(nee oh MYE sin, pol i MIKS in bee, & pred NIS oh lone)
Steroid-responsive inflammatory ocular condition in which bacterial infection or a risk of bacterial ocular infection exists
Hypersensitivity to neomycin, polymyxin B, prednisolone, or any component of the formulation; viral diseases of cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella; mycobacterial infection of the eye; fungal diseases of the ocular structures; use after uncomplicated removal of a corneal foreign body
Ocular inflammation/infection: Ophthalmic: Instill 1-2 drops every 3-4 hours; acute infections may require every 30-minute instillation initially with frequency of administration reduced as the infection is brought under control. To treat the lids: Instill 1-2 drops every 3-4 hours, close the eye and rub the excess on the lids and lid margins.
Refer to adult dosing.
Refer to adult dosing.
Ophthalmic: Shake suspension before use.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Suspension, ophthalmic [drops]:
Poly-Pred ‚ ®: Neomycin 0.35%, polymyxin B 10,000 units, and prednisolone acetate 0.5% per 1 mL (5 mL)
AbobotulinumtoxinA: Aminoglycosides may enhance the neuromuscular-blocking effect of AbobotulinumtoxinA. Monitor therapy
Acarbose: Neomycin may enhance the adverse/toxic effect of Acarbose. Neomycin may enhance the therapeutic effect of Acarbose. Neomycin may decrease the metabolism of Acarbose. Monitor therapy
Acetylcholinesterase Inhibitors: Corticosteroids (Systemic) may enhance the adverse/toxic effect of Acetylcholinesterase Inhibitors. Increased muscular weakness may occur. Monitor therapy
Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Avoid combination
Aminoglutethimide: May increase the metabolism of Corticosteroids (Systemic). Monitor therapy
Amphotericin B: May enhance the nephrotoxic effect of Aminoglycosides. Monitor therapy
Amphotericin B: Corticosteroids (Systemic) may enhance the hypokalemic effect of Amphotericin B. Monitor therapy
Antacids: May decrease the bioavailability of Corticosteroids (Oral). Consider therapy modification
Antidiabetic Agents: Corticosteroids (Systemic) may diminish the hypoglycemic effect of Antidiabetic Agents. In some instances, corticosteroid-mediated HPA axis suppression has led to episodes of acute adrenal crisis, which may manifest as enhanced hypoglycemia, particularly in the setting of insulin or other antidiabetic agent use. Monitor therapy
Antifungal Agents (Azole Derivatives, Systemic): May decrease the metabolism of Corticosteroids (Systemic). Monitor therapy
Aprepitant: May increase the serum concentration of Corticosteroids (Systemic). Consider therapy modification
ARIPiprazole: CYP3A4 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. Management: Monitor for increased aripiprazole pharmacologic effects. Aripiprazole dose adjustments may or may not be required based on concomitant therapy and/or indication. Consult full interaction monograph for specific recommendations. Monitor therapy
Barbiturates: May decrease the serum concentration of Corticosteroids (Systemic). Monitor therapy
BCG: Immunosuppressants may diminish the therapeutic effect of BCG. Avoid combination
BCG: Antibiotics may diminish the therapeutic effect of BCG. Avoid combination
Bile Acid Sequestrants: May decrease the absorption of Corticosteroids (Oral). Monitor therapy
Bisphosphonate Derivatives: Aminoglycosides may enhance the hypocalcemic effect of Bisphosphonate Derivatives. Monitor therapy
Calcitriol: Corticosteroids (Systemic) may diminish the therapeutic effect of Calcitriol. Monitor therapy
Calcium Channel Blockers (Nondihydropyridine): May decrease the metabolism of Corticosteroids (Systemic). Exceptions: Bepridil [Off Market]. Monitor therapy
Capreomycin: May enhance the neuromuscular-blocking effect of Polymyxin B. Monitor therapy
Capreomycin: May enhance the neuromuscular-blocking effect of Aminoglycosides. Monitor therapy
CARBOplatin: Aminoglycosides may enhance the ototoxic effect of CARBOplatin. Especially with higher doses of carboplatin. Monitor therapy
Cardiac Glycosides: Aminoglycosides may decrease the serum concentration of Cardiac Glycosides. This effect has only been demonstrated with oral aminoglycoside administration. Monitor therapy
Cephalosporins (2nd Generation): May enhance the nephrotoxic effect of Aminoglycosides. Monitor therapy
Cephalosporins (3rd Generation): May enhance the nephrotoxic effect of Aminoglycosides. Monitor therapy
Cephalosporins (4th Generation): May enhance the nephrotoxic effect of Aminoglycosides. Monitor therapy
CISplatin: May enhance the nephrotoxic effect of Aminoglycosides. Monitor therapy
Coccidioidin Skin Test: Immunosuppressants may diminish the diagnostic effect of Coccidioidin Skin Test. Monitor therapy
Colistimethate: Aminoglycosides may enhance the nephrotoxic effect of Colistimethate. Aminoglycosides may enhance the neuromuscular-blocking effect of Colistimethate. Consider therapy modification
Colistimethate: Polymyxin B may enhance the neuromuscular-blocking effect of Colistimethate. Monitor therapy
