medicine at USF Salvador Machado in Oliveira de Azeméis, developing clinical activities in primary healthcare, follow-up of chronic patients, and health promotion in the community.

Complementing his medical training, Dr. João Silva also completed a Postgraduate Degree in Continuing and Palliative Care at CESPU, strengthening his preparation in the comprehensive approach to patient care, especially in situations requiring prolonged care and multidisciplinary support.

Camera Book a video appointment
€55
0.0 (17)
Doctor

Daniel Cichi

Family medicine 24 years exp.

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance. His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation. Patients commonly consult Dr Daniel Cichi for: 

  • acute symptoms: fever, infections, flu-like illness, cough, sore throat, shortness of breath;
  • chest discomfort, palpitations, dizziness, fatigue, and blood pressure concerns;
  • digestive problems: abdominal pain, nausea, diarrhoea, constipation, reflux;
  • sexually transmitted infections, erectile dysfunction;
  • muscle, joint, and back pain, minor injuries, post-traumatic symptoms;
  • chronic conditions: hypertension, diabetes, high cholesterol, thyroid disorders, weight loss, hair loss;
  • review and interpretation of lab tests, imaging reports, and medical documents;
  • medication review and treatment adjustment;
  • medical advice while travelling or living abroad;
  • second opinions and guidance on whether in-person care is needed.

Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.

Camera Book a video appointment
€55
5.0 (40)
Doctor

Lina Travkina

Family medicine 13 years exp.

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

Camera Book a video appointment
€70
5.0 (5)
Doctor

Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

Camera Book a video appointment
€80

Frequently Asked Questions

Is a prescription required for VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION?
VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION?
The active ingredient in VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION is tobramycin. This information helps identify medicines with the same composition but different brand names.
Who manufactures VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION?
VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION is manufactured by Pari Pharma Gmbh. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to VANTOBRA 170 mg SOLUTION FOR NEBULIZER INHALATION?
Other medicines with the same active substance (tobramycin) include BRAMITOB 300 mg/4 ml SOLUTION FOR NEBULIZER INHALATION, TOBI PODHALER 28 mg POWDER FOR INHALATION (HARD CAPSULE), TOBRAMICIN ACCORD 300 mg / 5 ml SOLUTION FOR NEBULIZER INHALATION. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
bg-pattern-dark

Stay informed about Oladoctor

News about new services, product updates and useful information for patients.

Follow us on social media