Neomycin, Colistin, Hydrocortisone, and Thonzonium

• It is used to treat ear infections.

• Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists.
• Do not use longer than you have been told. A second infection may happen.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using neomycin, colistin, hydrocortisone, and thonzonium while you are pregnant.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Keep out of your eyes.
• To gain the most benefit, do not miss doses.
• Keep using neomycin, colistin, hydrocortisone, and thonzonium as you have been told by your doctor or other health care provider, even if you feel well.
• For the ear only.
• Shake suspension well before use.
• Wash your hands before and after use.
• Lie on your side with problem ear up.
• Pull the outer ear outward and upward.
• For children younger than 3 years of age, pull the outer ear outward and downward.
• Put drops in ear without touching dropper to ear. Stay on side for 2 minutes or put cotton plug in ear.

What do I do if I miss a dose?

• Use a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not use 2 doses or extra doses.

• Colistin, Hydrocortisone, Neomycin, and Thonzonium
• Hydrocortisone, Neomycin, Colistin, and Thonzonium
• Thonzonium, Neomycin, Colistin, and Hydrocortisone

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Suspension, otic [drops]:

Coly-Mycin S: Neomycin 0.33%, colistin 0.3%, hydrocortisone acetate 1%, and thonzonium bromide 0.05% (5 mL [DSC], 10 mL) [contains thimerosal]

Cortisporin-TC: Neomycin 0.33%, colistin 0.3%, hydrocortisone acetate 1%, and thonzonium bromide 0.05% (10 mL [DSC]) [contains thimerosal]

For otic use only. Shake otic suspension well before using. Thoroughly cleanse external auditory canal and dry with a sterile cotton applicator. Patient should lie down with affected ear upward and medication instilled. This position should be maintained for 5 minutes to facilitate penetration of the drops. Repeat, if necessary, for the opposite ear. Alternatively, a cotton wick may be inserted into the canal and the cotton may be saturated with the suspension; keep wick moist by adding suspension every 4 hours. Replace wick at least once every 24 hours. Otic preparations should not be used when the integrity of the tympanic membrane is in question (AAP [Rosenfeld 2014]).

Neomycin sensitization (eg, low-grade reddening with swelling, dry scaling, itching, failure to heal)

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience burning or stinging. Have patient report immediately to prescriber severe ear irritation, severe skin irritation, or hearing impairment (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.