polymyxin B/bacitracin ophthalmic (Rx)

Brand and Other Names:Ak-Poly-Bac, Polysporin Ophthalmic, more...Polycin
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Dosing & Uses

AdultPediatric

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

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Interactions

Interaction Checker

and polymyxin B/bacitracin ophthalmic

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            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 (14)

            • 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.

            • 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.

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            Adverse Effects

            <1%

            Allergic contact dermatitis

            Conjunctival erythema

            Swelling

            Itching

            Burning

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            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
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            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.

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            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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            Images

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            Patient Handout

            A Patient Handout is not currently available for this monograph.
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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.