Neomycin, polymyxin b, and hydrocortisone (Otic)
Medically reviewed by Drugs.com. Last updated on Jan 14, 2022.
Commonly used brand name(s)
In the U.S.
- Antibiotic Otic
- Casporyn HC
Available Dosage Forms:
Therapeutic Class: Anti-Infective/Anti-Inflammatory Combination
Pharmacologic Class: Adrenal Glucocorticoid
Chemical Class: Neomycin
Uses for neomycin, polymyxin b, and hydrocortisone
Neomycin, polymyxin B, and hydrocortisone combination ear drops is used to treat infections of the ear canal and to help provide relief from redness, irritation, and discomfort of certain ear problems. It is also used to treat ear infections as a complication after ear surgery (eg, mastoidectomy, fenestration).
Neomycin and polymyxin B belong to the class of medicines known as antibiotics. They work by killing the bacteria or preventing their growth. Hydrocortisone is a steroid medicine that is used to relieve the redness, itching, and swelling caused by ear infections.
Neomycin, polymyxin b, and hydrocortisone is available only with your doctor's prescription.
Before using neomycin, polymyxin b, and hydrocortisone
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For neomycin, polymyxin b, and hydrocortisone, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to neomycin, polymyxin b, and hydrocortisone or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of neomycin, polymyxin B, and hydrocortisone ear drops in the pediatric population. Safety and efficacy have been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of neomycin, polymyxin B, and hydrocortisone eye drops in the elderly.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Interactions with food/tobacco/alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other medical problems
The presence of other medical problems may affect the use of neomycin, polymyxin b, and hydrocortisone. Make sure you tell your doctor if you have any other medical problems, especially:
- Any other ear infection or condition—Use with caution. May make these conditions worse.
- Punctured eardrum or
- Chickenpox or
- Herpes simplex or
- Measles—Should not be used in patients with these conditions.
Proper use of neomycin, polymyxin b, and hydrocortisone
Use neomycin, polymyxin b, and hydrocortisone exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may increase the chance of side effects.
Neomycin, polymyxin b, and hydrocortisone should be used only in the ear. Do not put it into the eyes or nose, and do not take it by mouth. If neomycin, polymyxin b, and hydrocortisone is swallowed by accident or gets into your eyes, call your doctor right away.
You may warm the ear drops to body temperature (37 °C or 98.6 °F), but no higher, by holding the bottle in your hand for a few minutes before using the medicine. If the medicine gets too warm, it may break down and not work at all.
To use the ear drops:
- Wash hands thoroughly with soap and water.
- Shake the bottle well before using it.
- Lie down or tilt your head so that the infected ear faces up. Gently pull the earlobe up and back for adults (down and back for children) to straighten the ear canal.
- Drop the prescribed number of drops into the ear canal. Keep the ear facing up for about 5 minutes to allow the medicine to coat the ear canal. (For young children and other patients who cannot stay still for 5 minutes, try to keep the ear facing up for at least 1 or 2 minutes.)
- Your doctor may insert a gauze or cotton wick inside your ear and may want you to keep the wick moistened with neomycin, polymyxin b, and hydrocortisone. Your doctor also may have other directions for you, such as how long you should keep the wick inside your ear or when you should return to your doctor to have the wick replaced. If you have any questions about this, check with your doctor.
- To keep the medicine as germ-free as possible, do not touch the dropper to any surface (including the ear). Also, keep the container tightly closed.
To help clear up your infection completely, keep using neomycin, polymyxin b, and hydrocortisone for the full time of treatment, even if your symptoms have disappeared. Do not miss any doses.
The dose of neomycin, polymyxin b, and hydrocortisone will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of neomycin, polymyxin b, and hydrocortisone. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For otic dosage form (ear drops):
- For ear canal infection:
- Adults—4 drops into the affected ear 3 or 4 times a day.
- Children—3 drops into the ear 3 or 4 times a day.
- For mastoid cavity infection:
- Adults—4 to 10 drops in the ear every 6 to 8 hours.
- Children—4 or 5 drops in the ear every 6 to 8 hours.
- For ear canal infection:
If you miss a dose of neomycin, polymyxin b, and hydrocortisone, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Precautions while using neomycin, polymyxin b, and hydrocortisone
If you and your child's symptoms do not improve within 1 week, or if they become worse, check with your doctor.
Do not use neomycin, polymyxin b, and hydrocortisone for more than 10 days unless otherwise directed by your doctor.
Neomycin, polymyxin b, and hydrocortisone side effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
- Itching, skin rash, redness, swelling, or other signs of irritation in or around the ear not present before the use of neomycin, polymyxin b, and hydrocortisone
- Stinging and burning feeling in the middle ear
Incidence not known
- Blood in the urine
- change in the frequency of urination or amount of urine
- difficulty in breathing
- feeling of fullness in the ears
- increased thirst
- loss of appetite
- loss of balance
- loss of hearing
- ringing or buzzing in the ears
- swelling of the feet or lower legs
- trouble in hearing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- difficulty swallowing
- fast heartbeat
- hives, itching, skin rash
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- tightness in the chest
- unusual tiredness or weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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