Gramicidin + Neomycin Sulphate + Nystatin + Triamcinolone Acetonide (Topical)

Introduction: Gramicidin + Neomycin Sulphate + Nystatin + Triamcinolone Acetonide Topical is a combination cream used for infected eczema, corticosteroid-responsive dermatoses, cutaneous candidiasis and superficial bacterial infections.

How it works: Triamcinolone is a fluorinated corticosteroid with anti-inflammatory, antipruritic and anti-allergic actions. Nystatin is a polyene antifungal antibiotic that binds to ergosterol and interferes with cell membrane permeability of susceptible fungi. Neomycin is an aminoglycoside and Gramicidin is active against many Gram-positive bacteria.

Important Information: Apply sparingly to the affected area 2-3 times daily. Avoid contact with eyes or mucous membranes. If no improvement after 7 days, discontinue use. Not recommended for children under 1 year.

• Infected eczema
• Atopic eczema
• Contact eczema
• Infantile eczema
• Otitis externa
• Anogenital pruritus
• Nummular eczema
• Seborrhoeic or flexural eczema
• Neurodermatitis
• Psoriasis
• Cutaneous candidiasis

Triamcinolone & Combined preparations

Corticosteroid + Antibiotic + Antifungal

Triamcinolone is a fluorinated corticosteroid with anti-inflammatory, antipruritic and anti-allergic actions. Nystatin, a polyene antifungal antibiotic, binds to ergosterol and interferes with the permeability of cell membrane of susceptible fungi. Neomycin is an aminoglycoside, often used topically in the infections against susceptible staphylococci and other organisms. Gramicidin is active against many Gram-positive bacteria. Used together, this combination provides a wide coverage against gram-positive, gram-negative bacteria and yeast.

Triamcinolone reduces inflammation and itching, Nystatin inhibits fungal growth and Neomycin with Gramicidin stops bacterial growth.

Adult Dose:

• As cream/ointment: Apply sparingly to the affected area 2-3 times daily
• Elderly: Use sparingly for short periods of time

Child Dose:

• As cream/ointment: Apply sparingly to the affected area 2-3 times daily
• Under 1 year: Not recommended

* Use as directed by the registered physician

For external use only. Clean and dry the affected area. Apply sparingly and rub gently. Do not bandage unless instructed by your doctor. Avoid contact with eyes and mouth.

If you miss a dose, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and follow your regular schedule. Do not double the dose.

Common Side Effects:

• Burning
• Itching
• Redness
• Skin rash

With prolonged use:

• Sensitivity reactions
• Impaired wound healing
• Thinning of skin
• Striae
• Telangiectasia
• Hirsutism
• HPA axis suppression
• Cushing's syndrome

Precautions:

• Caution in patients with established hearing loss
• Avoid occlusive dressing and prolonged or recurrent use
• Avoid contact with eyes or mucous membranes
• If no clinical improvement after 7 days, discontinue use
• Limit use to 5 days if used on face or children under 1 year
• Use with caution on inflamed or damaged skin

Contraindications:

• Tuberculous
• Viral lesions of the skin (herpes simplex, varicella)
• Fungal lesions not susceptible to nystatin
• Facial rosacea
• Acne vulgaris
• Perioral dermatitis
• Perforated tympanic membranes
• Children under 1 year

Drug Interactions:

• Other topical products (corticosteroids/antiseptics)
• Aminoglycoside antibiotics (gentamicin, tobramycin)
• Oral corticosteroids (prednisone)

Food Interactions: No interaction found/established.

Use in Pregnancy: FDA has not yet classified the drug into a specified pregnancy category.

Use in Lactation: Limited information available. Consult your doctor.

Pediatric Use: Not recommended for children under 1 year.

Geriatric Use: Elderly have naturally thinning skin - use sparingly for short periods.

Renal & Hepatic Impairment: Minimal systemic absorption due to topical use - no known restrictions.

Overdose: Overdose is unlikely when used as directed. Excessive use may cause skin irritation.

Storage: Store at room temperature (15°-30°C), do not freeze, keep away from heat and light.

Gramicidin + Neomycin Sulphate + Nystatin + Triamcinolone Acetonide Topical Cream