Maxitrol (Neomycin Sulfate, Polymyxin B Sulfate, Dexamethasone)

Maxitrol is used to manage bacterial eye infections and associated inflammatory responses.

• Bacterial conjunctivitis: reduces bacterial load and inflammation, promoting faster resolution of redness and discharge.
• Keratitis: controls infection and swelling of the cornea, aiding visual recovery.
• Post‑operative ocular inflammation: limits postoperative swelling and prevents secondary bacterial contamination.
• Other ocular inflammatory conditions with bacterial involvement: alleviates pain, redness, and purulent discharge while treating the underlying infection.

• Neomycin and Polymyxin B bind to bacterial cell membranes, disrupting membrane integrity and causing rapid bacterial cell death. Dexamethasone penetrates ocular tissues and activates intracellular glucocorticoid receptors, inhibiting phospholipase A2 and downstream prostaglandin and cytokine synthesis, thereby suppressing inflammatory cell migration and edema in the eye.

Common Side Effects

• Stinging or burning sensation upon instillation.
• Transient blurred vision.
• Mild ocular itching or irritation.
• Redness of the conjunctiva.
• Foreign‑body feeling in the eye.
• Temporary tearing.

Serious or Rare Side Effects

• Allergic reaction with swelling, rash, or hives.
• Severe eye pain or worsening redness.
• Rapid vision loss or sudden visual disturbance.
• Corneal ulceration or perforation.
• Increased intra‑ocular pressure leading to glaucoma.
• Secondary ocular infection due to altered flora.

Before using Maxitrol, consider the following precautions:

• Hypersensitivity: discontinue if any signs of allergic reaction occur.
• Contact lens wear: remove lenses before instillation and wait at least 15 minutes before reinserting.
• Pre‑existing glaucoma or ocular hypertension: monitor intra‑ocular pressure regularly.
• Viral or fungal eye infections: avoid use as it may exacerbate non‑bacterial infections.
• Systemic aminoglycoside therapy: use with caution due to potential additive toxicity.
• Store at room temperature: keep in the original container, protect from light and moisture.

Maxitrol may interact with other ophthalmic agents and systemic drugs.

Major Interactions (Avoid)

• Concurrent use of other topical corticosteroids: may increase risk of elevated intra‑ocular pressure.
• Systemic immunosuppressants: could reduce local anti‑infective efficacy.

Moderate Interactions (Monitor Closely)

• Other ophthalmic antibiotics: assess for additive toxicity or reduced effectiveness.
• Contact lens solutions containing preservatives: may cause increased ocular irritation.
• Systemic nephrotoxic drugs: monitor renal function if prolonged ocular absorption is suspected.