Generic
Hydrocortisone + Neomycin Sulphate + Polymixin B E/E prep
3 brands available in the market
At a glance
Hydrocortisone + Neomycin Sulphate + Polymixin B E/E prep is used for bacterial ear infections and ocular inflammation with suspected or confirmed bacterial infection.
Description
Hydrocortisone + Neomycin Sulphate + Polymixin B E/E prep is used for bacterial ear infections (Otitis externa) and ocular inflammation with suspected or confirmed bacterial infection. This combination is active against Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella-Enterobacter species, Neisseria species, and Pseudomonas aeruginosa.
Indications
- Otitis externa (outer ear infection)
- Ocular inflammation with suspected or confirmed bacterial infection
Therapeutic class
Ophthalmic steroid - antibiotic combined preparations, Ophthalmic Steroid preparations
Pharmacological class
Corticosteroid + Aminoglycoside + Polymixin Antibiotic
Pharmacology
Neomycin, an aminoglycoside, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. Polymyxin B disrupts bacterial cell membrane and has bactericidal action against most Gram-negative bacilli. Hydrocortisone, a corticosteroid with mainly glucocorticoid activity, suppresses inflammatory response.
Mechanism of action
Neomycin kills bacteria by inhibiting protein synthesis; Polymyxin B disrupts bacterial cell membrane; Hydrocortisone reduces inflammation and swelling.
Dosage
Adult Dose (Otic/Aural):
- Neomycin sulfate 3.5 mg, polymyxin B sulfate 10,000 units, hydrocortisone 10 mg (1%) per ml: Instill 4 drops into affected ear 3-4 times daily
- Instill drop with the affected ear upward and remain in this position for 5 minutes
Child Dose (2-16 years):
- Instill 3 drops into affected ear 3-4 times daily
Ophthalmic Dose:
- 1-2 drops every 3-4 hours
Administration
Shake the closed bottle gently before each use; clean and dry the ears; do not use soap; do not put drops in eyes.
Missed dose
If you miss a dose, apply it as soon as possible; if it is almost time for your next dose, skip the missed dose.
Side effects
Ophthalmic:
- Irritation
- Increased intraocular pressure
- Glaucoma
- Posterior subcapsular cataract formation
- Delayed wound healing
- Secondary infections
Otic: Burning and stinging (if product enters the middle ear)
Precautions & warnings
Precautions:
- Ophthalmic: Monitor intraocular pressure if used for >10 days
- Otic: Limit use to ≤10 days to reduce risk of ototoxicity
- Caution in pre-existing nerve deafness
Contraindications
Contraindications:
- Hypersensitivity to aminoglycosides and any components
- Pre-existing nerve deafness
- TB, fungal or viral infections
- Do not use in external eardrum if tympanic membrane is perforated
Drug interactions
Drug Interactions:
- Additive toxicity with neurotoxic, ototoxic or nephrotoxic drugs
- Increased neuromuscular blockade and possibly respiratory depression with neuromuscular blocking agents if significant amounts of neomycin absorbed significantly
Food interactions
No food interaction found/established.
Use in pregnancy
No adequate information regarding use in pregnancy; consult your doctor.
Use in lactation
No adequate information regarding use in lactation; consult your doctor.
Pediatric use
Safety and efficacy not established in children under 2 years; dose provided for 2-16 years.
Geriatric use
No specific data for elderly.
Renal / hepatic impairment
Caution in kidney problems.
Overdose effects
No information on overdose; do not exceed the recommended dose.
Storage conditions
Store in a cool and dry place, protected from light; keep out of reach of children.
Chemical structure
Hydrocortisone + Neomycin Sulphate + Polymixin B E/E prep