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Neomycin, Polymyxin B, and Hydrocortisone (Topical)

Medically reviewed by Drugs.com. Last updated on July 5, 2020.

Pronunciation

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

Index Terms

  • Hydrocortisone, Neomycin, and Polymyxin B
  • Neomycin/Polymyxin B Sulf/Hc
  • Polymyxin B, Neomycin, and Hydrocortisone

Dosage Forms

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

Cream, External:

Cortisporin: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 0.5% per g (7.5 g) [contains methylparaben, propylene glycol]

Brand Names: U.S.

  • Cortisporin

Pharmacologic Category

  • Antibiotic, Topical
  • Antibiotic/Corticosteroid, Topical
  • Corticosteroid, Topical

Pharmacology

See individual agents.

Use: Labeled Indications

Corticosteroid-responsive dermatoses with secondary infection: Treatment of corticosteroid-responsive dermatoses with secondary infection.

Contraindications

Hypersensitivity to neomycin, polymyxin B, hydrocortisone, or any component of the formulation; tuberculous, fungal, or viral lesions of the skin (herpes simplex, vaccinia, and varicella); application to external ear canal if eardrum is perforated; ophthalmic administration

Dosing: Adult

Corticosteroid-responsive dermatoses with secondary infection: Topical: Apply a thin layer 2 to 4 times daily. Therapy should be discontinued when control is achieved; if no improvement is seen, reassessment of diagnosis may be necessary

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Dermatologic inflammation/infection: Limited data available: Infants, Children, and Adolescents: Topical: Apply a thin layer to affected areas 2 to 4 times daily for up to 7 days (Bradley 2015). Therapy should be discontinued when control is achieved or after 7 days.

Administration

Topical: For external use only. Rub gently into affected area, as condition permits

Storage

Store at 15°C to 25°C (59°F to 77°F).

Drug Interactions

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

Calcipotriene: Hydrocortisone (Topical) may diminish the therapeutic effect of Calcipotriene. Management: Monitor for reduced calcipotriene efficacy if combined with hydrocortisone valerate. Consider separating the administration of these agents by 10 to 12 hours to minimize the risk of this potential interaction. Monitor therapy

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

For additional information, see hydrocortisone (topical).

Warnings/Precautions

Concerns related to adverse effects:

• Adrenal suppression: Systemic absorption of topical corticosteroids 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.

• Immunosuppression: Prolonged use of corticosteroids may also increase the incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines.

• Kaposi sarcoma: Prolonged treatment with corticosteroids has been associated with the development of Kaposi sarcoma (case reports); if noted, discontinuation of therapy should be considered (Goedert 2002).

• 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.

• Systemic effects: Topical corticosteroids may be absorbed percutaneously. Absorption of topical corticosteroids may cause manifestations of Cushing's 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:

• Elderly: Because of the risk of adverse effects associated with systemic absorption, topical corticosteroids should be used cautiously in the elderly in the smallest possible effective dose for the shortest duration.

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

Dosage form specific issues:

• Sulfites: Some formulations may contain sulfites, which may cause allergic-type reactions in susceptible individuals.

Pregnancy Risk Factor

C

Pregnancy Considerations

Animal reproduction studies have not been conducted with this combination. See individual agents.

Patient Education

What is this drug used for?

• It is used to treat skin irritation.

• It is used to treat skin 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:

• Adrenal gland problems like severe nausea, vomiting, severe dizziness, passing out, muscle weakness, severe fatigue, mood changes, lack of appetite, or weight loss.

• High blood sugar like confusion, fatigue, increased thirst, increased hunger, passing a lot of urine, flushing, fast breathing, or breath that smells like fruit.

• Skin changes like acne, stretch marks, slow healing, or hair growth.

• Unable to pass urine

• Change in amount of urine passed

• Change in hearing

• Severe skin 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.

More about hydrocortisone / neomycin / polymyxin b topical

Consumer resources

Professional resources

Other brands: Cortisporin Cream

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