Adult Dosing
Inflammatory ocular conditions
- Instill 1-2 gtt in the affected eye(s) q3-4 hrs, depending on severity of the condition
Note:
- Gradually taper dose to discontinue
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Not for injection into the eye; this product should never be directly introduced into the anterior chamber of the eye
- Ocular hypertension and/or glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation may occur as a result of prolonged corticosteroid use
- Long-term use may suppress the host response and thus increase the risk of secondary ocular infections
- Various ocular diseases have been known to cause corneal and scleral thinning; use of topical corticosteroids in those diseases may lead to perforations
- Corticosteroids may mask or enhance existing infection in acute purulent conditions of the eye
- Routinely monitor intraocular pressure if in case therapy is used for 10 days or longer; use cautiously in the presence of glaucoma
- Use of corticosteroids after cataract surgery may delay healing and increase the incidence of filtering blebs
- Ocular corticosteroids may prolong the course and may exacerbate the severity of many viral infections of the eye such as herpes simplex
- Topical antibiotics, particularly neomycin, may cause cutaneous sensitization which may be manifested as itching, reddening, and edema of the conjunctiva and eyelid
- A sensitization reaction may manifest as a failure to heal. Perform periodic examination for such signs during long-term use of topical antibiotics and suspend therapy if such signs are observed
- Prior to initial prescription and renewal of the medication order beyond 20 mL, examine the patient carefully with the aid of magnification, such as slit lamp biomicroscopy and, where appropriate, fluorescein staining
- Re-evaluate the patient if signs and symptoms fail to improve after two days
- Consider the possibility of fungal infections of the cornea following long-term corticosteroid use; fungal cultures should be taken when appropriate
- Patients may develop bacterial keratitis with the use of contaminated topical ophthalmic products, most of whom had a concurrent corneal disease or a disruption of the ocular epithelial surface
- Allergic cross-sensitivity may occur which could prevent the use of antibiotics such as kanamycin, streptomycin, paromomycin, and gentamycin for the treatment of future infections
Cautions: Use cautiously in
- Herpes simplex infection
- Corneal or scleral thinning
Supplemental Patient Information
- Instruct patients to avoid touching the tip of the dispensing container to the eye, eyelid, or any other surface in order to prevent contamination of the product; serious damage to the eye and subsequent vision loss may result from using contaminated products
- Advise patients to stop use and consult a physician if the condition persists or gets worse, or if a rash or allergic reaction develops
- Keep tightly closed when not in use. Keep out of reach of children
Pregnancy Category:C
Breastfeeding: Safety unknown. Systemically absorbed hydrocortisone may have minimal excretion in breast milk. Ophthalmic neomycin is excreted in very low levels in breastmilk and presents negligible risk to the infant. Polymyxin B is poorly absorbed following topical application and is considered a low risk to the nursing infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 June 2011). Due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of the drug, analyzing the importance of the drug to the mother.
US Trade Name(s)
US Availability
hydrocortisone/neomycin/polymyxin B (generic)
- SUSP: [1%/3.5 mg/10,000 units]/mL
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]