Corticorelin: Corticosteroids may diminish the therapeutic effect of Corticorelin. Specifically, the plasma ACTH response to corticorelin may be blunted by recent or current corticosteroid therapy. Monitor therapy
CycloSPORINE: Aminoglycosides may enhance the nephrotoxic effect of CycloSPORINE. Monitor therapy
CycloSPORINE: May increase the serum concentration of PrednisoLONE. PrednisoLONE may increase the serum concentration of CycloSPORINE. PrednisoLONE may decrease the serum concentration of CycloSPORINE. Monitor therapy
CycloSPORINE (Systemic): Aminoglycosides may enhance the nephrotoxic effect of CycloSPORINE (Systemic). Monitor therapy
CycloSPORINE (Systemic): May increase the serum concentration of PrednisoLONE. PrednisoLONE may increase the serum concentration of CycloSPORINE (Systemic). PrednisoLONE may decrease the serum concentration of CycloSPORINE (Systemic). Monitor therapy
Deferasirox: Corticosteroids (Systemic) may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy
Deferasirox: Corticosteroids may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy
Denosumab: May enhance the adverse/toxic effect of Immunosuppressants. Specifically, the risk for serious infections may be increased. Monitor therapy
Echinacea: May diminish the therapeutic effect of Immunosuppressants. Consider therapy modification
Estrogen Derivatives: May increase the serum concentration of Corticosteroids (Systemic). Monitor therapy
Fluconazole: May decrease the metabolism of Corticosteroids (Systemic). Monitor therapy
Fosaprepitant: May increase the serum concentration of Corticosteroids (Systemic). The active metabolite aprepitant is likely responsible for this effect. Consider therapy modification
Fosphenytoin: May decrease the serum concentration of PrednisoLONE. Monitor therapy
Gallium Nitrate: Aminoglycosides may enhance the nephrotoxic effect of Gallium Nitrate. Avoid combination
Hyaluronidase: Corticosteroids may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving corticosteroids (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required. Consider therapy modification
Indacaterol: May enhance the hypokalemic effect of Corticosteroids (Systemic). Monitor therapy
Isoniazid: Corticosteroids (Systemic) may decrease the serum concentration of Isoniazid. Monitor therapy
Leflunomide: Immunosuppressants may enhance the adverse/toxic effect of Leflunomide. Specifically, the risk for hematologic toxicity such as pancytopenia, agranulocytosis, and/or thrombocytopenia may be increased. Management: Consider not using a leflunomide loading dose in patients receiving other immunosuppressants. Patients receiving both leflunomide and another immunosuppressant should be monitored for bone marrow suppression at least monthly. Consider therapy modification
Loop Diuretics: May enhance the adverse/toxic effect of Aminoglycosides. Specifically, nephrotoxicity and ototoxicity. Monitor therapy
Loop Diuretics: Corticosteroids (Systemic) may enhance the hypokalemic effect of Loop Diuretics. Monitor therapy
Macrolide Antibiotics: May decrease the metabolism of Corticosteroids (Systemic). Exceptions: Azithromycin; Azithromycin (Systemic); Fidaxomicin; Spiramycin. Consider therapy modification
Mifepristone: May diminish the therapeutic effect of Corticosteroids (Systemic). Mifepristone may increase the serum concentration of Corticosteroids (Systemic). Management: Avoid mifepristone in patients who require long-term corticosteroid treatment of serious illnesses or conditions (e.g., for immunosuppression following transplantation). Corticosteroid effects may be reduced by mifepristone treatment. Avoid combination
Mitotane: May decrease the serum concentration of Corticosteroids (Systemic). Consider therapy modification
Natalizumab: Immunosuppressants may enhance the adverse/toxic effect of Natalizumab. Specifically, the risk of concurrent infection may be increased. Avoid combination
Neuromuscular-Blocking Agents: Polymyxin B may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Consider therapy modification
Neuromuscular-Blocking Agents: Aminoglycosides may enhance the respiratory depressant effect of Neuromuscular-Blocking Agents. Monitor therapy
Neuromuscular-Blocking Agents (Nondepolarizing): May enhance the adverse neuromuscular effect of Corticosteroids (Systemic). Increased muscle weakness, possibly progressing to polyneuropathies and myopathies, may occur. Consider therapy modification
NSAID (COX-2 Inhibitor): Corticosteroids (Systemic) may enhance the adverse/toxic effect of NSAID (COX-2 Inhibitor). Monitor therapy
NSAID (Nonselective): Corticosteroids (Systemic) may enhance the adverse/toxic effect of NSAID (Nonselective). Monitor therapy
OnabotulinumtoxinA: Aminoglycosides may enhance the neuromuscular-blocking effect of OnabotulinumtoxinA. Monitor therapy
