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Neomycin sulfate, Polymyxin B Sulfate and Dexamethasone
Overview
What is Neomycin Polymyxin B Sulfates and Dexamethasone?
Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension, USP is a multiple dose anti-infective steroid combination in a sterile suspension for topical application. The active ingredient, Dexamethasone, is represented by the following structural formula:
C
H
FO
Mol. Wt. 392.47
Chemical Name: Pregna-1,4-diene-3,20-dione, 9-fluoro-11,17,21-trihydroxy-16-methyl-, (11β,16α)-.
Neomycin Sulfate is the sulfate salt of neomycin B and C which are produced by the growth of
Waksman (Fam. Streptomycetaceae). It has a potency equivalent to not less than 600 micrograms of neomycin base per milligram, calculated on an anhydrous basis. The structural formula is:
Polymyxin B Sulfate is the sulfate salt of polymyxin B
and B
which are produced by the growth of
(Prazmowski) Migula (Fam. Bacillaceae). It has a potency of not less than 6,000 polymyxin B units per milligram, calculated on an anhydrous basis. The structural formula is:
Each mL contains:
What does Neomycin Polymyxin B Sulfates and Dexamethasone look like?
What are the available doses of Neomycin Polymyxin B Sulfates and Dexamethasone?
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What should I talk to my health care provider before I take Neomycin Polymyxin B Sulfates and Dexamethasone?
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How should I use Neomycin Polymyxin B Sulfates and Dexamethasone?
For steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial ocular infection exists.
Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroids use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation. They are also indicated in chronic anterior uveitis and corneal injury from chemical, radiation or thermal burns; or penetration of foreign bodies.
The use of a combination drug with an anti-infective component is indicated where the risk of infection is high or where there is an expectation that potentially dangerous numbers of bacteria will be present in the eye.
The particular anti-infective drug in this product is active against the following common bacterial eye pathogens:
,
species,
species, and
This product does not provide adequate coverage against:
and streptococci, including
One or two drops in the conjunctival sac(s). In severe disease, drops may be used hourly, being tapered to discontinuation as the inflammation subsides. In mild disease, drops may be used up to four to six times daily.
Not more than 20 mL should be prescribed initially and the prescription should not be refilled without further evaluation as outlined in
above.
FOR TOPICAL OPHTHALMIC USE ONLY.
SHAKE WELL BEFORE USING.
What interacts with Neomycin Polymyxin B Sulfates and Dexamethasone?
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What are the warnings of Neomycin Polymyxin B Sulfates and Dexamethasone?
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What are the precautions of Neomycin Polymyxin B Sulfates and Dexamethasone?
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What are the side effects of Neomycin Polymyxin B Sulfates and Dexamethasone?
Adverse reactions have occurred with corticosteroid/anti-infective combination drugs which can be attributed to the corticosteroid component, the anti-infective component, or the combination. Exact incidence figures are not available since no denominator of treated patients is available.
Reactions occurring most often from the presence of the anti-infective ingredient are allergic sensitizations. The reactions due to the corticosteroid component are: elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage; posterior subcapsular cataract formation; and delayed wound healing.
Corticosteroid-containing preparations have also been reported to cause perforation of the globe. Keratitis, conjunctivitis, corneal ulcers, and conjunctival hyperemia have occasionally been reported following local use of steroids.
To report SUSPECTED ADVERSE REACTIONS, contact Bausch + Lomb, a division of Valeant Pharmaceuticals North America LLC, at 1-800-321-4576 or FDA at 1-800-FDA-1088 or
.
What should I look out for while using Neomycin Polymyxin B Sulfates and Dexamethasone?
Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension is contraindicated in most viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, and also in mycobacterial infection of the eye and fungal diseases of ocular structures. Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension is also contraindicated in individuals with known or suspected hypersensitivity to any of the ingredients of this preparation and to other corticosteroids.
Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision, and in posterior subcapsular cataract formation. Prolonged use may also suppress the host immune response and thus increase the hazard of secondary ocular infections.
Various ocular diseases and long-term use of topical corticosteroids have been known to cause corneal and scleral thinning. Use of topical corticosteroids in the presence of thin corneal or scleral tissue may lead to perforation.
Acute purulent infections of the eye may be masked or activity enhanced by the presence of corticosteroid medication.
If this product is used for 10 days or longer, intraocular pressure should be routinely monitored even though it may be difficult in children and uncooperative patients. Steroids should be used with caution in the presence of glaucoma. Intraocular pressure should be checked frequently.
The use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation.
Use of ocular steroids may prolong the course and may exacerbate the severity of many viral infections of the eye (including herpes simplex). Employment of a corticosteroid medication in the treatment of patients with a history of herpes simplex requires great caution; frequent slit lamp microscopy is recommended.
Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension is not for injection. It should never be injected subconjunctivally, nor should it be directly introduced into the anterior chamber of the eye.
Products containing neomycin sulfate may cause cutaneous sensitization.
