Neofloxin-D

Indications

Eye: This medication is used to treat inflammatory ocular conditions responsive to steroids, where bacterial infections or the risk of such infections are present. It is also effective for post-operative inflammation and other ocular inflammations associated with infection.

Ear: Indicated for treating ear infections accompanied by inflammation, such as otitis externa and both acute and chronic otitis media. It is also useful for post-operative ear care.

Pharmacology

• Dexamethasone: A glucocorticoid with anti-inflammatory and anti-allergic properties. It is applied topically to reduce inflammation by inhibiting prostaglandin synthesis and the infiltration of neutrophils into inflamed areas.
• Ciprofloxacin: A broad-spectrum antibiotic effective against a variety of Gram-negative and Gram-positive bacteria. It works by interfering with DNA gyrase, essential for bacterial DNA synthesis, thus exerting its bactericidal effect.

Dosage & Administration

• Eye: Instill 1 drop into the conjunctival sac(s) every 4 to 6 hours. For the first 24 to 48 hours, increase to 1 drop every 2 hours if needed.
• Ear:
  • Acute Otitis Media in Pediatric Patients: Apply 4 drops into the affected ear twice daily for 7 days.
  • Acute Otitis Externa: Apply 4 drops into the affected ear twice daily for 7 days.
• Pediatric Use: Safety and efficacy in children under 1 year have not been established.

Interaction

No specific interaction studies have been conducted with this ophthalmic preparation. However, systemic quinolones may affect the metabolism of theophylline, caffeine, and warfarin, and can cause transient elevations in serum creatinine levels when used with cyclosporin.

Contraindications

Do not use if you have a hypersensitivity to any component of the product, or if you have herpes simplex or other viral infections, mycosis, glaucoma, or fungal infections of the eye or ear.

Side Effects

• Eye: Common side effects include transient burning or discomfort, stinging, redness, itching, and foreign body sensation. Rare side effects may include dizziness, elevated intraocular pressure, and potential glaucoma, cataract formation, and delayed wound healing.
• Ear: Common adverse effects are discomfort and ear pain. Other reactions may include irritability, dizziness, and erythema.

Pregnancy & Lactation

• Pregnancy: Use only if the potential benefit outweighs the risk to the fetus, as there are no well-controlled studies in pregnant women.
• Nursing Mothers: It is unclear if this medication is excreted in human milk. Exercise caution when administering to nursing mothers.

Precautions & Warnings

Consider the risk of fungal infections with long-term steroid use and persistent corneal ulcers. Prolonged use may also lead to overgrowth of non-susceptible organisms and potential glaucoma, optic nerve damage, visual acuity defects, and cataract formation. Regular monitoring of intraocular pressure is advised.

Therapeutic Class

Aural Steroid & Antibiotic Combination Preparations

Storage Conditions

Store in a cool, dry place away from light. Keep out of reach of children. Shake well before use. Use within 30 days of opening. Ensure the bottle is tightly closed after each use.