Penicillins: May decrease the serum concentration of Aminoglycosides. Primarily associated with extended spectrum penicillins, and patients with renal dysfunction. Exceptions: Amoxicillin; Ampicillin; Cloxacillin; Dicloxacillin; Nafcillin; Oxacillin; Penicillin G (Parenteral/Aqueous); Penicillin G Benzathine; Penicillin G Procaine; Penicillin V Potassium. Consider therapy modification
Phenytoin: May decrease the serum concentration of PrednisoLONE. Monitor therapy
Pimecrolimus: May enhance the adverse/toxic effect of Immunosuppressants. Avoid combination
Pimozide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Pimozide. Avoid combination
Primidone: May decrease the serum concentration of Corticosteroids (Systemic). Monitor therapy
Quinolone Antibiotics: May enhance the adverse/toxic effect of Corticosteroids (Systemic). Risk of tendon-related side effects, including tendonitis and rupture, may be enhanced. Monitor therapy
Rifamycin Derivatives: May increase the metabolism of Corticosteroids (Systemic). Monitor therapy
RimabotulinumtoxinB: Aminoglycosides may enhance the neuromuscular-blocking effect of RimabotulinumtoxinB. Monitor therapy
Ritonavir: May increase the serum concentration of PrednisoLONE. Management: Consider prednisolone dose reductions in patients receiving ritonavir, and monitor for increased adverse effects with concomitant use. Consider therapy modification
Roflumilast: May enhance the immunosuppressive effect of Immunosuppressants. Consider therapy modification
Salicylates: May enhance the adverse/toxic effect of Corticosteroids (Systemic). These specifically include gastrointestinal ulceration and bleeding. Corticosteroids (Systemic) may decrease the serum concentration of Salicylates. Withdrawal of corticosteroids may result in salicylate toxicity. Monitor therapy
Sipuleucel-T: Immunosuppressants may diminish the therapeutic effect of Sipuleucel-T. Monitor therapy
SORAfenib: Neomycin may decrease the serum concentration of SORAfenib. Monitor therapy
Tacrolimus (Topical): May enhance the adverse/toxic effect of Immunosuppressants. Avoid combination
Telaprevir: May increase the serum concentration of Corticosteroids (Systemic). Corticosteroids (Systemic) may decrease the serum concentration of Telaprevir. Management: Concurrent use of telaprevir and systemic corticosteroids is not recommended. When possible, consider alternatives. If used together, employ extra caution and monitor closely for excessive corticosteroid effects and diminished telaprevir effects. Consider therapy modification
Telaprevir: Corticosteroids may decrease the serum concentration of Telaprevir. Telaprevir may increase the serum concentration of Corticosteroids. Management: Concurrent use of telaprevir and systemic corticosteroids is not recommended. When possible, consider alternatives. If used together, employ extra caution and monitor closely for excessive corticosteroid effects and diminished telaprevir effects. Consider therapy modification
Thiazide Diuretics: Corticosteroids (Systemic) may enhance the hypokalemic effect of Thiazide Diuretics. Monitor therapy
Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy
Trastuzumab: May enhance the neutropenic effect of Immunosuppressants. Monitor therapy
Vaccines (Inactivated): Immunosuppressants may diminish the therapeutic effect of Vaccines (Inactivated). Monitor therapy
Vaccines (Live): Corticosteroids (Systemic) may enhance the adverse/toxic effect of Vaccines (Live). Consider therapy modification
Vancomycin: May enhance the nephrotoxic effect of Aminoglycosides. Monitor therapy
Vitamin K Antagonists (eg, warfarin): Neomycin may enhance the anticoagulant effect of Vitamin K Antagonists. Monitor therapy
Warfarin: Corticosteroids (Systemic) may enhance the anticoagulant effect of Warfarin. Monitor therapy
Frequency not defined.
Ocular: Allergic sensitivity, cataracts, conjunctival erythema, conjunctival hyperemia, conjunctivitis, corneal ulcers, delayed wound healing, glaucoma, globe perforation, increased intraocular pressure, itching, keratitis, optic nerve damage, secondary infection, swelling
Miscellaneous: Anaphylaxis, hypercorticoidism, hypersensitivity
Concerns related to adverse effects:
- Infection: Steroids may mask infection or enhance existing ocular infection; prolonged use may result in secondary infections due to immunosuppression.
- Ocular effects: Prolonged use of corticosteroids may result in glaucoma, damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation.
- Sensitivity reactions: Sensitivity to neomycin may develop; discontinue if sensitivity reaction occurs.
Special populations:
- Contact lens wearers: Suspension contains a preservative which may be adsorbed by contact lenses; contact lenses should not be worn during treatment of ophthalmic infections.
Other warnings/precautions:
- Appropriate use: For ophthalmic use only. A maximum 20 mL of suspension should be prescribed initially; patients should be evaluated prior to additional refills.
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Animal reproduction studies have not been conducted with this combination. See individual agents.
See individual agents.
See individual agents.