Prednisolone Acetate / Neomycin Sulfate / Polymyxin B Sulfate
Pronouncation: (pred-NISS-oh-lone ASS-uh-TATE/NEE-oh-MY-sin SULL-fate/pahl-ee-MIX-in BEE SULL-fate)Class: Corticosteroid, Antibacterial
Trade Names:
Poly-Pred Liquifilm
- Ophthalmic Suspension 0.5% prednisolone acetate/neomycin sulfate equiv. to 0.35% neomycin base/10,000 units/mL polymyxin B sulfate
Pharmacology
Feedback for Prednisolone Acetate/Neomycin Sulfate/Polymyxin B Sulfate
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Depresses formation, release, and activity of endogenous mediators of inflammation including prostaglandins, kinins, histamine, liposomal enzymes, and complement system.
NeomycinInhibits protein synthesis by binding to ribosomal RNA, causing bacterial genetic code misreading.
Polymyxin BInteracts with phospholipid components of bacterial cell membrane, increasing cell wall permeability.
Indications and Usage
Treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial ocular infection exists; inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of steroid use in certain infective conjunctivitis is accepted to obtain a diminution in edema and inflammation; chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns or penetration of foreign bodies; when risk of infection is high or where there is expectation that potentially dangerous numbers of bacteria will be present in the eye.
Contraindications
Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, and many other viral diseases of the corneal and conjunctiva; mycobacterial eye infections; fungal diseases of the ocular structures; uncomplicated removal of a corneal foreign body; hypersensitivity to any component of the product.
Dosage and Administration
EyeOphthalmic Instill 1 or 2 gtt in the eye every 3 or 4 h or more frequently as required. Acute infections may require administration every 30 min, with decreasing frequency as the infection is brought under control.
LidsOphthalmic Instill 1 or 2 gtt in the eye every 3 to 4 h, close the eye, and rub the excess on the lids and lid margins.
General Advice
- For ophthalmic use only. Not for use in the ears or on the skin.
- Shake well before instilling gtt.
- Do not allow tip of dropper bottle to touch eye, eyelid, fingers, or any other surface.
- If using other topical ophthalmic medications, instill drops first, wait at least 5 min, and instill ointment last.
Storage/Stability
Store at controlled room temperature (less than 77°F). Keep bottle tightly capped and protect from freezing.
Drug Interactions
None well documented.
Laboratory Test Interactions
None well documented.
Adverse Reactions
EENT
Elevated IOP with possible development of glaucoma; optic nerve damage; posterior subcapsular cataract formation; delayed wound healing; secondary infection; fungal infection; acute anterior uveitis and perforation of the globe.
Miscellaneous
Allergic sensitivity.
Precautions
Pregnancy
Category C .
Lactation
Excreted in breast milk.
Children
Safety and efficacy have not been established.
Superinfection
Prolonged use may result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Cross-sensitivity
Allergic cross-sensitivity to kanamycin, paromomycin, streptomycin, and, possibly, gentamicin may occur.
Glaucoma
Prolonged use may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation.
Secondary infection
Secondary bacterial ocular infection following suppression of host responses may occur.
Patient Information
- Review prescribed dosing schedule with patient, family, or caregiver.
- Remind patient, family, or caregiver that suspension is for use in the eye only.
- Teach patient, family, or caregiver proper technique for instilling suspension: wash hands; do not allow tip of dropper bottle to touch eye, eyelid, fingers, or any other surface. Tilt head back, look up; pull lower eyelid down to form pocket; place prescribed number of drops in the pocket. Look downward before closing eye. Do not rub eye.
- Advise patient, family, or caregiver that if more than 1 topical ophthalmic drug is being used, instill eye drops first, wait at least 5 min and then instill ointment last.
- Inform patient that temporary blurred vision and stinging of the eye are the most common side effects and to contact health care provider if these symptoms occur and are bothersome.
- Advise patient to contact eye doctor if eye or eyelid inflammation is noted or if eye symptoms do not improve or worsen.
- Advise patient that the entire course of therapy must be completed to ensure maximal benefit and to complete full course of therapy even if symptoms have resolved.
- Instruct patient not to wear contact lenses during treatment.
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Conjunctivitis -- Bacterial, Uveitis, Keratitis, Blepharitis, Keratoconjunctivitis
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