Dosing & Uses
Dosage Forms & Strengths
hydrocortisone/neomycin/polymyxin otic
otic solution/suspension
- 10mg (1%)/3.5mg (0.35%)/10000units/10mL
Superficial Bacterial Infections of External Auditory Canal
4 drops in ear q6-8hr; not to exceed 10 days
Bacterial Infections of Mastoidectomy & Fenestration Cavities
4 drops in ear q6-8hr; not to exceed 10 days
Dosage Forms & Strengths
hydrocortisone/neomycin/polymyxin otic
solution
- 10mg (1%)/3.5mg (0.35%)/10000units/10mL
Superficial Bacterial Infections of External Auditory Canal
3 drops in ear q6-8hr; not to exceed 10 days
Bacterial Infections of Mastoidectomy & Fenestration Cavities
3 drops in ear q6-8hr; not to exceed 10 days
Adverse Effects
Frequency Not Defined
Hypersensitivity
Itching
Redness
Skin rash
Swelling
Warnings
Contraindications
Hypersensitivity to any agent
Cutaneous viral infection of the external auditory canal (solution only); patients with herpes simplex, vaccinia, and varicella infections
Cautions
Neomycin sensitization, including itching, reddening, edema, and failure to heal may occur; discontinue therapy if it occurs
Solution does not penetrate quite as well as suspension does
Systemic absorption of topical corticosteroids may cause hypothalamic-pituitary-adrenal axis suppression, which may lead to adrenal crisis, especially in children and in patients receiving large doses for prolonged periods
Prolonged use of corticosteroids may increase the incidence of secondary infection, mask acute infection, and may also prolong or exacerbate viral infections
Development of Kaposi sarcoma associated with prolonged treatment with corticosteroids; discontinue therapy if it occurs
Neomycin can induce permanent sensorineural hearing loss due to cochlear damage, including destruction of hair cells in the organ of Corti; risk of ototoxicity is greater with prolonged use
Percutaneous absorption of topical corticosteroids may occur, which may cause manifestations of hyperglycemia, Cushing syndrome, or glycosuria; use of occlusive dressings, application fo denuded skin, or application to large surface areas may increase risk of absorption
Pregnancy & Lactation
Pregnancy category: C
Lactation: Unknown whether drug is excreted in milk; use with caution
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
Hydrocortisone: Suppresses inflammatory response
Neomycin: Inhibits protein synthesis
Polymyxin: Bactericidal; active against gram-negative bacteria; disrupts bacterial cytoplasmic membrane structure and alters membrane permeability to allow leakage of intracellular contents
Absorption
Agent is absorbed if eardrum is perforated or tissue damage is present
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Formulary
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