Dexamethasone/neomycin/polymyxin

Dexamethasone/neomycin/polymyxin is a prescription medication used to treat the symptoms of Inflammatory Ocular Conditions/Infections.

• Dexamethasone/neomycin/polymyxin is available under various brand names: Maxitrol, Dexasporin

Common side effects of Dexamethasone/neomycin/polymyxin include:

• stinging/burning of the eyes for 1 to 2 minutes when Maxitrol is applied,
• irritation,
• itching,
• redness,
• blurred vision,
• eyelid itching,
• eyelid swelling, or
• sensitivity to light.

Serious side effects of Dexamethasone/neomycin/polymyxin include:

• blurred vision,
• tunnel vision,
• eye pain,
• seeing halos around lights,
• swelling, redness, severe discomfort, crusting, or drainage (may be signs of infection),
• pain behind the eyes,
• sudden vision changes, and
• a wound that will not heal

Rare side effects of Dexamethasone/neomycin/polymyxin include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Ophthalmic ointment

• (0.1%/3.5mg/10,000units)/g (3.5 g)
• Ophthalmic suspension
• (0.1%/3.5mg/10,000 units)/ mL (5 mL)

Inflammatory Ocular Conditions/Infections

Adult and pediatric dosage

• Ophthalmic suspension: Instill 1-2 drops to the affected eye(s) every 4 to 6 hours; may use hourly in severe disease followed by a taper for discontinuation
• Ophthalmic ointment: Apply ribbon (~0.5-in) to the affected eye(s) in the conjunctival sac every 4 to 6 hours or as an adjunct to suspension

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Dexamethasone/neomycin/polymyxin has severe interactions with the following drugs:
  • allogeneic cultured keratinocytes/fibroblasts in bovine collagen
  • apixaban
• Dexamethasone/neomycin/polymyxin has serious interactions with at least 131 other drugs.
• Dexamethasone/neomycin/polymyxin has moderate interactions with at least 316 other drugs.
• Dexamethasone/neomycin/polymyxin has minor interactions with at least 125 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity
• Viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella
• Mycobacterial infection of the eye and fungal diseases of ocular structures

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Dexamethasone/neomycin/polymyxin?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Dexamethasone/neomycin/polymyxin?”

Cautions

• Monitor intraocular pressure if used for more than 10 days
• Prolonged use of topical anti-bacterial agents may give rise to the overgrowth of nonsusceptible organisms including fungi
• Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation
• Prolonged use may also suppress the host immune response and thus increase the hazard of secondary ocular infections
• Various ocular diseases and long-term use of topical corticosteroids have been known to cause corneal and scleral thinning, possibly leading to perforation
• Acute purulent infections of the eye may be masked or activity enhanced by the presence of corticosteroid medication
• Products containing neomycin sulfate may cause cutaneous sensitization; sensitivity to topically administered aminoglycosides, such as neomycin, may occur in some patients; severity of hypersensitivity reactions may vary from local effects to generalized reactions such as erythema, itching, urticaria, skin rash, anaphylaxis, anaphylactoid reactions, or bullous reactions; discontinue if hypersensitivity occurs
• Acute purulent or parasitic infections of the eye may be masked or activity enhanced by the presence of corticosteroid medication

Pregnancy & Lactation

• Dexamethasone showed to be teratogenic in mice and rabbits following topical ophthalmic application in multiples of therapeutic dose
• In mice, corticosteroids produce fetal resorptions and a specific abnormality, cleft palate; in the rabbit, corticosteroids have produced fetal resorptions and multiple abnormalities involving the head, ears, limbs, palate, etc
• There are no adequate or well-controlled studies in pregnant women; however, prolonged or repeated corticoid use during pregnancy associated with increased risk of intra-uterine growth retardation; neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension should be used during pregnancy only if the potential benefit to mother justifies the potential risk to embryo or fetus; infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be observed for signs of hypoadrenalism

Lactation

• Systemically administered corticosteroids appear in human milk, could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects; not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk; because many drugs are excreted in human milk, caution exercise caution when drug administered to a nursing woman