neomycin / polymyxin B / dexamethasone
Maxitrol is an eye drop medication and eye ointment that's used to treat and relieve bacterial eye infections. Maxitrol is a combination medication — it contains two antibiotics (neomycin and polymyxin B) and a corticosteroid (dexamethasone). The antibiotics help fight the infection, while the corticosteroid helps lessen eye inflammation. Maxitrol typically has few to no side effects when it's used as directed, but it's usually used multiple times throughout the day.
What is Maxitrol?
What is Maxitrol used for?
Eye inflammation from a bacterial infection in the eye
Eye inflammation when there's a risk for a bacterial infection in the eye
How Maxitrol works
Maxitrol is a combination of three medications.
Neomycin is an antibiotic. It kills bacteria by preventing them from making proteins that they need to survive.
Polymyxin B is another antibiotic that kills bacteria. It destroys the bacteria's protective covering.
Dexamethasone is a corticosteroid. When it’s used in the eye, it lowers the amount of chemicals that cause pain, redness, and swelling there. This helps lower eye inflammation and relieve eye pain.
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What are the side effects of Maxitrol?
Common Side Effects
- Eye irritation
Other Side Effects
- Eye redness
- Slowed eye healing
- Headache
Serious Side Effects
- Severe allergic reaction: swollen eyelids, redness, itching, rash, shortness of breath
- High eye pressure: eye pain when you move your eye or when you touch your eye
- Cataract: blurry vision, seeing double, seeing faded colors, can't see well at night, seeing a halo around lights
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Eye pain, change in vision, vision loss
- New or worsening eye pain, redness, irritation, or discharge
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Eye irritation or itching
- Headache
Pros and cons of Maxitrol
Pros
Relieves eye inflammation and treats bacterial eye infection at the same time
Combines three medications into one eye product for convenience
Can usually start to see improvement after 2 days of use
Available as a lower-cost generic
Cons
Need to use multiple times a day
Can cause temporary blurry vision
Requires an eye exam to check your eye pressure if you need to use for more than 10 days
Only treats some bacterial eye infections; it doesn't treat fungal or viral infections
Pharmacist tips for Maxitrol
Use Maxitrol as instructed by your care team. Make sure you use the medication for as long as prescribed, even if your eye starts to get better. Your infection might come back or become harder to treat if you stop using the medication too soon.
Let your primary care provider know if your eye inflammation or eye infection gets worse or if it lasts more than 2 days after you start using Maxitrol. You might need to get your eye examined to see whether the medication is the most appropriate treatment for you.
Don't let the tip of the Maxitrol bottle or tube touch the eye, eyelid, or other surfaces. Don't touch the tip with your fingers. Always wash your hands with soap and water before and after you use Maxitrol. It's important to prevent getting the medication contaminated because using contaminated medication in the eye can cause new or worsened eye infection.
Maxitrol can cause temporary blurry vision. Don't drive a car or operate machinery until you know how Maxitrol affects how well you see and until you can see clearly.
Contact your primary care provider or optometrist if you need more than 4 bottles of Maxitrol eye drops or more than 2 tubes of Maxitrol eye ointment. Also call them if you need to use this medication for more than 10 days. They'll examine your eye and make sure the medication is appropriate and safe for you.
How to use Maxitrol eye drops (ophthalmic suspension):
To use the eye drops, gently pull down your lower eyelid with one hand. Hold the bottle upside down with the other hand so that the bottle tip is right above your eye. Squeeze the bottle to get the number of drops you need in the eye. Then, close your eye and press your finger to the inner corner of your eye for a minute. This helps the medication stay in your eye and prevents it from leaking into the nose.
If you need to use another eye drop in the same eye, wait at least a few minutes in between drops so the second eye drop doesn't rinse off the first one.
How to use Maxitrol eye ointment:
First, tilt your head back. Then, pull down your lower eyelid with one hand and hold the tube of ointment with the other.
Place a small amount (about one-half of an inch) of ointment in the space between your eyelid and eyeball. Look down before closing your eye. Keep your eye closed for 1 to 2 minutes. This helps the medication cover all areas of the eye.
Frequently asked questions about Maxitrol
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What are the risks and warnings for Maxitrol?
Maxitrol can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Only use on the surface of the eye
Use Maxitrol on the surface of the eye only. Don't place the medication in your mouth, nose, or anywhere else on your body. Also don't use Maxitrol as an injection into any parts of the eye.
Higher eye pressure
Risk factors: Using Maxitrol for more than 10 days | History of glaucoma
Using eye medications that contain a steroid for a long time can raise the pressure in your eye. This can damage the eye and cause vision problems. Talk with your prescriber about the risks and benefits of using Maxitrol (contains the steroid dexamethasone) if you have glaucoma or high eye pressure.
Your prescriber might recommend that you get an eye exam to check your eye pressure and make sure that Maxitrol is safe for you to use. Your prescriber is more likely to suggest regular eye exams if you need to use Maxitrol for more than 10 days.
You don't usually have symptoms when your eye pressure is high. But you might feel pain when you move your eye around or when you touch your eye if you have high eye pressure. Talk with your primary care provider or optometrist right away if you have eye pain or any vision problems while you're using Maxitrol.