What might happen if I take too much Neomycin Polymyxin B Sulfates and Dexamethasone?
Sorry No Records found
How should I store and handle Neomycin Polymyxin B Sulfates and Dexamethasone?
Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Storage:Sandimmune is a registered trademark of Novartis Pharmaceuticals Corporation. ATGAM is a registered trademark of Pharmacia and Upjohn Company. Neoral is a registered trademark of Novartis Pharmaceuticals Corporation. Orthoclone OKT is a registered trademark of Ortho Biotech Inc. Maalox is a registered trademark of Novartis Consumer Health, Inc. NOVAPLUS is a registered trademark of Vizient, Inc. NMM00N Rev. 01/18 Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension, USP is supplied in a controlled drop tip bottle with a white cap in the following size:NDC 68071-4375-5 BOX OF 5mLDO NOT USE IF IMPRINTED NECKBAND IS NOT INTACT.Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension, USP is supplied in a controlled drop tip bottle with a white cap in the following size:NDC 68071-4375-5 BOX OF 5mLDO NOT USE IF IMPRINTED NECKBAND IS NOT INTACT.Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension, USP is supplied in a controlled drop tip bottle with a white cap in the following size:NDC 68071-4375-5 BOX OF 5mLDO NOT USE IF IMPRINTED NECKBAND IS NOT INTACT.
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
Corticosteroids suppress the inflammatory response to a variety of agents and they probably delay or slow healing. Since corticosteroids may inhibit the body’s defense mechanism against infection, a concomitant antimicrobial drug may be used when this inhibition is considered to be clinically significant in a particular case.
When a decision to administer both a corticosteroid and an antimicrobial is made, the administration of such drugs in combination has the advantage of greater patient compliance and convenience, with the added assurance that the appropriate dosage of both drugs is administered, plus assured compatibility of ingredients when both types of drugs are in the same formulation and, particularly, that the correct volume of drug is delivered and retained.
The relative potency of corticosteroids depends on the molecular structure, concentration and release from the vehicle.
Non-Clinical Toxicology
Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension is contraindicated in most viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, and also in mycobacterial infection of the eye and fungal diseases of ocular structures. Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension is also contraindicated in individuals with known or suspected hypersensitivity to any of the ingredients of this preparation and to other corticosteroids.Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision, and in posterior subcapsular cataract formation. Prolonged use may also suppress the host immune response and thus increase the hazard of secondary ocular infections.
Various ocular diseases and long-term use of topical corticosteroids have been known to cause corneal and scleral thinning. Use of topical corticosteroids in the presence of thin corneal or scleral tissue may lead to perforation.
Acute purulent infections of the eye may be masked or activity enhanced by the presence of corticosteroid medication.
If this product is used for 10 days or longer, intraocular pressure should be routinely monitored even though it may be difficult in children and uncooperative patients. Steroids should be used with caution in the presence of glaucoma. Intraocular pressure should be checked frequently.
The use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation.
Use of ocular steroids may prolong the course and may exacerbate the severity of many viral infections of the eye (including herpes simplex). Employment of a corticosteroid medication in the treatment of patients with a history of herpes simplex requires great caution; frequent slit lamp microscopy is recommended.
Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension is not for injection. It should never be injected subconjunctivally, nor should it be directly introduced into the anterior chamber of the eye.
Products containing neomycin sulfate may cause cutaneous sensitization.
The initial prescription and renewal of the medication order beyond 20 mL of Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Suspension should be made by a physician only after examination of the patient with the aid of magnification, such as slit lamp biomicroscopy and, where appropriate, fluorescein staining. If signs and symptoms fail to improve after two days, the patient should be re-evaluated.
As fungal infections of the cornea are particularly prone to develop coincidentally with long-term local corticosteroid applications, fungal invasion should be suspected in any persistent corneal ulceration where a corticosteroid has been used or is in use. Fungal cultures should be taken when appropriate.
If this product is used for 10 days or longer, intraocular pressure should be monitored (see ).
Prolonged use of topical antibacterial agents may give rise to overgrowth of nonsusceptible organisms including fungi.
Adverse reactions have occurred with corticosteroid/anti-infective combination drugs which can be attributed to the corticosteroid component, the anti-infective component, or the combination. Exact incidence figures are not available since no denominator of treated patients is available.
Reactions occurring most often from the presence of the anti-infective ingredient are allergic sensitizations. The reactions due to the corticosteroid component are: elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage; posterior subcapsular cataract formation; and delayed wound healing.
Corticosteroid-containing preparations have also been reported to cause perforation of the globe. Keratitis, conjunctivitis, corneal ulcers, and conjunctival hyperemia have occasionally been reported following local use of steroids.
To report SUSPECTED ADVERSE REACTIONS, contact Bausch + Lomb, a division of Valeant Pharmaceuticals North America LLC, at 1-800-321-4576 or FDA at 1-800-FDA-1088 or .
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
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