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DOSAGE
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1-2 gtts q3-4hrs, depending on the severity of the condition.
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The suspension may be used more frequently if necessary.
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GENERIC
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neomycin 0.35%, polymyxin B + hydrocortisone 1%
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INDICATIONS
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Neomycin and Polymyxin B Sulfates and Hydrocortisone Ophthalmic Suspension is indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial ocular infection exists. Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation. They are also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns, or penetration of foreign bodies. The use of a combination drug with an anti-infective component is indicated where the risk of infection is high or where there is an expectation that potentially dangerous numbers of bacteria will be present in the eye
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MECHANISM OF ACTION
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aminoglycoside / bactericidal peptid / steroid: Neomycin binds to the 30S ribosome preventing protein synthesis. Polymyxin B is a cell membrane disruptor. Hydrocortisone (a.k.a. cortisol) inhibits phospholipase A (thus arachidonic acid metabolism).
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MICROBIOLOGY
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Neomycin is active against Gram-negative aerobes and some anaerobic bacilli. Polymyxin B sulfate is active against Gram-negative species. Hydrocortisone is a weak short acting steroid.
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The anti-infective components in Neomycin and Polymyxin B Sulfates and Hydrocortisone Ophthalmic Suspension are included to provide action against specific organisms susceptible to it. Neomycin sulfate and polymyxin B sulfate are active in vitro against susceptible strains of the following microorganisms: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa. The product does not provide adequate coverage against Serratia marcescens and streptococci, including Streptococcus pneumoniae
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CONTRAINDICATIONS & WARNINGS
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Neomycin and Polymyxin B Sulfates and Hydrocortisone Ophthalmic Suspension is contraindicated in most viral diseases of the cornea and conjunctiva including: epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also in mycobacterial infection of the eye and fungal diseases of ocular structures.
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Neomycin and Polymyxin B Sulfates and Hydrocortisone Ophthalmic Suspension is also contraindicated in individuals who have shown hypersensitivity to any of its components. Hypersensitivity to the antibiotic component occurs at a higher rate than for other components.
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PEDIATRIC USE
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Safety and effectiveness in pediatric patients have not been established.
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PREGNANCY
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Category C. Corticosteroids have been found to be teratogenic in rabbits when applied topically at concentrations of 0.5% on days 6 -18 of gestation and in mice when applied topically at a concentration of 15% on days 10 -13 of gestation. There are no adequate and well-controlled studies in pregnant women. Neomycin and Polymyxin B Sulfates and Hydrocortisone Ophthalmic Suspension should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
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NOTE
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Preserved with thimerosal 0.001%. Prolonged use may result in ocular hypertension / glaucoma, and cataract. Monitor IOP if used for more than 10 days.
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Neomycin is notable for its tendency to cause Type IV delayed hypersensitivity reaction.
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