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Bacitracin, Neomycin, Polymyxin B, and Hydrocortisone (Ophthalmic)

Medically reviewed by Drugs.com. Last updated on Jun 17, 2020.

Pronunciation

(bas i TRAY sin, nee oh MYE sin, pol i MIKS in bee, & hye droe KOR ti sone)

Index Terms

  • Hydrocortisone, Bacitracin, Neomycin, and Polymyxin B
  • Neomycin, Bacitracin, Polymyxin B, and Hydrocortisone
  • Polymyxin B, Bacitracin, Neomycin, and Hydrocortisone

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Ointment, Ophthalmic:

Neo-Polycin HC: Bacitracin 400 units, neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per g (3.5 g)

Generic: Bacitracin 400 units, neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per g (3.5 g)

Brand Names: U.S.

  • Neo-Polycin HC

Pharmacologic Category

  • Antibiotic, Ophthalmic
  • Corticosteroid, Ophthalmic

Pharmacology

See individual agents.

Use: Labeled Indications

Inflammatory ocular conditions: Corticosteroid-responsive inflammatory ocular conditions where bacterial infection or risk of bacterial infection exists

Contraindications

Hypersensitivity to bacitracin, neomycin, polymyxin B, hydrocortisone, or any component of the formulation; most viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia and varicella; mycobacterial ophthalmic infection; fungal diseases of ocular structures.

Dosing: Adult

Inflammatory ocular conditions: Ophthalmic: Apply to inside of lower lid of affected eye(s) every 3 or 4 hours (depending on severity of condition)

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Inflammatory ocular conditions: Limited data available: Children and Adolescents: Ophthalmic: Apply sparingly to inside of lower lid of affected eye(s) every 3 to 4 hours has been used by some centers; dosing based on experience with other combination ophthalmic products with similar ingredients

Administration

Ophthalmic: For topical ophthalmic use only; apply directly into conjunctival sac. To avoid contamination, do not touch tube tip to eyelids or other surfaces when placing ointment in eye(s).

Storage

Store at 15°C to 30°C (59°F to 86°F).

Drug Interactions

Nonsteroidal Anti-Inflammatory Agents (Ophthalmic): May enhance the adverse/toxic effect of Corticosteroids (Ophthalmic). Healing of ophthalmic tissue during concomitant administration of ophthalmic products may be delayed. Monitor therapy

Adverse Reactions

See individual agents.

Warnings/Precautions

Concerns related to adverse effects:

• Infection: Steroids may mask infection, enhance existing ocular infection, or reactivate latent disease (eg, herpes infection of cornea); prolonged use may result in secondary bacterial or fungal superinfection due to immunosuppression. Lack of prompt clinical response may indicate resistance to therapy and warrant discontinuation of therapy and further evaluation.

• Neomycin sensitization: Neomycin may cause cutaneous sensitization. Symptoms of neomycin sensitization include itching, reddening, edema, and failure to heal. Discontinuation of product and avoidance of similar products should be considered.

• Ocular effects: Avoid prolonged use of corticosteroids, which may result in ocular hypertension and/or glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation. Use with caution in glaucoma. Monitor intraocular pressure (routinely if duration of therapy is >10 days). Long-term use may cause corneal and scleral thinning; potentially resulting in perforation. Ophthalmic ointments may retard corneal wound healing.

Other warnings/precautions:

• Appropriate use: For topical use only. Do not inject subconjunctivally or introduce directly into anterior chamber of the eye. Use following ocular cataract surgery may delay healing and increase the incidence of filtering blebs. Inadvertent contamination of multiple-dose ophthalmic tube tip has caused bacterial keratitis. Use of topical corticosteroids to prevent scarring in the healing stages of herpes simplex infection should be done with extreme caution and close observation; may reactivate disease. A maximum of 8 g should be prescribed initially; reevaluate patients (eg, intraocular pressure and exams using magnification and fluorescein staining, where appropriate) prior to additional refills. Use >10 days should include routine monitoring of intraocular pressure.

Monitoring Parameters

If ophthalmic ointment is used >10 days or in patients with glaucoma, monitor intraocular pressure (IOP).

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events have been observed with topical corticosteroids in animal reproduction studies. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus (Samples, 1988). Refer to individual agents.

Patient Education

What is this drug used for?

• It is used to treat or prevent eye infections.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Vision changes

• Eye pain

• Severe eye irritation

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.