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Neomycin / polymyxin B / dexamethasone

Anti-inflammatory · Rx
Trade namesMaxitrol
Drug classAntibiotic + corticosteroid (combination)
StrengthNeomycin 0.35% + polymyxin B 10,000 U/mL + dexamethasone 0.1%
AvailabilityRx
Mechanism of actionTwo antibacterials with a potent corticosteroid.
Indication / reason for useSteroid-responsive inflammation with infection risk of the lids, conjunctiva and anterior segment.
Usual adult dosing1-2 drops q3-4h (or more frequently initially); ointment TID-QID.
PreservativeBAK
Contact lensesNo lens wear during treatment.
Common / important adverse effectsNeomycin contact hypersensitivity (common, periocular dermatitis), IOP rise, cataract, infection potentiation.
Contraindications & cautionsHSV epithelial keratitis, fungal/mycobacterial/most viral infection; neomycin allergy.
Pregnancy / lactationLimited data.
Practice notesThe neomycin component is a frequent cause of a worsening 'allergic' picture, consider switching if the eye deteriorates.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.

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