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Overview: Neomycin/polymyxin B/hydrocortisone otic is an ear drop that is commonly used to treat ear infections caused by certain bacteria. It works by killing the bacteria causing the infection and by calming the immune system to reduce swelling and other ear symptoms. Common side effects include skin irritation, itching, and dryness. Contact your health care provider if your infection does not get better within one week of starting this medicine.

Uses

What is neomycin/polymyxin B/hydrocortisone otic (ear) used for?

Neomycin/polymyxin B/hydrocortisone otic is commonly used to treat the following infections caused by certain bacteria. 

  • Outer ear infections 
  • Infections at the surgery site after certain ear procedures, such as a mastoidectomy 

Neomycin/polymyxin B/hydrocortisone otic may not be appropriate for some of the infections listed above, depending on which germs are causing the infection. Bacteria in some locations may have developed resistance to neomycin/polymyxin B/hydrocortisone otic, which will make it not work as well.

Neomycin/polymyxin B/hydrocortisone otic may also be used for other conditions as determined by your health care provider.

Other forms of neomycin/polymyxin B/hydrocortisone are available for use in the eyes. See Neomycin/Polymyxin B/Hydrocortisone ophthalmic for more information.

How does neomycin/polymyxin B/hydrocortisone otic work (mechanism of action)?

Neomycin/polymyxin B/hydrocortisone otic contains multiple medicines that each work in different ways. Some of these ingredients are antibiotics and one is a corticosteroid. The antibiotics kill certain types of bacteria by blocking their ability to create proteins they need to grow and by weakening their cell membrane. The corticosteroid reduces ear swelling and other symptoms by calming (suppressing) the immune system.

How is neomycin/polymyxin B/hydrocortisone otic supplied (dosage forms)?

Brands and other names

  • Casporyn HC
  • Cortisporin Otic
  • Oticair

Dosage forms and strengths

  • 3.5 mg/10,000 units/1% per milliliter (mL) otic solution (ear drops)
  • 3.5 mg/10,000 units/1% per milliliter (mL) otic suspension (ear drops)

How should I store neomycin/polymyxin B/hydrocortisone otic?

Neomycin/polymyxin B/hydrocortisone otic should be stored at room temperature, between 59 F to 77 F (15 C to 25 C). Store in a cool, dry place.

Side Effects

What are the most common side effects of neomycin/polymyxin B/hydrocortisone otic?

The most common side effects of neomycin/polymyxin B/hydrocortisone otic are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Allergic skin reactions
  • Burning or irritation of the skin
  • Itchy or dry skin

There may be other side effects of neomycin/polymyxin B/hydrocortisone otic that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of neomycin/polymyxin B/hydrocortisone otic?

While less common, the most serious side effects of neomycin/polymyxin B/hydrocortisone otic are described below, along with what to do if they happen.

Severe Allergic Reactions. Neomycin/polymyxin B/hydrocortisone otic may cause allergic reactions, which can be serious. Stop using neomycin/polymyxin B/hydrocortisone otic and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Ear redness, swelling, scaling, or itching

Hearing Loss. Neomycin/polymyxin B/hydrocortisone otic may be linked with hearing loss, which is also called ototoxicity. The risk is higher if you use the medicine for a long time. You should only use this medicine for as long as your health care provider recommends, usually no more than 10 days. Tell your health care provider right away if you have hearing loss or if you hear a ringing or roaring sound in your ears.

Another Infection With Prolonged Use. Using neomycin/polymyxin B/hydrocortisone otic for a long time may lead to an infection with other types of germs, such as fungi. Call your health care provider if your ear infection does not improve within one week of starting this medicine or if it gets worse.

Warnings & Precautions

Who should not use neomycin/polymyxin B/hydrocortisone otic?

Allergies to Ingredients. People who are allergic to any of the following should not use neomycin/polymyxin B/hydrocortisone otic.

  • Neomycin
  • Polymyxin B
  • Hydrocortisone
  • Casporyn HC
  • Cortisporin Otic
  • Oticair
  • Any of the ingredients in the specific product dispensed, including sulfites (a sulfite allergy is different than a sulfa allergy)

Your pharmacist can tell you all of the ingredients in the specific neomycin/polymyxin B/hydrocortisone otic products they stock.

Ruptured Eardrum. Neomycin/polymyxin B/hydrocortisone otic should not be used in people who have a ruptured eardrum because the medicine can cause burning and stinging inside the ear.  Tell your health care provider if you have a ruptured eardrum. Your health care provider may look inside your ear before you begin using this medicine to make sure your eardrum is not ruptured.

Viral Ear Infection. You should not use neomycin/polymyxin B/hydrocortisone otic if you have an infection in your outer ear canal that is caused by a virus, such as shingles or chickenpox. Ask your health care provider if you are not sure what is causing your infection. 

What should I know about neomycin/polymyxin B/hydrocortisone otic before using it?

Do not use neomycin/polymyxin B/hydrocortisone otic unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share neomycin/polymyxin B/hydrocortisone otic with other people, even if they have the same condition as you. It may harm them.

Keep neomycin/polymyxin B/hydrocortisone otic out of the reach of children.

Neomycin/polymyxin B/hydrocortisone otic should only be applied to the ear. Do not use it in the eyes. Shake the bottle well before using. Do not touch the tip of the dropper to your ear or any other surface, including your finger. Ask your pharmacist if you are unsure how to use neomycin/polymyxin B/hydrocortisone otic. 

Contact your health care provider if your infection does not get better within one week of starting neomycin/polymyxin B/hydrocortisone otic.

What should I tell my health care provider before using neomycin/polymyxin B/hydrocortisone otic?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if neomycin/polymyxin B/hydrocortisone otic is right for you.

In particular, make sure that you discuss any of the following.

Allergies to Other Antibiotics. People who have had an allergic reaction to certain antibiotics, such as gentamicin, kanamycin, paromomycin, streptomycin, or tobramycin, may also be allergic to neomycin/polymyxin B/hydrocortisone otic. Tell your health care provider if you have had an allergic reaction to any medicine.

Pregnancy. It is not known if or how neomycin/polymyxin B/hydrocortisone otic could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant. Your health care provider will advise you if you should use neomycin/polymyxin B/hydrocortisone otic while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if neomycin/polymyxin B/hydrocortisone otic passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should use neomycin/polymyxin B/hydrocortisone otic while breastfeeding.

Interactions

Does neomycin/polymyxin B/hydrocortisone otic interact with foods or drinks?

There are no known interactions between neomycin/polymyxin B/hydrocortisone otic and foods or drinks.

There are no known interactions between neomycin/polymyxin B/hydrocortisone otic and alcohol.

Does neomycin/polymyxin B/hydrocortisone otic interact with other medicines (drug interactions)?

There are no known interactions between neomycin/polymyxin B/hydrocortisone otic and other medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much neomycin/polymyxin B/hydrocortisone otic?

If you or someone else has used too much neomycin/polymyxin B/hydrocortisone otic, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of neomycin/polymyxin B/hydrocortisone otic?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.

It is important to complete your prescribed course of neomycin/polymyxin B/hydrocortisone otic, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to neomycin/polymyxin B/hydrocortisone otic or other similar medicines.