Polymyxin B Sulfate

Polymyxin B Sulfate is a prescription medication used to treat Systemic Infections.  

• Polymyxin B Sulfate is available under the following different brand names: Polymyxin B. 

Adult and pediatric dosage

Systemic Infections

Adult dosage

• IV: 15,000-25,000 units/kg/day divided every 12 hours; not to exceed 25,000 units/kg/day
• IM: 25,000-30,000 units/kg/day divided every 4-6 hours
• Intrathecal: 50,000 once daily for 3-4 days; then once daily or every other day for at least 2 weeks after CSF cultures are negative and normal for glucose content
• Total daily dose not to exceed 2,000,000 units/day

Infant dosage

• IM: May receive up to 40,000 units/kg/day divided every 6 hours if renal function healthy
• IV: May receive up to 40,000 units/kg/day divided every 12 hours
• Intrathecal: 20,000 units/day for 3-4 days; follow with 25,000 units every other day for at least 2 weeks after CSF cultures are negative and CSF (glucose) has returned to normal

Child dosage

• IM: 25,000-30,000 units/kg/day divided every 12 hours
• IV: 15,000-25,000 units/kg/day divided every 12 hours; not to exceed 25,000 units/kg/day
• Intrathecal: 50,000 once daily for 3-4 days; then once daily or once every other day for at least 2 weeks after CSF cultures are negative and normal for glucose content 

Dosage Considerations – Should Polymyxin B Sulfate Given as Follows: 

• See "Dosages."

Common side effects of Polymyxin B Sulfate include:

• pain, redness, and swelling at the injection site, 
• temporary stinging, burning, redness, and itching of the eye, and 
• temporary blurred vision (if used as eye drops)

Serious side effects of Polymyxin B Sulfate include:

• hives, 
• rash, 
• swelling in the face, tongue, and throat, 
• flushing, 
• loss of coordination, 
• drowsiness, 
• fever, 
• headache, 
• numbness or tingling in the hands or feet, 
• back pain, 
• stiff neck, 
• unsteadiness, and
• rash

Rare side effects of Polymyxin B Sulfate include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result 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.

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

• Polymyxin B Sulfate has severe interactions with the following drugs:
  • allogeneic cultured keratinocytes/fibroblasts in bovine collagen
• Polymyxin B Sulfate has serious interactions with at least 14 other drugs.
• Polymyxin B Sulfate has moderate interactions with at least 19 other drugs.
• Polymyxin B Sulfate has minor interactions with the following drugs:
  • adefovir
  • entecavir
  • foscarnet
  • methoxyflurane
  • paromomycin
  • pentamidine
  • streptomycin
  • vancomycin
  • verteporfin 

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

Contraindications

• Hypersensitivity 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Polymyxin B Sulfate?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Polymyxin B Sulfate?”

Cautions

• Oliguria, myasthenia gravis, pregnancy, renal disease
• Potential risk of nephrotoxicity and neurotoxicity
• May inhibit neuromuscular transmission
• Inactivated strong acidic or alkaline solution
• Discontinue if diminished urine output, rise in SCr or BUN, or signs of respiratory paralysis appear
• Do not use IM routinely, particularly in peds, Polymyxin B Sulfate because of severe injection site pain

Pregnancy and Lactation

• Use may be acceptable during pregnancy when benefits outweigh risk. 
• Use with caution when lactation; no available data.