Neomycin, Polymyxin, Bacitracin, and Hydrocortisone Ophthalmic

WHY is this medicine prescribed?

Neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination is used to treat and prevent eye infections caused by certain bacteria and to reduce the irritation, redness, burning, and swelling of eye inflammation caused by infection, chemicals, heat, radiation, foreign bodies in the eye, and other eye conditions. Neomycin, polymyxin, and bacitracin are in a class of medications called antibiotics. They work by stopping the growth of bacteria. Hydrocortisone is in a class of medications called corticosteroids. It works by activating natural substances in the eye to reduce swelling, redness, and itching.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

These ophthalmic combinations come as an ointment (containing neomycin, polymyxin, bacitracin, and hydrocortisone) to apply to the eye and as a suspension (liquid with undissolved particles) (containing neomycin, polymyxin, and hydrocortisone) to instill in the eye. It is usually used in the affected eye(s) every three to four hours depending on the condition that you have. Use neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Do not share your medication, even with someone who was also prescribed this medication. If more than one person uses the same tube or bottle, infection may spread.

Your symptoms should begin to improve during the first few days of treatment with neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination. If symptoms of pain and swelling do not improve or get worse within 48 hours after starting treatment, stop using the medication and call your doctor.

Use neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination for as long as directed by your doctor, even if you feel better. If you stop using neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

To apply the eye ointment, follow these steps:

1. Wash your hands thoroughly with soap and water.
2. Use a mirror or have someone else apply the ointment.
3. Avoid touching the tip of the tube against your eye or anything else.
4. Tilt your head forward slightly.
5. Holding the tube between your thumb and index finger, place the tube as near as possible to your eyelid without touching it.
6. Brace the remaining fingers of that hand against your cheek or nose.
7. With the index finger of your other hand, pull the lower lid of your eye down to form a pocket.
8. Place a small amount of ointment into the pocket made by the lower lid and the eye. A 1/2-inch (1.25-centimeter) strip of ointment usually is enough unless otherwise directed by your doctor.
9. Gently close your eyes and keep them closed for 1 to 2 minutes to allow the medication to be absorbed.
10. Replace and tighten the cap right away.
11. Wipe off any excess ointment from your eyelids and lashes with a clean tissue. Wash your hands again.

To instill the eye drops, follow these steps:

1. Wash your hands thoroughly with soap and water.
2. Use a mirror or have someone else put the drops in your eye.
3. Make sure the end of the dropper is not chipped or cracked.
4. Avoid touching the dropper against your eye, fingers, or anything else.
5. Hold the dropper tip down at all times to prevent drops from flowing back into the bottle and contaminating the remaining contents.
6. Lie down or tilt your head back.
7. Holding the bottle between your thumb and index finger, place the dropper as near as possible to your eyelid without touching it.
8. Brace the remaining fingers of that hand against your cheek or nose.
9. With the index finger of your other hand, pull the lower lid of the eye down to form a pocket.
10. Drop the prescribed number of drops into the pocket made by the lower lid and the eye. Placing the drops on the surface of the eyeball can cause stinging.
11. Close your eye and press lightly against the lower lid with your finger for 2 to 3 minutes to keep the medication in the eye. Do not blink.
12. Replace and tighten the cap right away. Do not wipe or rinse it off.
13. Wipe off any excess liquid from your cheek with a clean tissue. Wash your hands again.

What SPECIAL PRECAUTIONS should I follow?

Before using neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination,

• tell your doctor and pharmacist if you are allergic to neomycin (Neo-Fradin, Mycifradin, others); polymyxin; bacitracin (Baciim); hydrocortisone (Anusol HC, Cortef, others); aminoglycoside antibiotics such as amikacin, gentamicin (Gentak, Genoptic), kanamycin, paromomycin, streptomycin, and tobramycin (Tobrex, Tobi); any other medications; or any of the ingredients in neomycin, polymyxin, bacitracin, and hydrocortisone ointment or suspension. Ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have any type of viral, fungal, or mycobacterial (rare type of eye infection caused by the same or similar bacteria that causes tuberculosis) eye infection. Your doctor will probably tell you not to use neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination.

• tell your doctor if you have recently had cataract surgery and if you have or have ever had glaucoma (condition in which increased pressure in the eye can lead to gradual loss of vision) or any eye condition.

• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination, call your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use extra ointment or suspension to make up for a missed dose.

What SIDE EFFECTS can this medicine cause?

Neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• burning or stinging after applying the medication
• decreased or blurred vision

Some side effects can be serious. If you experience any of these symptoms, stop using neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination and call your doctor immediately or get emergency medical treatment:

• itching, redness, or swelling of the eye or eyelid
• eye pain
• double vision
• narrowed (tunnel) vision
• seeing a halo or strong glare around lights
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

Neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor. If you will be using this medication for more than 10 days, your doctor will probably order certain tests to check your body's response to neomycin, polymyxin, bacitracin, and hydrocortisone ophthalmic combination.

Do not let anyone else take your medication.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.