How does this medication work? What will it do for me?

Hydrocortisone - neomycin - polymyxin B - bacitracin compound (ointment)] is no longer being manufactured for sale in Canada. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

This medication contains a combination of ingredients. Neomycin, polymyxin B, and bacitracin zinc belong to a class of medications called antibiotics, and hydrocortisone belongs to a class of medications called corticosteroids. This medication works by reducing inflammation and killing the bacteria that cause infection.

Hydrocortisone - neomycin - polymyxin B - bacitracin zinc ointment is used to treat skin infections as well as infection and inflammation of the front portion of the eye in people who are 2 years of age or above. Do not use this ointment in the eyes.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each gram of ointment contains 5,000 units of polymyxin B sulfate, 400 units of bacitracin zinc, 5 mg of neomycin sulfate, and 10 mg of hydrocortisone in a low-melting-point petrolatum base.

How should I use this medication?

Before treatment, any wound debris such as pus or crusts should be removed from the affected area. Apply a thin film of ointment to the affected area 2 to 4 times daily.

This medication should not be used for more than 7 days without medical supervision. If there is no improvement after 7 days of using this medication, call your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. Use it for the full duration of prescribed treatment even if the affected area starts to look better.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Hydrocortisone - neomycin - polymyxin B - bacitracin zinc ointment should not be used by or given to anyone who:

  • ise allergic to hydrocortisone, neomycin, polymyxin B, bacitracin zinc, or any ingredients of the medication
  • is allergic to aminoglycosides (e.g., gentamicin)
  • is under 2 years of age
  • has external ear infection with a ruptured eardrum
  • has preexisting nerve deafness
  • has viral, tuberculous, primary bacterial, or fungal infections of the skin

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • burning, dryness, irritation, itching, or redness of skin
  • burning or stinging when applying medication
  • increased redness or scaling or skin sores
  • skin rash

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • increased skin sensitivity
  • lack of healing of skin condition
  • painful, red or itchy, pus-containing blisters in hair follicles
  • skin infection
  • thinning of skin with easy bruising

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of an allergic reaction such as severe rash or hives, difficulty breathing, or swelling

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Absorption: The absorption of topically-applied (i.e., applied to the skin) steroids into the bloodstream is increased if treating a large area of the body or if using dressings that don't breathe. Your doctor will monitor you closely.

Ear and kidney damage: Neomycin that is absorbed into the bloodstream can cause ear damage (e.g., affect balance and hearing) and kidney damage. This medication should not be used over a large area or for extended periods of time.

If your condition does not improve after you have been using this medication for a week, contact your doctor. Using this medication in large quantities or on large areas for a prolonged period of time is not recommended.

Skin reactions: It is possible to become sensitized to neomycin while using this medication. Sensitization to neomycin usually appears as reddening of the skin with swelling, dry scaling, and itching. Neomycin may simply cause a failure to heal. It may also cause a skin rash. If these symptoms occur, call your doctor. These symptoms should disappear quickly after stopping the medication. Medications that contain neomycin should then be avoided in the future.

Pregnancy: This medication should not be used in pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if this medication passes into breast milk. This medication should not be used in women who are breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 2 years of age.

What other drugs could interact with this medication?

There may be an interaction between hydrocortisone - neomycin - polymyxin B - bacitracin zinc ointment and any of the following:

  • neuromuscular blocking medications (e.g., atracurium, cisatracurium)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.