Neladex

Neladex is a complex drug with anti-inflammatory and antibacterial activity.

Neomycin is an aminoglycoside antibiotic with a broad range of therapeutic effects. It has a bactericidal effect by disrupting protein binding processes within bacterial cells.

Polymyxin B is a polypeptide antibiotic that is synthesized with phospholipids of bacterial cell walls, thereby causing their destruction.

Dexamethasone is a GCS substance that does not have a mineralocorticoid effect. It has a strong anti-inflammatory, as well as desensitizing and anti-allergic effect.

Indications Neladexa

It is used in cases of inflammation affecting the eye tissues, accompanied by the risk of superficial bacterial infection or its development (keratitis or conjunctivitis ). During such diseases, the administration of corticosteroids is prescribed.

In addition, it is prescribed in cases of external otitis (chronic or active phase) or active otitis media, not accompanied by a ruptured eardrum.

Release form

The drug is released in the form of drops, inside dropper bottles with a capacity of 5 ml.

Pharmacodynamics

The component neomycin has an effect on relatively gram-negative and -positive bacteria, including pneumococci, proteus with Staphylococcus aureus, Escherichia coli and Shigella. Its activity is quite low with respect to streptococci and Pseudomonas aeruginosa.

It has no effect on viruses and pathogenic fungi, as well as anaerobic microflora. Bacterial resistance to neomycin develops weakly and slowly.

Polymyxin B has an effect on relatively gram-negative microbes, including enterobacter, salmonella with shigella, hemophilic, intestinal and pertussis bacilli, as well as klebsiella. It has high activity against pseudomonas aeruginosa. It does not affect neisseria and proteus, and in addition to this, on gram-positive microorganisms and obligate anaerobes.

Vibrios cholerae (excluding the eltor subgroup) and Coccidioides immitis are sensitive to polymyxin B, but most fungi are resistant to this substance.

Dexamethasone successfully suppresses inflammation, the release of inflammatory mediators through eosinophils and the movement of mast cells, and at the same time strengthens the strength of capillaries.

Dosing and administration

Before using the medicine, shake the bottle. When instilling, make sure that the dropper tip does not touch the eyelids, eyes or other surfaces, as this can lead to contamination with microbes.

Mild types of pathology require instillation of 1-2 drops into the conjunctival sac (4-6 times a day). In case of severe infections, drops are used hourly, but such a regime can be used for a maximum of 2 days. The frequency of procedures can be reduced to 2-3 per day. The duration of the course of therapy is individually selected by the doctor.

After performing the instillation, it is necessary to close the eyelids tightly or perform occlusion of the nasolacrimal canal. Such manipulations allow to weaken the systemic absorption of ophthalmic substances, which reduces the risk of developing general negative symptoms.

The duration of therapy and the implementation of repeated cycles are determined by the severity of the disease and the effectiveness of the medication. Often the duration of treatment is 6-10 days.

In case of external otitis (for example, eczema of an infected nature affecting the external auditory canal) or the active phase of otitis media, not accompanied by a ruptured eardrum, 1-5 drops are instilled into both ears 2 times a day.

The duration of the course of therapy is determined by the doctor, based on the intensity and nature of the disease. On average, such a cycle lasts 1 week.

Before using the medicine, hold the bottle in your hand for a while to warm it up. The medicine cannot be administered under pressure. To instill the drops, tilt your head to the required side, and then hold it in this position for a few minutes after the procedure.

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Use Neladexa during pregnancy

The use of the drug is permitted only in situations where the potential benefit to the woman is more likely to outweigh the risks to the fetus.

Breastfeeding should be discontinued while using Neladex.

Contraindications

Main contraindications:

• severe intolerance associated with elements of the drug or other aminoglycosides;
• keratitis caused by the herpes simplex bacteria;
• viruses that affect the conjunctiva and cornea (this includes chickenpox and cowpox);
• untreated purulent eye lesions;
• suspected or diagnosed ruptured eardrum;
• eye lesions of mycobacterial origin;
• fungal infections of the ears or eyes;
• viruses that infect the ears;
• tuberculosis.

In addition, the medication cannot be prescribed after an uncomplicated procedure to remove a foreign object from the cornea.

Side effects Neladexa

The use of Neladex may cause adverse effects associated with dexamethasone or antibacterial agents, as well as their combination. General side effects may develop in case of intensive use of the drug.

Signs of intolerance are usually delayed, which is often observed with local use of neomycin.

Among the negative manifestations:

• immune disorders: increased sensitivity;
• ophthalmologic disorders: increased intraocular pressure, which may further cause glaucoma and the formation of posterior subcapsular cataracts. In addition, wound regeneration may be slowed down (in the case of diseases that cause thinning of the sclera or cornea, and in addition, perforation of the fibrous membrane associated with the local use of corticosteroids may be observed). In addition, photophobia, visual blurring, ptosis affecting the eyelids, keratitis, mydriasis, pain or discomfort in the eye area, foreign body sensation, eye irritation, conjunctivitis, increased lacrimation, discoloration of the cornea, keratoconjunctivitis sicca, visual impairment, formation of scales on the edges of the eyelids and corneal erosion may occur;
• disorders associated with the functioning of the nervous system: dizziness, dysgeusia or headaches;
• Lesions involving the subcutaneous layer and epidermis: symptoms of severe sensitivity, including irritation, redness, rash, swelling, itching and contact dermatitis.

The occurrence of secondary infections may be associated with the introduction of combinations that include antimicrobial elements and corticosteroids.

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Overdose

Clinical manifestations of Neladex intoxication (erythema, itching or swelling affecting the eyelids, punctate keratitis and increased lacrimation) may occur, which are similar to adverse effects occurring in individual patients. Prolonged intensive use may cause the development of general adverse effects.

In case of overdose of the medicine during local administration, it is necessary to wash the excess out of the eye with warm water. Symptomatic actions are performed.

Interactions with other drugs

When administering other local ophthalmic substances, it is necessary to observe a 10-15 minute interval between drug instillations.

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Storage conditions

Neladex should be stored in a place closed to children. Temperature values are within the 25°C mark.

Shelf life

Neladex can be used for a 2-year period from the date of sale of the medicine. The shelf life of an opened bottle is 1 month.

Application for children

It is prohibited to use in pediatrics, because no studies have been conducted on the effectiveness of the drug and its safety for this group.

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Analogues

The analogs of the drug are Tobrosodex, Azidex, Obradex and Dex-tobrin with Maxitrol, as well as Tobradex and Dexa-gentamicin.