Neomycin and polymyxin B belongs to a group of medication known as antibiotics, which are used to treat the cause of an infection. Dexamethasone belongs to the family of medications called corticosteroids, which are used to help reduce inflammation in the eye. Together in combination, this medication is used to treat certain eye infections associated with redness and inflammation of the eye.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given 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.

The recommended dose of the eye drops is 1 or 2 drops into the affected eye(s) 4 to 6 times daily.

The recommended dose of the ointment is approximately ½ inch of the ointment into the eye(s) 3 or 4 times a day, or at bedtime along with the eye drops. Follow the directions that your doctor has given you.

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.

The following procedure is recommended when using the eye drops:

• Wash your hands.
• Shake the bottle of eye drops to ensure the suspension is evenly distributed.
• Tilt the head back and gently pull the lower eyelid away from the eye to make a pouch under the eye.
• Drop the medication into this space and then let go of the eyelid and gently close the eyes.
• Do not blink.
• Keep the eyes closed and apply gentle pressure to the inner corner of the eye with your finger for 1 or 2 minutes to prevent excessive absorption into the body.
• Wash your hands to remove any medication that may have got on them.
• Do not touch the dropper or the applicator tip to any surface (including the eye).

The following procedure is recommended when using the eye ointment:

• Wash your hands.
• Roll the ointment tube in your hands for a minute to make the ointment flow easier.
• Do not touch the tip of the tube or let it touch your eye to avoid contamination.
• Tilt your head back, gaze upward, and pull down the lower eyelid to make a pouch.
• Place ¼ to ½ inch of ointment into the pouch by squeezing the tube gently.
• Close the eye and roll the eyeball in all directions to spread the medication.
• Try not to blink and do not rub the eye.

If you are using both the ointment and the drops, use the drops first and wait for at least 5 minutes before applying the ointment.

It is important to use this medication exactly as prescribed by your doctor. 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 apply 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 the eye drops and ointment at room temperature, away from heat and direct light, and keep it out of reach of children.

Eye Ointment
Each g of sterile ointment contains polymyxin B sulfate 6,000 units, neomycin (as sulfate) 3.5 mg, and dexamethasone 1 mg (0.1%) in a white petrolatum base. Nonmedicinal ingredients: anhydrous lanolin, methylparaben, and propylparaben.

Eye Suspension
Each mL contains dexamethasone 1 mg (0.1%), neomycin (as sulfate) 3.5 mg, and polymyxin B sulfate 6,000 units. Preserved with benzalkonium chloride. Nonmedicinal ingredients: hydrochloric acid and/or sodium hydroxide (to adjust pH), 0.5% hydroxypropyl methylcellulose, polysorbate 20, purified water, and sodium chloride.

Neomycin sulfate - dexamethasone - polymyxin B sulfate should not be used by anyone who:

• is allergic to neomycin sulfate, dexamethasone, polymyxin B sulfate, or to any of the ingredients of the medication
• has acute herpes simplex
• has tuberculosis of the eye
• has vaccinia
• has varicella (chickenpox)
• has other viral or fungal diseases of the eye

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.

• blurred vision (especially after using eye ointment)
• eye irritation
• headache
• itchy eyes
• sensitivity to light
• watering eyes

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

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

• eye pain
• new or worsening eye infection
• skin rash, itching, redness, or swelling in or around the eyes
• vision changes

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.

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.

Blurred vision: This medication may cause a temporary blurring of vision. Do not drive or operate machinery until your vision has cleared.

Contact lenses: If you use contact lenses, ask your doctor about wearing them while using this medication. Usually, contact lenses should not be worn when treating an eye infection. The drop form of this medication contains an ingredient that can discolour contact lenses. Contact lenses must be removed from the eye before putting the drops in the affected eye and should not be reinserted until at least 15 minutes after using the drops.

Long-term use: Long-term use of this medication may result in eye problems such as glaucoma, increased eye pressure, and cataracts. It may also result in problems with delayed healing and overgrowth of microorganisms (e.g., certain bacteria or fungi) that are not killed by the antibiotic. If you are using this medication for a prolonged period of time, your doctor should check your eye pressure regularly.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if neomycin - dexamethasone - polymyxin B passes into breast milk. If you are breast-feeding and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

There may be an interaction between neomycin sulfate - dexamethasone  - polymyxin B and any of the following:

• cobicistat
• non-steroidal anti-inflammatory (NSAID) eye drops (e.g., diclofenac, ketorolac)
• ritonavir

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. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.