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Adult Dosing .
Dosage forms: OINTMENT: 3.5 mg/10,000 units/1 mg per g; SUSPENSION: 3.5 mg/10,000 units/1 mg per mL
ocular inflammation
- [ointment]
- Dose: apply in eye(s) tid-qid; Info: for ocular inflammation with superficial bacterial infection or risk; taper dose gradually to D/C if long-term use
- [suspension]
- Dose: 1-2 drops in eye(s) q4-6h; Info: for ocular inflammation with superficial bacterial infection or risk; taper dose gradually to D/C if long-term use; for severe disease, may start 1-2 drops in eye(s) q1h x1-2 days, then taper dose gradually to D/C
Peds Dosing .
- Dosage forms: OINTMENT: 3.5 mg/10,000 units/1 mg per g; SUSPENSION: 3.5 mg/10,000 units/1 mg per mL
ocular inflammation
- [ointment, 2 yo and older (off-label)]
- Dose: apply in eye(s) tid-qid; Info: for ocular inflammation with superficial bacterial infection or risk; taper dose gradually to D/C if long-term use
- [suspension, 2 yo and older]
- Dose: 1-2 drops in eye(s) q4-6h; Info: for ocular inflammation with superficial bacterial infection or risk; taper dose gradually to D/C if long-term use; for severe disease, may start 1-2 drops in eye(s) q1h x1-2 days, then taper dose gradually to D/C
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to aminoglycosides
- ocular viral infection
- ocular mycobacterial infection
- ocular fungal infection
- corneal abrasion
- abrupt withdrawal (long-term use)
- caution: hypersensitivity to corticosteroids
- caution: glaucoma
- caution: corneal thinning
- caution: scleral thinning
- caution: HSV infection history
Drug Interactions .
Overview
dexamethasone ophthalmic
corticosteroid ophthalmic
- delays ocular healing
- immunomodulatory effects
neomycin ophthalmic
aminoglycoside ophthalmic
-
None
polymyxin B ophthalmic
polypeptide antibiotic
-
None
Avoid/Use Alternative
Monitor/Modify Tx
Caution Advised
Adverse Reactions .
Serious Reactions
- optic nerve damage
- cataracts
- IOP elevated
- glaucoma
- vision changes
- delayed ocular wound healing
- secondary ocular infection
- masking of infection symptoms
- hypersensitivity reaction
- anaphylaxis
- anaphylactoid reaction
- Stevens-Johnson syndrome
- ulcerative keratitis
Common Reactions
- ocular burning
- ocular stinging
- ocular irritation
- IOP elevated
Safety/Monitoring .
Monitoring Parameters
IOP if tx >10 days
Look/Sound-Alike Drug Names
Maxitrol confused with: metipranolol
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; no human data available, though risk of fetal harm not expected based on expected limited systemic absorption
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on limited systemic absorption in breastfeeding patients
Pharmacology .
Metabolism: for neomycin: none; CYP450: none; Info: minimal systemic absorption; for polymyxin B: unknown; CYP450: unknown; Info: minimal systemic absorption; for dexamethasone: local primarily, liver; CYP450: 3A4 substrate; Info: minimal systemic absorption
Excretion: for neomycin: unknown; Half-life: unknown; for polymyxin B: unknown; Half-life: unknown; for dexamethasone: urine primarily; Half-life: 4h (plasma), 36-54h (biological)
Subclass: Antibacterial/Corticosteroid Combos, Ophthalmic
Mechanism of Action
for neomycin: binds to bacterial 30S ribosomal subunit, inhibiting protein synthesis; for polymyxin B: increases cell wall permeability (polypeptide); for dexamethasone: exact mechanism of anti-inflammatory action unknown; inhibits multiple inflammatory cytokines; produces multiple glucocorticoid and mineralocorticoid effects
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: Sandoz Pharmaceuticals Inc. (OINT form) and Harrow Health, Inc. (SUSP form)
DEA/FDA: Rx
Retail Price
Estimated prices only. For current pricing, visit GoodRx.
ophthalmic suspension:
- 1 mg/3.5 mg/10000 units/mL (1 eye dropper, 5 mL): $122.00
ophthalmic ointment:
- 3.5 mg/g/10000 units/g/0.1% (1 tube of ointment, 3.5 g): $208.00
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