How does this medication work? What will it do for me?
This is a combination medication containing 3 active ingredients: hydrocortisone, neomycin, and polymyxin B. Neomycin and polymyxin B belong to the class of medications called antibiotics and they work to kill certain bacteria that cause infection. Hydrocortisone belongs to the class of medications called corticosteroids and it works to reduce inflammation.
Hydrocortisone - neomycin - polymyxin B ear drops are used to treat certain bacterial infections of the outer ear canal. This medication should start to work within 48 hours.
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 using this medication, speak to your doctor. Do not stop using 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 use this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Sandoz Cortimyxin otic solution is no longer being manufactured for sale in Canada. For brands that may still be available, search under hydrocortisone - neomycin - polymyxin B compound (ear drops). 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.
How should I use this medication?
The usual recommended dose for adults and children 2 years and older is 4 drops into the ear 3 to 4 times daily.
Shake the ear drops well before using. The outer ear should be thoroughly cleaned and dried with a sterile cotton applicator. Do not use soap as this may make this medication ineffective.
To apply the medication, lie with the affected ear upward, and instill the drops into the ear canal. Stay still in this position for at least 5 minutes to allow the ear drops to enter the ear canal. Do not use this medication for longer than 7 days unless recommended by your doctor.
Do not allow the dropper tip of the bottle to touch the ear or other surrounding structures, your fingers, or any other surface. This can contaminate the dropper.
Many things can affect the dose of a 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 using 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 feel better. If you miss a dose, use 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 instill 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, protect it from light, 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?
Do not use this medication if you:
- are allergic to hydrocortisone, neomycin, polymyxin B, or any ingredients of the medication
- are allergic to aminoglycosides (e.g., gentamicin)
- have active vaccinia or varicella infections
- have or may have a ruptured eardrum (leaking fluid from the ear)
- have untreated herpes simplex, herpes zoster, and fungal infections
Do not use the ear drops on your eyes.
Do not give this medication to children under 2 years of age.
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 or stinging when applying medication
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:
- changes in hearing (e.g. loss of hearing, ringing in the ears)
- itching, rash, redness, swelling, or other sign of irritation not present before use of this medication
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.
Allergy: The ear drops contain potassium meta-bisulfite, a sulfite that may cause allergy-type reactions or asthma attacks in certain people. Talk to your doctor if you have any concerns. Some people have also developed allergic reactions, including skin rash, to the neomycin component of this medication.
If you notice redness, swelling, itching, and dry scales, or if the infection doesn't seem to be healing, stop using the medication and contact your doctor as soon as possible.
Duration of treatment: If your condition does not improve after you have been using this medication for a week, contact your doctor.
Kidney function: If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Overgrowth of organisms (superinfection): As with other antibiotics, treatment with this medication may allow normal fungus, yeast, or types of bacteria not killed by the antibiotic to overgrow, causing unwanted infections. If the infection has not improved after one week of therapy, contact your doctor.
Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor.
Breast-feeding: It is not known if this medication passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. This medication is not recommended for 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 compound ear drops and any of the following:
- aminoglycosides (e.g., gentamicin, tobramycin)
- corticosteroids (e.g. hydrocortisone, methylprednisolone)
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.