Inflammatory ocular conditions: Ophthalmic: Apply to inside of lower lid of affected eye(s) every 3 or 4 hours (depending on severity of condition)
There are no dosage adjustments provided in the manufacturer's labeling. Dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling. Dosage adjustment unlikely due to low systemic absorption.
Refer to adult dosing.
(For additional information see "Bacitracin, neomycin, polymyxin B, and hydrocortisone (ophthalmic): Pediatric drug information")
Inflammatory ocular conditions: Limited data available: Children and Adolescents: Ophthalmic: Apply sparingly to inside of lower lid of affected eye(s) every 3 to 4 hours has been used by some centers; dosing based on experience with other combination ophthalmic products with similar ingredients
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely due to low systemic absorption.
See individual agents.
Hypersensitivity to bacitracin, neomycin, polymyxin B, hydrocortisone, or any component of the formulation; most viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia and varicella; mycobacterial ophthalmic infection; fungal diseases of ocular structures.
Concerns related to adverse effects:
• Infection: Steroids may mask infection, enhance existing ocular infection, or reactivate latent disease (eg, herpes infection of cornea); prolonged use may result in secondary bacterial or fungal superinfection due to immunosuppression. Lack of prompt clinical response may indicate resistance to therapy and warrant discontinuation of therapy and further evaluation.
• Neomycin sensitization: Neomycin may cause cutaneous sensitization. Symptoms of neomycin sensitization include itching, reddening, edema, and failure to heal. Discontinuation of product and avoidance of similar products should be considered.
• Ocular effects: Avoid prolonged use of corticosteroids, which may result in ocular hypertension and/or glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation. Use with caution in glaucoma. Monitor intraocular pressure (routinely if duration of therapy is >10 days). Long-term use may cause corneal and scleral thinning; potentially resulting in perforation. Ophthalmic ointments may retard corneal wound healing.
Other warnings/precautions:
• Appropriate use: For topical use only. Do not inject subconjunctivally or introduce directly into anterior chamber of the eye. Use following ocular cataract surgery may delay healing and increase the incidence of filtering blebs. Inadvertent contamination of multiple-dose ophthalmic tube tip has caused bacterial keratitis. Use of topical corticosteroids to prevent scarring in the healing stages of herpes simplex infection should be done with extreme caution and close observation; may reactivate disease. A maximum of 8 g should be prescribed initially; reevaluate patients (eg, intraocular pressure and exams using magnification and fluorescein staining, where appropriate) prior to additional refills. Use >10 days should include routine monitoring of intraocular pressure.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, Ophthalmic:
Neo-Polycin HC: Bacitracin 400 units, neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per g (3.5 g)
Generic: Bacitracin 400 units, neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone 10 mg per g (3.5 g)
Yes
Ointment (Neo-Polycin HC Ophthalmic)
1% (per gram): $17.14
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Ophthalmic: For topical ophthalmic use only; apply directly into conjunctival sac. To avoid contamination, do not touch tube tip to eyelids or other surfaces when placing ointment in eye(s).
Ophthalmic: Do not use topical ointment in the eyes; wash hands before use; avoid contact of tube tip with skin or eye
Inflammatory ocular conditions: Corticosteroid-responsive inflammatory ocular conditions where bacterial infection or risk of bacterial infection exists
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Nonsteroidal Anti-Inflammatory Agents (Ophthalmic): May enhance the adverse/toxic effect of Corticosteroids (Ophthalmic). Healing of ophthalmic tissue during concomitant administration of ophthalmic products may be delayed. Risk C: Monitor therapy
Adverse events have been observed with topical corticosteroids in animal reproduction studies. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus (Samples, 1988). Refer to individual agents.
It is not known if systemic absorption following topical administration results in detectable quantities in human milk. The manufacturers recommend a decision be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of treatment to the mother. Refer to individual agents.
If ophthalmic ointment is used >10 days or in patients with glaucoma, monitor intraocular pressure (IOP).
See individual agents.
See individual agents.
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