Neomycin-Polymyxin B Gu (neomycin sulfate/polymyxin B sulfate)

Dosage of polymyxin B sulfate usually is expressed in terms of polymyxin B activity (units of polymyxin B). Dosage of the drug also may be expressed as mg of polymyxin B base. Each mg of polymyxin B is equivalent to 10,000 units of polymyxin B.

Dosage of polymyxin B should be decreased in patients with renal impairment. Serum polymyxin B concentrations should be monitored and IV or IM dosage adjusted to maintain desired serum concentrations of the drug.

Various dosage regimens have been recommended for use of polymyxin B in patients with renal impairment; however, these regimens are not well established and are not based on pharmacokinetic data from patients with renal impairment.

It has been recommended that patients with creatinine clearances of 30-80 mL/minute receive an IV loading dose of polymyxin B of 2.5 mg/kg on the first day of treatment followed by 1-1.5 mg/kg daily and that those with creatinine clearances less than 25-30 mL/minute receive these doses once every 2-3 days. For anuric patients, some clinicians have recommended an IV loading dose of 2.5 mg/kg followed by 1-1.5 mg/kg given once every 5-7 days.

Alternatively, it has been suggested that patients with creatinine clearances greater than 20 mL/minute receive 75-100% of the usual daily dose in 2 divided doses every 12 hours, those with creatinine clearances of 5-20 mL/minute receive 50% of the usual daily dose in 2 divided doses every 12 hours, and those with creatinine clearances less than 5 mL/minute receive 30% of the usual daily dose every 12-18 hours. Some clinicians have used 75% of the usual daily dose in those with creatinine clearances 20-50 mL/minute and 33% of the usual daily dose in those with creatinine clearances less than 20 mL/minute.

No dosing information is available for this tab.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

The safety of polymyxin B sulfate in pregnant women has not been established.

Some clinicians state that polymyxin B should not be used during pregnancy, except in rare situations when other appropriate anti-infectives cannot be used.

If use of the fixed-combination solution for irrigation containing polymyxin B sulfate and neomycin sulfate is being considered for a pregnant woman, the woman should be informed of the potential hazard to the fetus. Aminoglycosides cross the placenta and there have been reports of complete, irreversible, bilateral congenital deafness in children whose mothers received an aminoglycoside (i.e., streptomycin) during pregnancy.

Aminoglycosides may cause fetal harm following systemic absorption in pregnant women. The drugs cross the placenta and total, irreversible, bilateral, congenital deafness has been reported in some children whose mothers received parenteral streptomycin during pregnancy.

Fixed-combination topical preparations containing neomycin sulfate and a corticosteroid should be used during pregnancy only if potential benefits justify potential risks to the fetus. Corticosteroids have been teratogenic in animals (mice, rabbits) when applied topically.

If the irrigation solution containing neomycin sulfate and polymyxin B sulfate is used for bladder irrigation during pregnancy, the patient should be informed of the potential hazard to the fetus.

Clinically unimportant amounts of neomycin may distribute into breast milk following systemic absorption of the drug.

Fixed-combination topical preparations containing neomycin sulfate and a corticosteroid should be used with caution in nursing women. Corticosteroids administered systemically (e.g., orally) are distributed into human milk, and systemic absorption may occur when the drugs are applied topically.

No enhanced messaging available.