Dosing & Uses
Dosage Forms & Strengths
polymyxin B / bacitracin ophthalmic
ointment
- (polymyxin B 10,000units/bacitracin 500units)/g
Ophthalmic Infection
Often used in blepharitis, conjunctivitis, and post-operative prophylaxis
Apply thin 1/2 thin ribbon of ointment to conjunctival sac q3-4hr for 7-10 days
Dosage Forms & Strengths
polymyxin B / bacitracin ophthalmic
ointment
- (polymyxin B 10,000units/bacitracin 500units)/g
Ophthalmic Infection
Often used in blepharitis, conjunctivitis, and post-operative prophylaxis
Apply thin 1/2 thin ribbon of ointment to conjunctival sac q3-4hr for 7-10 days
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- allogeneic cultured keratinocytes/fibroblasts in bovine collagen
polymyxin B decreases effects of allogeneic cultured keratinocytes/fibroblasts in bovine collagen by Other (see comment). Contraindicated. Comment: Exposure to topical antibiotics has been antibiotics shown to degrade Gintuit; if exposed, irrigate the wound thoroughly with saline and allow a suitable wash-out period to elapse before applying Gintuit.
Serious - Use Alternative (15)
- amphotericin B deoxycholate
amphotericin B deoxycholate and polymyxin B both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- atracurium
polymyxin B increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- bacitracin
polymyxin B and bacitracin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Avoid concurrent use of bacitracin with other nephrotoxic drugs
- cholera vaccine
polymyxin B, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.
- cidofovir
cidofovir and polymyxin B both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- cisatracurium
polymyxin B increases effects of cisatracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- incobotulinumtoxinA
polymyxin B increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- microbiota oral
polymyxin B decreases effects of microbiota oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Microbiota oral contains bacterial spores. Antibacterial agents may decrease efficacy if coadministered. Complete antibiotic regimens 2-4 days before initiating microbiota oral. .
- neomycin PO
neomycin PO and polymyxin B both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- onabotulinumtoxinA
polymyxin B increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- pancuronium
polymyxin B increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- rapacuronium
polymyxin B increases effects of rapacuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- rocuronium
polymyxin B increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- succinylcholine
polymyxin B increases effects of succinylcholine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- vecuronium
polymyxin B increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
Monitor Closely (19)
- acyclovir
acyclovir and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- amikacin
amikacin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- capreomycin
capreomycin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- carboplatin
carboplatin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- cephaloridine
cephaloridine and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- cisplatin
cisplatin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- colistin
colistin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- contrast media (iodinated)
contrast media (iodinated) and polymyxin B both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- cyclosporine
cyclosporine and polymyxin B both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
polymyxin B and elvitegravir/cobicistat/emtricitabine/tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- gentamicin
gentamicin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- ioversol
ioversol and polymyxin B both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- oxaliplatin
oxaliplatin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
polymyxin B decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.
- streptozocin
polymyxin B and streptozocin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- tacrolimus
polymyxin B and tacrolimus both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- teicoplanin
polymyxin B and teicoplanin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- tobramycin
polymyxin B and tobramycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- voclosporin
voclosporin, polymyxin B. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
Minor (9)
- adefovir
adefovir and polymyxin B both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- entecavir
polymyxin B, entecavir. Either increases effects of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.
- foscarnet
foscarnet and polymyxin B both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- methoxyflurane
methoxyflurane and polymyxin B both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- paromomycin
paromomycin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- pentamidine
pentamidine and polymyxin B both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- streptomycin
polymyxin B and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- vancomycin
polymyxin B and vancomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- verteporfin
polymyxin B increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
Adverse Effects
<1%
Allergic contact dermatitis
Conjunctival erythema
Swelling
Itching
Burning
Warnings
Contraindications
Minor ocular irritation; hypersensitivity to polymixin or product components
Cautions
Ointment may blur vision
Not for injection into the eye
Never to be directly introduced into anterior chamber of the eye; ophthalmic ointments may retard corneal wound healing
Allergic cross-reactions may occur which could prevent the use of any or all of the antibiotics for treatment of future infections, including kanamycin, paromomycin, streptomycin, and possibly gentamicin
Infections
- As with other antibiotic preparations, prolonged use may result in overgrowth of nonsusceptible organisms including fungi; if superinfection occurs, appropriate measures should be initiated
- Bacterial resistance may develop; if purulent discharge, inflammation, or pain become aggravated, the patient should discontinue use of the medication and consult a physician
- There have been reports of bacterial keratitis associated with use of topical ophthalmic products in multiple-dose containers which have been inadvertently contaminated by patients, most of whom has a concurrent corneal disease or a disruption of the ocular epithelial surface
- Patients should be instructed to avoid allowing tip of dispensing container to contact eye, eyelid, fingers, or any other surface; use of this product by more than one person may spread infection; serious damage to the eye and subsequent loss of vision may result from using contaminated products
Sensitization
- Topical antibiotics may cause cutaneous sensitization; precise incidence of hypersensitivity reactions (primarily skin rash) due to topical antibiotics not known; manifestations of sensitization to topical antibiotics are usually itching, reddening, and edema of the conjunctiva and eyelid
- A sensitization reaction may manifest simply, as a failure to heal; during long-term use of topical antibiotic products, periodic examination for such signs is advisable, and the patient should be told to discontinue the product if they are observed
- Symptoms usually subside quickly on withdrawing the medication; application of products containing these ingredients should be avoided for the patient
Pregnancy & Lactation
Pregnancy
Not known whether therapy can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity; the drug should be given to a pregnant woman only if clearly needed
Animal reproduction studies not conducted
Lactation
Not known whether drug is excreted in human milk; because many drugs are excreted in human milk, caution should be exercised when the drug is administered to a nursing woman
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Inhibits bacterial cell wall synthesis by preventing the incorporation of amino acids and nucleotides into the cell wall
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Formulary
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