Adult Dosing
Inflammatory ocular conditions
- Apply to the affected eye(s) q3-4 hrs, depending on the severity of the condition
Notes:- Taper dose gradually after prolonged use
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Product should never be directly introduced into the anterior chamber of the eye
- Therapy may retard corneal wound healing
- 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 long-term use of corticosteroids
- Long-term use may suppress the host response and thus increase the risk of secondary ocular infections during therapy
- Various ocular diseases and long-term use of topical corticosteroids have been known to cause corneal and scleral thinning. Use of topical corticosteroids in those diseases causing thinning of the corneal or scleral tissue may lead to perforations
- Corticosteroids may mask or enhance acute purulent infections of the eye
- Routinely monitor intraocular pressure if therapy is used for 10 days or longer
- 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 (including 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 8 grams, 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
- Bacterial keratitis, such as a concurrent corneal disease or a disruption of the ocular epithelial surface, may develop due to contamination of ointment
- Allergic cross-sensitivity to kanamycin, streptomycin, paromomycin, and gentamycin may occur
Cautions: Use cautiously in
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
Pregnancy Category:C
Breastfeeding: Safety unknown. Bacitracin is poorly absorbed after topical application; hence, poses a low risk to the nursing infant. 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 hence may have minimal excretion into breast milk. 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, taking into account the importance of the drug to the mother.
US Trade Name(s)
US Availability
bacitracin/hydrocortisone/neomycin/polymyxin B (generic)
- OINT: [400 U/10 mg/3.5 mg/10000 U]/g
Neo-Polycin HC (bacitracin/hydrocortisone/neomycin/polymyxin B)
Canadian Trade Name(s)
Canadian Availability
Sandoz Cortimyxin (bacitracin/hydrocortisone/neomycin/polymyxin B)
- OINT: [400 U/10 mg/3.5 mg/10000 U]/g
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]