Polytrim Ophth Soln
It is used to treat eye infections.
Drug Class
Ophthalmic Anti-infective
Pharmacologic Class
Antibiotic (Folic acid antagonist + Polypeptide antibiotic)
Pregnancy Category
Category C
FDA Approved
Jun 1981
DEA Schedule
Not Controlled
Overview
What is this medicine?
Polytrim Ophthalmic Solution is an antibiotic eye drop used to treat bacterial infections of the eye, such as conjunctivitis (pink eye). It contains two different antibiotics, trimethoprim and polymyxin B, which work together to kill the bacteria causing the infection.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Continue using the medication as directed, even if your symptoms improve. This medication is for eye use only.
Administering the Medication
1. Avoid touching the container tip to your eye, lid, or surrounding skin, as this can introduce bacteria into the medication and potentially cause severe eye problems or vision loss.
2. Tilt your head back and gently drop the medication into your eye.
3. After administering the medication, keep your eyes closed and apply gentle pressure to the inside corner of your eye for 1 to 2 minutes. This helps retain the medication in your eye.
Storage and Disposal
Store this medication at room temperature, protected from light and moisture. Avoid storing it in a bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposal, consult your pharmacist. You may also have access to drug take-back programs in your area.
Missed Dose
If you miss a dose, use it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not use two doses at once or take extra doses.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Continue using the medication as directed, even if your symptoms improve. This medication is for eye use only.
Administering the Medication
1. Avoid touching the container tip to your eye, lid, or surrounding skin, as this can introduce bacteria into the medication and potentially cause severe eye problems or vision loss.
2. Tilt your head back and gently drop the medication into your eye.
3. After administering the medication, keep your eyes closed and apply gentle pressure to the inside corner of your eye for 1 to 2 minutes. This helps retain the medication in your eye.
Storage and Disposal
Store this medication at room temperature, protected from light and moisture. Avoid storing it in a bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposal, consult your pharmacist. You may also have access to drug take-back programs in your area.
Missed Dose
If you miss a dose, use it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not use two doses at once or take extra doses.
Lifestyle & Tips
- Wash hands thoroughly before and after applying eye drops.
- Do not touch the dropper tip to your eye or any other surface to avoid contamination.
- Remove contact lenses before applying drops and wait at least 15 minutes before reinserting them, or as advised by your doctor.
- Do not share eye drops with others.
- Complete the full course of treatment, even if symptoms improve, to prevent recurrence and antibiotic resistance.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Instill 1 drop into the affected eye(s) every 3 hours for a maximum of 10 days.
Condition-Specific Dosing:
bacterial_conjunctivitis:
Instill 1 drop into the affected eye(s) every 3 hours (maximum of 6 doses per day) for 7 to 10 days.
Pediatric Dosing
Neonatal:
Not established (use with caution, consult ophthalmologist)
Infant:
Instill 1 drop into the affected eye(s) every 3 hours (maximum of 6 doses per day) for 7 to 10 days (for children âĨ2 months of age).
Child:
Instill 1 drop into the affected eye(s) every 3 hours (maximum of 6 doses per day) for 7 to 10 days.
Adolescent:
Instill 1 drop into the affected eye(s) every 3 hours (maximum of 6 doses per day) for 7 to 10 days.
Dose Adjustments
Renal Impairment:
Mild:
Not applicable due to minimal systemic absorption.
Moderate:
Not applicable due to minimal systemic absorption.
Severe:
Not applicable due to minimal systemic absorption.
Dialysis:
Not applicable due to minimal systemic absorption.
Hepatic Impairment:
Mild:
Not applicable due to minimal systemic absorption.
Moderate:
Not applicable due to minimal systemic absorption.
Severe:
Not applicable due to minimal systemic absorption.
Pharmacology
Mechanism of Action
Trimethoprim is a dihydrofolate reductase inhibitor, blocking the production of tetrahydrofolic acid, an essential precursor in bacterial DNA and RNA synthesis. Polymyxin B is a polypeptide antibiotic that binds to the phospholipids of the bacterial cytoplasmic membrane, disrupting its integrity and increasing permeability, leading to leakage of intracellular components and bacterial cell death.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption from ophthalmic administration.
Tmax:
Not applicable (primarily local action)
FoodEffect:
Not applicable (ophthalmic)
Distribution:
Vd:
Not applicable (primarily local action)
ProteinBinding:
Not applicable (primarily local action)
CnssPenetration:
No (minimal systemic absorption)
Elimination:
HalfLife:
Not applicable (minimal systemic absorption)
Clearance:
Not applicable (minimal systemic absorption)
ExcretionRoute:
Not applicable (minimal systemic absorption)
Unchanged:
Not applicable (minimal systemic absorption)
Pharmacodynamics
OnsetOfAction:
Within hours (clinical improvement typically seen within 2-3 days)
PeakEffect:
Not precisely defined for ophthalmic use, but antibacterial effect is continuous with dosing.
