Maxitrol Ointment (neomycin 0.35%, polymyxin B, dexamethasone 0.1%)

Neomycin sensitization: Cutaneous sensitization may occur, ranging from local effects to erythema, itching, urticaria, skin rash, anaphylaxis, anaphylactoid reactions, or bullous reactions; discontinue if hypersensitivity develops.

Aminoglycoside cross-sensitivity: Sensitization to the topical aminoglycoside may extend to other topical or systemic aminoglycosides.

Periocular contact allergy: In a German patch test series of periorbital dermatitis, allergic contact dermatitis was the leading cause (44.3% and 31.6% across two cohorts) and neomycin sulfate ranked among the five most relevant allergens at 8%.

Prolonged steroid use: Glaucoma with optic nerve damage, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation.

Host response suppression: Prolonged use increases the hazard of secondary ocular infection and the possibility of persistent fungal corneal infection after prolonged steroid dosing; suspect fungal infection in any persistent corneal ulceration.

Infection masking: In acute purulent or parasitic ocular infection, steroids may mask infection or enhance existing infection.

Herpes simplex exacerbation: Ocular steroids may prolong the course and worsen many viral eye infections; treatment of herpes simplex requires great caution and frequent slit lamp microscopy.

Corneal or scleral thinning: Perforation has occurred with topical steroids in diseases that thin these tissues.

IOP monitoring at 10 days: Routine monitoring is required with use of 10 days or longer, including in children and uncooperative patients; use with caution in glaucoma and check IOP frequently.

Post-cataract surgery healing: Steroid use after cataract surgery may delay healing and increase the incidence of bleb formation.