Neomycin, Polymyxin B, and HydrocortisoneU.S. Brand Names: AntibiOtic�(r) Ear; Cortisporin�(r) Cream; Cortisporin�(r) Ophthalmic; Cortisporin�(r) Otic; PediOtic�(r)
Synonyms: Hydrocortisone, Neomycin, and Polymyxin B; Polymyxin B, Neomycin, and Hydrocortisone
Generic Available: Yes
Canadian Brand Names: Cortimyxin�(r); Cortisporin�(r) Otic
Use: Steroid-responsive inflammatory condition for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial infection exists
Pregnancy Risk Factor: C
Contraindications: Hypersensitivity to neomycin, polymyxin B, hydrocortisone, or any component of the formulation
Adverse Reactions: Frequency not defined. Dermatologic: Contact dermatitis, erythema, rash, urticaria Local: Burning, itching, swelling, pain, stinging Ocular: Intraocular pressure increased, glaucoma, cataracts, conjunctival erythema, transient irritation, burning, stinging, itching, inflammation, angioneurotic edema, urticaria, vesicular and maculopapular dermatitis Otic: Ototoxicity Miscellaneous: Hypersensitivity, sensitization to neomycin, secondary infection
Drug Interactions: Hydrocortisone: Substrate of CYP3A4 (minor); Induces CYP3A4 (weak) Also see individual agents.
Mechanism of Action: See individual agents.
Pharmacodynamics/Kinetics: See individual agents.
Dosage: Duration of use should be limited to 10 days unless otherwise directed by the physician Otic solution is used only for swimmer's ear (infections of external auditory canal) Otic: Children: Instill 3 drops into affected ear 3-4 times/day Adults: Instill 4 drops 3-4 times/day; otic suspension is the preferred otic preparation Children and Adults: Ophthalmic: Drops: Instill 1-2 drops 2-4 times/day, or more frequently as required for severe infections; in acute infections, instill 1-2 drops every 15-30 minutes gradually reducing the frequency of administration as the infection is controlled Topical: Apply a thin layer 1-4 times/day. Therapy should be discontinued when control is achieved; if no improvement is seen, reassessment of diagnosis may be necessary.
Administration: Shake suspension well before using. Otic solution should not be used when the integrity of the tympanic membrane is in question.
Patient Education: Otic: Hold container in hand to warm; if drops are in suspension form, shake well for approximately 10 seconds, lie on your side with affected ear up; for adults hold the ear lobe up and back, for children hold the ear lobe down and back; instill drops in ear without inserting dropper into ear; maintain tilted ear for 2 minutes Ophthalmic: May cause sensitivity to bright light; may cause temporary blurring of vision or stinging following administration, but discontinue product and see prescriber if problems persist or increase; to use, tilt head back and place medication in conjunctival sac and close eyes; apply light pressure on lacrimal sac for 1 minute Cream: Discontinue product if irritation persists or increases
Nursing Implications: Otic suspension is the preferred otic preparation; otic suspension can be used for the treatment of infections of mastoidectomy and fenestration cavities caused by susceptible organisms; otic solution is used only for superficial infections of the external auditory canal (ie, swimmer's ear)
Dental Health: Effects on Dental Treatment: No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions: No information available to require special precautions
Mental Health: Effects on Mental Status: None reported
Mental Health: Effects on Psychiatric Treatment: None reported
Dosage Forms: Cream, topical (Cortisporin�(r)): Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 5 mg per g (7.5 g) Solution, otic (AntibiOtic�(r) Ear; Cortisporin�(r)): Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per mL (10 mL) [contains potassium metabisulfite] Suspension, ophthalmic (Cortisporin�(r)): Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per mL (7.5 mL) [contains thimerosal] Suspension, otic: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per mL (10 mL) AntibiOtic�(r) Ear, Cortisporin�(r): Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per mL (10 mL) [contains thimerosal] PediOtic�(r): Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per mL (7.5 mL) [contains thimerosal]
International Brand Names: Cortimyxin�(r) (CA); Cortisporin�(r) Otic (CA)
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