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Neomycin and Fluocinolone

Medically reviewed by Last updated on Sep 5, 2020.


(nee oh MYE sin & floo oh SIN oh lone)

Dosage Forms

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

Cream, External:

Neo-Synalar: Neomycin sulfate 0.5% and fluocinolone acetonide 0.025% (60 g) [contains cetyl alcohol, disodium edta, methylparaben, propylene glycol, propylparaben]

Kit, External:

Neo-Synalar: Neomycin sulfate 0.35% and fluocinolone acetonide 0.025% [contains cetyl alcohol, edetate disodium, methylparaben, propylene glycol, propylparaben, trolamine (triethanolamine)]

Brand Names: U.S.

  • Neo-Synalar

Pharmacologic Category

  • Antibiotic, Topical
  • Corticosteroid, Topical


Neomycin interferes with bacterial protein synthesis by binding to 30S ribosomal subunits.

Topical corticosteroids have anti-inflammatory, antipruritic, and vasoconstrictive properties. May depress the formation, release, and activity of endogenous chemical mediators of inflammation (kinins, histamine, liposomal enzymes, prostaglandins) through the induction of phospholipase A2 inhibitory proteins (lipocortins) and sequential inhibition of the release of arachidonic acid. Fluocinolone has low to intermediate range potency (dosage-form dependent).

Use: Labeled Indications

Corticosteroid-responsive dermatoses with secondary infection: Treatment of corticosteroid-responsive dermatoses with secondary infection. Use of this combination has not shown greater benefit than the steroid component alone after 7 days of treatment.


Hypersensitivity to fluocinolone, neomycin, or any component of the formulation; use in external auditory canal if eardrum is perforated

Documentation of allergenic cross-reactivity for corticosteroids is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Dosing: Adult

Note: Dosage should be based on severity of disease and patient response; use smallest amount for shortest period of time. Therapy should be discontinued when control is achieved.

Corticosteroid-responsive dermatoses: Topical: Apply a thin film to affected area 2 to 4 times daily depending on severity of condition.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Note: Dosage should be based on severity of disease and patient response; use smallest amount for shortest period of time. Therapy should be discontinued when control is achieved.

Corticosteroid-responsive dermatoses: Topical: Children and Adolescents: Refer to adult dosing.


Topical: For external use only; not for oral use. Unless otherwise directed by health care professional, do not use with occlusive dressing.


Store between 15°C and 25°C (59°F and 77°F); avoid freezing and excessive heat above 40°C (104°F).

Drug Interactions

Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Avoid combination

Adverse Reactions

See individual agents.


Concerns related to adverse effects:

• Adrenal suppression: May cause hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis.

• Local effects: Local adverse reactions may occur (eg, skin atrophy, striae, telangiectasias, burning, itching, irritation, dryness, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection miliaria); may be irreversible. Local adverse reactions are more likely to occur with occlusive and/or prolonged use. If irritation develops, discontinue use and institute appropriate therapy.

• Ototoxicity: Neomycin may increase the risk of ototoxicity with extended use. Do not use in any patient with a perforated tympanic membrane.

• Systemic effects: Topical corticosteroids may be absorbed percutaneously. Absorption of topical corticosteroids may cause manifestations of Cushing syndrome, hyperglycemia, or glycosuria. Absorption is increased by the use of occlusive dressings, application to denuded skin, or application to large surface areas.

Special populations:

• Pediatric: Children may absorb proportionally larger amounts after topical application and may be more prone to systemic effects. HPA axis suppression, intracranial hypertension, and Cushing syndrome have been reported in children receiving topical corticosteroids. Prolonged use may affect growth velocity; growth should be routinely monitored in pediatric patients.

Other warnings/precautions:

• Appropriate use: Not for oral use. Unless otherwise directed by healthcare professional, do not use with occlusive dressing; do not use on children's skin covered by diapers or plastic pants.

Monitoring Parameters

Growth in pediatric patients; HPA axis suppression (eg, ACTH stimulation test, morning plasma cortisol test, urinary free cortisol test); signs of bacterial or fungal infection

Pregnancy Risk Factor


Pregnancy Considerations

Adverse events have been observed with corticosteroids in animal reproduction studies.

Patient Education

What is this drug used for?

• It is used to treat certain skin problems when a skin infection is present.

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:

• 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.

More about fluocinolone / neomycin topical

Consumer resources

Professional resources

Other brands: Neo-Synalar

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