In the U.S.—

In Canada—

• Antibacterial-corticosteroid, otic

Colistin, neomycin, and hydrocortisone (koe-LIS-tin, nee-oh-MYE-sin, and hye-droe-KOR-ti-sone) combination contains two antibiotics and a cortisone-like medicine. It is used in the ear to treat infections of the ear canal and to help provide relief from redness, irritation, and discomfort of certain ear problems.

Colistin, neomycin, and hydrocortisone combination is available only with your doctor's prescription, in the following dosage form:

Otic
• Suspension (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For colistin, neomycin, and hydrocortisone combination, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or to any related antibiotics such as amikacin (e.g., Amikin), colistin by mouth or by injection (e.g., Coly-Mycin), gentamicin (e.g., Garamycin), kanamycin (e.g., Kantrex), neomycin by mouth or by injection (e.g., Mycifradin), netilmicin (e.g., Netromycin), paromomycin (e.g., Humatin), polymyxin B (e.g., Aerosporin), streptomycin, or tobramycin (e.g., Nebcin). Also tell your health care professional if you are allergic to any other substances, such as thimerosal or other preservatives.

Pregnancy—Colistin, neomycin, and hydrocortisone otic drops have not been shown to cause birth defects or other problems in humans.

Breast-feeding—Colistin, neomycin, and hydrocortisone otic drops have not been reported to cause problems in nursing babies.

Children—Although there is no specific information comparing use of colistin, neomycin, and hydrocortisone combination in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of colistin, neomycin, and hydrocortisone combination in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine that is to be used in the ear.

• Other ear infection or problem, including punctured eardrum—Use of colistin, neomycin, and hydrocortisone combination may make the condition worse or may increase the chance of side effects

• Herpes simplex—Use of hydrocortisone may make the condition worse

Before applying this medicine, thoroughly clean the ear canal and dry it with a sterile cotton applicator.

You may warm the ear drops to body temperature (37 °C or 98.6 °F), but no higher, by holding the bottle in your hand for a few minutes before applying. If this medicine gets too warm, it may break down and not work properly.

To apply this medicine:

• Lie down or tilt the head so that the infected ear faces up. Gently pull the earlobe up and back for adults (down and back for children) to straighten the ear canal. Drop the medicine into the ear canal. Keep the ear facing up for about 5 minutes to allow the medicine to coat the ear canal. (For young children and other patients who cannot stay still for 5 minutes, try to keep the ear facing up for at least 1 or 2 minutes.) Your doctor may have inserted a gauze or cotton wick into your ear and may want you to keep the wick moistened with this medicine. Your doctor also may have other directions for you, such as how long you should keep the wick in your ear or when you should return to your doctor to have the wick replaced. If you have any questions about this, check with your doctor.

To keep the medicine as germ-free as possible, do not touch the dropper to any surface (including the ear). Also, keep the container tightly closed.

Do not use this medicine for more than 10 days unless otherwise directed by your doctor.

To help clear up your infection completely, keep using this medicine for the full time of treatment, even if your symptoms begin to clear up after a few days. If you stop using this medicine too soon, your symptoms may return. Do not miss any doses.

Dosing—

The dose of otic colistin, neomycin, and hydrocortisone combination will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of otic colistin, neomycin, and hydrocortisone combination. If your dose is different, do not change it unless your doctor tells you to do so.

• For otic suspension (ear drops) dosage form:
  • For infections of the ear canal:
    • Adults—Use four drops in the ear every six to eight hours.
    • Children—Use up to three drops in the ear every six to eight hours.

Missed dose—

If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

If your symptoms do not improve within 1 week, or if they become worse, check with your doctor immediately.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• More common
  • Itching, skin rash, redness, swelling, or other sign of irritation not present before use of this medicine 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.