Hydrocortisone, Neomycin, and Polymyxin (patient information)

Why this medication is prescribed

The combination of hydrocortisone, neomycin, and polymyxin eliminates bacteria that cause ear, eye, and skin infections and relieves pain, inflammation, redness, and itching.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How this medication should be used

This combination of drugs comes in eardrops, eyedrops, and a skin cream. For eye infections, this medication usually is used every 3 to 4 hours; for ear and skin infections, it usually is used two to four times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use this combination exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Do not use this medication for more than 10 days. If your infection does not improve within 1 week or if it worsens, call your doctor.

To apply the eardrops, follow these directions (to make this procedure easier, have someone else insert the drops):

1. Gently clean and dry your ear with a sterile cotton swab.
2. Wash your hands thoroughly with soap and water.
3. Check the dropper to make sure it is not chipped or cracked.
4. The eardrops must be kept clean. Avoid touching the dropper against your ear, fingers, or any other source of contamination.
5. Warm the drops to near (but not higher than) body temperature by holding the container in your hand for a few minutes.
6. If the drops are a cloudy suspension (not a clear solution), shake the container well for 10 seconds.
7. Draw some medication into the dropper.
8. Tilt your head so that the affected ear is up, or lie on your side with the affected ear up.
9. To allow the drops to run in, hold the ear lobe up and back for an adult and hold the ear lobe down and back for a child.
10. Place the prescribed number of drops in your ear and keep your ear tilted up for 5 minutes. To avoid injury, do not insert the dropper into your ear.
11. If you prefer, insert a soft cotton gauze wick plug (ask your doctor or pharmacist to recommend a product) and saturate it with the eardrops. Keep the cotton moist by adding eardrops every 4 hours or as directed by your doctor, and replace the cotton every 24 hours.
12. Wash your hands to remove any medicine.

To apply the eyedrops, shake the bottle well and follow these directions:

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

To use the skin cream, wash the affected skin area thoroughly. Then apply a small amount of cream and rub it in gently. If you use the cream on your face, keep it out of your eyes.

When using the cream, do not bandage or otherwise wrap your skin unless directed by your doctor. Do not apply this medication to other areas of the body unless directed by your doctor.

Do not apply cosmetics or other skin preparations to the treated skin area without talking with your doctor.

If you use this medication on a child's diaper area, do not use tight-fitting diapers or plastic pants. Such use may increase side effects.

Special precautions

Before using hydrocortisone, neomycin, and polymyxin:

• tell your doctor and pharmacist if you are allergic to hydrocortisone, neomycin, polymixin, or any other drugs.
• tell your doctor what prescription and nonprescription medications you are taking, especially cancer chemotherapy agents, other topical medications, and vitamins.
• tell your doctor if you have or have ever had kidney disease, a heart attack, diabetes, glaucoma, cataracts, a perforated eardrum, a circulation disorder, or an immune disorder.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using hydrocortisone, neomycin, and polymyxin, call your doctor immediately.

What to do if you forget 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 apply a double dose to make up for a missed one.

Side effects

Minor side effects

Hydrocortisone, neomycin, and polymyxin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• itching
• burning
• pain
• swelling
• drying or cracking of the skin
• acne
• change in skin color
• blurred vision
• hearing difficulty

Severe side effects

If you experience any of the following symptoms, call your doctor immediately:

• severe skin rash
• difficulty breathing or swallowing
• wheezing

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 [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it according to the package instructions. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medications.

Other information

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

• Bacticort®
• Cortisporin Ophthalmic®
• Otocort Ear Solution®
• Otosporin®

Other names

• Antibiotic Ear Solution