Polymyxin B
- Atc Codes:A07AA05#J01XB02#S01AA18#S02AA11#S03AA03
- CAS Codes:1405-20-5#1404-26-8
- PHARMGKB ID:1405-20-5#1404-26-8
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Drug Interactions
- Genes that may be involved
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Hungary: Polysor.
North America
USA: Polymyxine B, Poly-Rx.
Latin America
Brazil: Polimixina B.
Asia
Japan: Metamyxin, Polymyxin B.
Drug combinations
Polymyxin B and Bacitracin
Polymyxin B and Dexamethasone
Polymyxin B and Neomycin
Polymyxin B and Oxytetracycline
Polymyxin B and Trimethoprim
Polymyxin B, Bacitracin, and Hydrocortisone
Polymyxin B, Bacitracin, and Neomycin
Polymyxin B, Dexamethasone, and Neomycin
Polymyxin B, Dexamethasone, and Trimethoprim
Polymyxin B, Dipyrone, and Prednisolone
Polymyxin B, Fluocinolone, and Neomycin
Polymyxin B, Gramicidin and Neomycin
Polymyxin B, Hydrocortisone, and Neomycin
Polymyxin B, Hydrocortisone, and Oxytetracycline
Polymyxin B, Miconazole, and Prednisolone
Polymyxin B, Neomycin, and Nystatin
Polymyxin B, Neomycin, and Phenylephrine
Polymyxin B, Neomycin, and Prednisolone
Polymyxin B, Bacitracin, Hydrocortisone, and Neomycin
Polymyxin B, Bacitracin, Neomycin, and Pramoxine
Polymyxin B, Dexamethasone, Neomycin, and Lidocaine
Polymyxin B, Fludrocortisone, Lidocaine, and Neomycin
Polymyxin B, Metronidazole, Miconazole, and Neomycin
Polymyxin B, Gotu Kola, Hydrocortisone, Metronidazole, Miconazole, and Neomycin
Other Polymyxin B combinations: Lactic Acid; Gelatin; Glycerin; Mineral Oil; Paraben; Titanium; Witepsol
Chemistry
Polymyxin B Sulfate: C~48~H~84~N~16~O~17~S. Mw: 1189.3426. N-2-[4-amino-2-(formylamino)butanoyl]-N-(3-amino-1-{[6,9,18-tris(2-aminoethyl)-15-benzyl-3-(2-hydroxyethyl)-12-(2-methylpropyl)-2,5,8,11,14,17,20-heptaoxo-1,4,7,10,13,16,19-heptaazacyclotricosan-21-yl]carbamoyl}propyl)homoserinamide sulfate. CAS-1405-20-5; CAS-1404-26-8 (polymyxin B).
Pharmacologic Category
Antibacterials; Polymyxins. Skin and Mucous Membrane Agents; Antibacterials. EENT Preparations; Antibacterials. Irrigation Antibiotic. (ATC-Code: A07AA05; J01XB02; S01AA18; S02AA11; S03AA03).
Mechanism of action
Binds to phospholipids, alters permeability, and damages bacterial cytoplasmic membrane permitting leakage of intracellular constituents.
Therapeutic use
Used in fixed combination with other anti-infectives (e.g. bacitracin, neomycin, gramicidin, trimethoprim) for treatment of superficial eye infections caused by susceptible bacteria. Used in fixed combination with corticosteroids and other anti-infectives in certain bacterial ocular infections. Used in fixed combination with corticosteroids (with or without other anti-infectives) for treatment of otitis externa caused by susceptible bacteria.
Pregnancy and lactiation implications
Safety in pregnant women not established. Excretion in breast milk unknown (use caution).
Unlabeled use
Contraindications
Hypersensitivity to polymyxin B or any component of the formulation. Concurrent use of neuromuscular blockers.
Warnings and precautions
May cause nephrotoxicity (avoid concurrent or sequential use of other nephrotoxic drugs (e.g. aminoglycosides)). May cause neurotoxicity, which can also result in respiratory paralysis from neuromuscular blockade, especially when drug is given soon after anesthesia or muscle relaxants (avoid concurrent or sequential use of other neurotoxic drugs). Neurotoxic reactions usually associated with high serum levels, often in renal dysfunction. Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Use with caution in impaired renal function. I.M./intrathecal administration only to hospitalized patients. Polymyxin B most toxic when given parenterally (avoid parenteral use whenever possible).