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DESCRIPTION
A sterile anti-bacterial and anti-inflammatory aqueous suspension containing in
each mL:
·
Colistin base activity, 3mg (as the sulfate)
·
Neomycin base activity, 3.3 mg (as the sulfate)
·
Hydrocortisone acetate, 10 mg (1%)
·
Thonzonium bromide, 0.5 mg (0.05%)
·
Polysorbate 80, acetic acid and sodium acetate in a buffered aqueous vehicle
·
Thimerosol (mercury derivative) 0.002% is added as a preservative
It is a non-viscous liquid, buffered at pH 5, for instillation into the canal of
the external ear or direct application to the affected aural skin.
Indications and Usage
For the treatment of superficial bacterial infections of the external auditory
canal, caused by organisms susceptible to the action of the antibiotics; and for
the treatment of infections of mastoidectomy and fenestration cavities, caused
by organisms susceptible to the antibiotics.
CONTRAINDICATIONS
This
product is contraindicated in those individuals who have shown hypersensitivity
to any of its components. This product should not be used if the external
auditory canal disorder is suspected or known to be due to cutaneous viral
infection (e.g., herpes simplex virus or varicella zoster virus).
Warnings
Neomycin can induce permanent sensorineural hearing loss due to cochlear damage,
mainly destruction of hair cells in the organ of Corti. The risk is greater with
prolonged use. Therapy should be limited to 10 consecutive days. (See
PRECAUTIONS-General.) Patients being treated with eardrops containing neomycin
should be under close clinical observation. Cortisporin® TC Otic
Suspension should be used cautiously in any patient with a perforated
tympanic membrane.
Neomycin sulfate may cause cutaneous sensitization. A precise
incidence of hypersensitivity reactions (primarily skin rash) due to topical
neomycin is not known. Discontinue promptly if sensitivity or irritation
occurs.
When using neomycin-containing products to control secondary
infection in the chronic dermatoses, such as chronic otitis externa or stasis
dermatitis, it should be borne in mind that the skin in these conditions is more
liable than is normal skin to become sensitized to many substances, including
neomycin. The manifestation of sensitization to neomycin is usually a low-grade
reddening with swelling, dry scaling, and itching; it may be manifest simply as
a failure to heal. Periodic examination for such signs is advisable, and the
patient should be told to discontinue the product if they are observed. These
symptoms regress quickly on withdrawing the medication. Neomycin-containing
applications should be avoided for the patient thereafter.
ADVERSE REACTIONS
Neomycin occasionally causes skin sensitization. Ototoxicity (see
WARNINGS section) and nephrotoxicity have also been reported.
Adverse reactions have occurred with topical use of antibiotic
combinations.
Exact incidence figures are not available since no denominator of
treated patients is available. The reaction occurring most often is allergic
sensitization. In one clinical study, using a 20% neomycin patch,
neomycin-induced allergic skin reactions occurred in two of 2,175 (0.09%)
individuals in the general population2. In another study the
incidence was found to be approximately 1%3.
The following local adverse events have been reported with topical
corticosteroids especially under occlusive dressings: burning, itching,
irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions,
hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration
of the skin, secondary infection, skin atrophy, striae, and miliaria.
Please see the full prescribing information link above for additional information and references.
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