New or worsened eye infections
Risk factors: Using Maxitrol for more than 10 days
Using Maxitrol long term can raise the risk of developing other eye infections, such as fungal or bacterial eye infections. Don't use Maxitrol if you have a viral eye infection because it can make your infection worse. Contact your primary care provider or urgent care if you have eye pain or redness, blurry vision, sensitivity to light, or watery discharge from your eye. These can be signs of a new eye infection that you should get examined.
New eye problems (e.g., injury, cataracts)
Risk factors: History of cataract | Using Maxitrol for more than 10 days
In some cases, using Maxitrol might cause your cornea (the clear, outer layer of the eye) or the "whites" of the eye to thin. Sometimes, this can lead to eye damage. Using Maxitrol for a long time can also cause cataracts (clouding of eye lens) to form. Get medical help right away if you have vision loss, blurry vision, or eye pain or if you your eye is more watery than usual.
Additionally, using Maxitrol after a cataract surgery might also slow down the healing process and raise the risk of fluid buildup in the eye. Speak with your eye surgeon if you’ve just had cataract surgery and you're having eye or vision problems.
Possible allergic reaction
Medications that contain neomycin, such as Maxitrol, can cause allergic reactions. Before you're prescribed Maxitrol, let your primary care provider or a member of the urgent care team know if you're allergic to neomycin or other similar antibiotics, such as gentamicin (Gentak) or tobramycin (Tobrex). It's possible that you could have an allergic reaction to Maxitrol.
Watch out for symptoms of allergic reactions, such as swollen eyelids, red or itchy eyes, or skin rash, while you're using Maxitrol. Stop using the medication and call your primary care provider if you have an allergic reaction. These reactions usually go away on their own once you stop the medication.
You might also be allergic to Maxitrol if your eye doesn't get better after you've used the medication for a while. Contact your primary care provider if your eye doesn't improve after a couple days of using the medication.
Maxitrol dosage forms
Typical dosing for Maxitrol
Maxitrol contains 3.5 mg of neomycin; 10,000 units of polymyxin B; and 0.1% of dexamethasone.
Eye drops (ophthalmic suspension): The typical dose is 1 to 2 drops in the affected eye(s) up to 4 to 6 times daily. Depending on how serious the eye inflammation is, your prescriber might ask you to use the eye drops more often (every hour) at the beginning of treatment and then go to 4 to 6 times daily as your eye starts getting better.
Eye ointment: The typical dose is one-half of an inch of ointment in the affected eye(s) up to 3 or 4 times daily.
How much does Maxitrol cost?
Maxitrol contraindications
Eye infections caused by viruses, such as varicella (from chickenpox or shingles) or herpes
Mycobacterial or fungal eye infections
What are alternatives to Maxitrol?
Eye inflammation from a bacterial infection in the eye
Eye inflammation when there's a risk for a bacterial infection in the eye
Eye inflammation from a bacterial infection in the eye
Eye inflammation when there's a risk for a bacterial infection in the eye
Eye inflammation caused by or at risk of a bacterial infection
What is the latest news about Maxitrol?
Maxitrol images
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References
Best studies we foundAmerican Academy of Allergy, Asthma, and Immunology. (2024). Tips for administering eye drops.
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American Academy of Ophthalmology. (2016). Sclera.
American Optometric Association. (n.d.). Hordeolum (stye).
American Optometric Association. (n.d.). Ocular hypertension.
Bausch & Lomb Incorporated. (2022). Neomycin polymyxin B sulfates and dexamethasone- neomycin sulfate, polymyxin b sulfate and dexamethasone suspension/ drops [package insert]. DailyMed.
Bausch & Lomb Incorporated. (2023). Neomycin polymyxin B sulfates and dexamethasone- neomycin sulfate, polymyxin b sulfate and dexamethasone ointment [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). Ear infections basics.
Centers for Disease Control and Prevention. (2024). Fungal eye infections basics.
Centers for Disease Control and Prevention. (2024). Symptoms of pink eye.
Centers for Disease Control and Prevention. (2024). What causes HSV (herpes simplex virus) keratitis.
Chaudhary, O. R., et al. (2022). Can I wear contact lenses while I have pink eye? American Academy of Ophthalmology.
Fung, A. T., et al. (2019). Local delivery of corticosteroids in clinical ophthalmology: A review. Clinical & Experimental Ophthalmology.
Hirschfield, G. S. (2019). Can I wear contacts while using eye ointment? American Academy of Ophthalmology.
Hodgens, A., et al. (2023). Corticosteroids. StatPearls.
MedlinePlus. (2016). Mycobacterial infections.
Porter, D., et al. (2022). Antibiotic eye drops. American Academy of Ophthalmology.
Roat, M. I. (2023). Herpes zoster ophthalmicus. Merck Manual Consumer Version.
SafeMedication. (n.d.). How to use eye ointments and gels.
Shah, T. J., et al. (2018). "Doctor, I have a sulfa allergy": Clarifying the myths of cross-reactivity. Ophthalmology and Therapy.
Syed, Z. A., et al. (2023). Infectious conjunctivitis. Merck Manual Consumer Version.
Trimble, M. J., et al. (2016). Polymyxin: Alternative mechanisms of action and resistance. Cold Spring Harbor Perspectives in Medicine.
Veirup, N., et al. (2023). Neomycin. StatPearls.
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