neomycin/polymyxin B/bacitracin topical (OTC)

Brand and Other Names:Neosporin Original Ointment, Triple Antibiotic Ointment
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

neomycin/polymyxin B/bacitracin topical

topical cream/ointment

  • (3.5mg/5,000units/400units)/1gram

Treatment/Prophylaxis Superficial Skin Infection

Apply topically qDay-TID

Also known as triple antibiotic cream/ointment

Dosage Forms & Strengths

neomycin/polymyxin B/bacitracin topical

topical cream/ointment

  • (3.5mg/5,000units/400units)/1gram

Treatment/Prophylaxis Superficial Skin Infection

Apply topically qDay-TID

Also known as triple antibiotic cream/ointment

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Interactions

Interaction Checker

and neomycin/polymyxin B/bacitracin topical

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.

              bacitracin topical 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.

              neomycin decreases effects of allogeneic cultured keratinocytes/fibroblasts in bovine collagen by Other (see comment). Contraindicated. Comment: Exposure to topical antibiotics has been 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 (18)

            • 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.

            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

            >10%

            Allergic contact dermatitis (60%)

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            Warnings

            Contraindications

            Hypersensitivity

            Use in eyes or over large areas of body

            Cautions

            Prolonged use may result in overgrowth of nonsusceptible organisms including fungi; if superinfection occurs, appropriate measures should be initiated

            Bacterial resistance to may develop; if purulent discharge, inflammation, or pain becomes aggravated, patient should discontinue use and consult a physician

            Allergic cross-reactions may occur which could prevent use of any or all of the following antibiotics for treatment of future infections: kanamycin, paromomycin, streptomycin, and possibly gentamicin

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            Pregnancy & Lactation

            Pregnancy

            Animal reproduction studies have not been conducted with neomycin sulfate, polymyxin B sulfate, or bacitracin; not known whether therapy can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity; treatment should be given to a pregnant woman only if clearly needed

            Lactation

            Not known whether drug is excreted in human milk; because many drugs are excreted in human milk, exercise caution when 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

            Neomycin: Antibiotic; inhibits production of protine in bacteria resulting in cell death

            Polymyxin: Antibiotic; increases permeability of bacterial cell wall membranes resulting in cell lysis

            Bacitracin: Antibiotic; bactericidal or bacteriostatic depending on concetnraiton; inhibits bacterial cell wall synthesis

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            Patient Handout

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