Hydrocortisone Acetate + Neomycin Sulphate

Indications

This preparation is indicated in Allergic skin conditions, Anal or vulvar pruritus, Anal pruritus, Burns, Eczema, Infected wounds & ulcers, Pain and itching caused by sunburn, Pruritic skin conditions, Pruritus, Pruritus and eczema, Pyogenic & seborrhoeic dermatitis, Seborrhoeic dermatitis, Ulcers, Vaginal or rectal irritation, Wounds

Pharmacology

Hydrocortisone is a corticosteroid used for its anti-inflammatory and immunosuppressive effects. Its anti-inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy in adrenocortical insufficiency.

Neomycin is an aminoglycoside antibiotic. It binds to 30S ribosomal subunits of bacterial ribosome thus inhibiting protein synthesis and generating errors in genetic code transcription causing cell death. It acts against many gram-negative aerobes and some gram-positive aerobes. It lacks activity against fungi, viruses and most anaerobic bacteria

Dosage & Administration

Adult: Apply this preparation into the affected area as directed by physician.

Interaction

Hydrocortisone: Thiazides may enhance hyperglycaemia and hypokalaemia caused by corticosteroids. Increased incidence of peptic ulcer or Gl bleeding with concurrent NSAIDs admin. Response to anticoagulants altered. Dose of antidiabetics and antihypertensives needs to be increased. Decreases serum cone of salicylates and antimuscarinic agents. Ethanol may enhance gastric mucosal irritation. Reduced efficacy with concurrent use of carbamazepine, phenytoin, primidone, barbiturates and rifampicin. Mutual inhibition of metabolism between ciclosporin and corticosteroids increase plasma cone of both drugs. Enhanced effect in women taking oestrogens or oral contraceptives.

Neomycin: Additive nephrotoxic and neurotoxic effect with other aminoglycosides (e.g. paromomycin), bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin. Enhanced toxicity with potent diuretics (e.g. ethacrynic acid, furosemide). May impair the absorption of other drugs (e.g. phenoxymethylpenicillin, digoxin, methotrexate and some vit). May reduce the efficacy of OCs. May enhance the effect of acarbose. May enhance the effect of non-depolarising muscle relaxants. May antagonise the parasympathomimetic effect of neostigmine and pyridostigmine. May increase the risk of hypocalcaemia in patients receiving bisphosphonates. May alter INR when given with anticoagulants. May inactivate oral typhoid vaccine.

Contraindications

Viral/ fungal infections, tubercular or syphilitic lesions, bacterial infections unless used in conjunction with appropriate chemotherapy.

Side Effects

Burning, itching, irritation, hypopigmentaion, skin atrophy, striae.

Pregnancy & Lactation

Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

Precautions & Warnings

CHR hypertension, DM, epilepsy, elderly, patients on prolonged therapy. Gradual withdrawal, pregnancy and lactation.

Therapeutic Class

Hydrocortisone & Combined preparations, Local Antipruritic