DurationOfAction:
Approximately 3 hours (requiring frequent dosing)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
If you experience any of the following severe side effects, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Changes in eyesight, eye pain, or severe eye irritation
Eyelid swelling
Other Possible Side Effects
Most people do not experience significant side effects, but some may occur. If you experience any of the following side effects or any other unusual symptoms, contact your doctor if they bother you or do not go away:
Eye irritation
Burning or stinging
Itching
Reporting Side Effects
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical advice about side effects.
If you experience any of the following severe side effects, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Changes in eyesight, eye pain, or severe eye irritation
Eyelid swelling
Other Possible Side Effects
Most people do not experience significant side effects, but some may occur. If you experience any of the following side effects or any other unusual symptoms, contact your doctor if they bother you or do not go away:
Eye irritation
Burning or stinging
Itching
Reporting Side Effects
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical advice about side effects.
Seek Immediate Medical Attention If You Experience:
- Worsening eye redness, pain, or discharge
- New or increased itching, burning, or stinging after applying drops
- Swelling around the eyes or eyelids
- Vision changes
- Signs of an allergic reaction (e.g., rash, severe itching, difficulty breathing - seek immediate medical attention)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to avoid potential interactions between this medication and other substances.
* Any existing health problems, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is vital to verify that it is safe to take this medication with all your current medications and health conditions. Always consult your doctor before starting, stopping, or changing the dose of any medication.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to avoid potential interactions between this medication and other substances.
* Any existing health problems, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is vital to verify that it is safe to take this medication with all your current medications and health conditions. Always consult your doctor before starting, stopping, or changing the dose of any medication.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. When taking this drug, exercise caution while driving or performing tasks that require clear vision to ensure your safety. Do not exceed the prescribed duration of use, as this may increase the risk of a secondary infection. If you are pregnant, planning to become pregnant, or are breastfeeding, consult your doctor to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Unlikely with ophthalmic use due to minimal systemic absorption. Local irritation may occur with excessive application.
What to Do:
If excessive drops are instilled, flush the eye with lukewarm water. If accidental ingestion occurs, contact a poison control center or seek medical attention. Call 1-800-222-1222
Drug Interactions
Monitoring
Baseline Monitoring
Visual acuity
Rationale: To establish baseline and monitor for changes related to infection or treatment.
Timing: Prior to initiation of therapy
Ocular examination (redness, discharge, swelling)
Rationale: To assess the severity and type of infection.
Timing: Prior to initiation of therapy
Routine Monitoring
Signs and symptoms of infection (e.g., redness, discharge, pain)
Frequency: Daily
Target: Improvement/resolution
Action Threshold: Worsening symptoms or no improvement after 3-5 days; consider alternative therapy or re-evaluation.
Signs of local irritation or allergic reaction (e.g., itching, swelling, increased redness)
Frequency: Daily
Target: Absence of new or worsening irritation
Action Threshold: Development of significant irritation; discontinue use and consult physician.
Symptom Monitoring
- Eye redness
- Eye discharge
- Eye pain or discomfort
- Itching of the eye
- Swelling of the eyelids
- Blurred vision (if new or worsening)
Special Patient Groups
Pregnancy
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. While trimethoprim is Category C (potential risk in first trimester for systemic use), and polymyxin B is Category B, systemic absorption from ophthalmic use is minimal, reducing systemic exposure.
Trimester-Specific Risks:
First Trimester:
Trimethoprim (systemic) has been associated with potential teratogenic effects (e.g., neural tube defects) when used in the first trimester due to its folate antagonist activity. Risk from ophthalmic use is considered very low due to minimal systemic absorption.
Second Trimester:
Low risk due to minimal systemic absorption.
Third Trimester:
Low risk due to minimal systemic absorption.
Lactation
Caution should be exercised when administered to a nursing woman. While trimethoprim and polymyxin B are excreted in breast milk after systemic administration, systemic absorption from ophthalmic use is minimal, making infant exposure unlikely to be significant.
Infant Risk:
Low risk due to minimal systemic absorption by the mother.
Pediatric Use
Safe and effective for use in pediatric patients 2 months of age and older. Safety and effectiveness in infants younger than 2 months of age have not been established.
Geriatric Use
No overall differences in safety or effectiveness have been observed between elderly and younger patients. Dosage adjustments are generally not needed.
Clinical Information
Clinical Pearls
- Polytrim is often a good first-line choice for bacterial conjunctivitis due to its broad spectrum against common ocular pathogens and low resistance rates.
- Emphasize proper instillation technique to patients to maximize efficacy and minimize contamination.
- Advise patients that improvement should be seen within 2-3 days; if not, re-evaluation by a healthcare professional is necessary.
- This combination is particularly effective against *Haemophilus influenzae* and *Streptococcus pneumoniae*, common causes of bacterial conjunctivitis.
Alternative Therapies
- Moxifloxacin ophthalmic solution
- Gatifloxacin ophthalmic solution
- Azithromycin ophthalmic solution
- Tobramycin ophthalmic solution
- Erythromycin ophthalmic ointment
Cost & Coverage
Average Cost:
$20 - $50 per 10 mL bottle
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.