Maxitrol

Leaflet accompanying the packaging: patient information

Warning! The leaflet should be kept. Information on the immediate packaging in a foreign language.

Maxitrol (Maxidrol)

(1 mg + 3500 IU + 6000 IU)/g, eye ointment
Dexamethasone + Neomycin sulfate + Polymyxin B sulfate
Maxitrol and Maxidrol are different trade names for the same drug.
You should carefully read the contents of the leaflet before using the drug, as it contains
important information for the patient.

• You should keep this leaflet so that you can read it again if necessary.
• In case of any doubts, you should consult a doctor, pharmacist, or nurse.
• This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
• If the patient experiences any side effects, including any side effects not listed in this leaflet, they should inform their doctor, pharmacist, or nurse. See section 4.

Table of contents of the leaflet

• 1. What is Maxitrol and what is it used for
• 2. Important information before using Maxitrol
• 3. How to use Maxitrol
• 4. Possible side effects
• 5. How to store Maxitrol
• 6. Contents of the packaging and other information

1. What is Maxitrol and what is it used for

Maxitrol is used to treat inflammatory eye diseases, which may be accompanied by

infection. Eye inflammation can be caused by infection or other factors
entering the eye or eye injuries.
Maxitrol is a combination drug containing antibacterial and corticosteroid components.
Corticosteroids (in this case, dexamethasone) are used to prevent and reduce
eye inflammation. The antibacterial drugs contained in the drug (in this case, neomycin
sulfate and polymyxin B sulfate) are active against most pathogenic bacteria
causing eye infections.

2. Important information before using Maxitrol

When not to use Maxitrol

• to neomycin sulfate, polymyxin B sulfate, dexamethasone, or any of the other components of this drug (listed in section 6),
• herpetic keratitis, chickenpox, shingles, or any other viral eye infection,
• fungal eye infection,
• untreated parasitic eye infections,
• tubercular eye infection,
• untreated purulent eye infections.

Warnings and precautions

For use in the eyes only.

• In some patients, hypersensitivity to topically applied aminoglycoside antibiotics, such as neomycin, may occur. If symptoms of hypersensitivity occur, the drug should be discontinued and the doctor should be consulted immediately (see section 4). Hypersensitivity reactions may occur in the form of local itching or skin redness, severe allergic reactions (anaphylactic reactions), or severe skin reactions. Such skin reactions may occur during the use of other topical or systemic antibiotics from the same family (aminoglycosides).
• Additionally, topical use of neomycin may lead to redness, irritation, and skin discomfort.
• Patients who have experienced hypersensitivity symptoms to topically applied neomycin may also be hypersensitive to other antibiotics.
• If the patient is using other antibiotics during treatment with Maxitrol, they should consult a doctor, as concurrent use of Maxitrol with other antibiotics may cause serious side effects.
• In patients using corticosteroids for a long time, the following may occur:
• increased intraocular pressure. Intraocular pressure should be regularly monitored during the use of this drug. This is especially important in pediatric patients, as corticosteroid-induced increased intraocular pressure may be greater and occur earlier in children than in adults. The doctor should be consulted, especially in the case of children. The risk of increased intraocular pressure and (or) cataract is also higher in patients with predisposing factors (e.g., diabetes).
• development of Cushing's syndrome caused by the drug entering the bloodstream. The doctor should be consulted if the patient experiences swelling and weight gain, especially on the trunk and face, as these are usually the first symptoms of Cushing's syndrome. Adrenal insufficiency may occur as a result of discontinuing long-term or intensive use of Maxitrol. The doctor should be consulted before the patient decides to discontinue treatment. This risk is particularly important in children and patients treated with ritonavir or cobicistat.
• In case of occurrence or worsening of eye infection symptoms, the doctor should be consulted immediately. Patients using Maxitrol may have reduced resistance to eye infections, including bacterial and fungal infections resistant to antibiotic treatment.
• In patients using corticosteroids and non-steroidal anti-inflammatory drugs concurrently, problems with healing of eye surface damage may occur.
• If the patient has diseases leading to thinning of the cornea or sclera, they should inform their doctor.
• It is not recommended to use contact lenses during the treatment of eye inflammation or infection.

If the patient experiences blurred vision or other vision disturbances, they should consult their doctor.
If the patient has glaucoma, the treatment period should be limited to two weeks, unless the doctor recommends otherwise.
The drug should be used for as long as recommended by the doctor. If the symptoms of the disease worsen or do not improve, the doctor should be consulted.

Children

The safety and efficacy of Maxitrol in children have not been established, so its use is not recommended in this age group.

Maxitrol and other drugs

The doctor or pharmacist should be informed about all drugs currently or recently used by the patient, as well as any drugs planned to be used, including those available without a prescription.
Particular attention should be paid to informing the doctor if the patient is taking:

• topically applied non-steroidal anti-inflammatory drugs. Concurrent topical use of a steroid drug and a non-steroidal anti-inflammatory drug may cause problems with healing of eye injuries;
• ritonavir or cobicistat, as they may increase the dexamethasone content in the blood. If the patient is using other eye drops or ointments, a minimum of 5 minutes should be allowed between administrations of consecutive drugs. Eye ointments should be used last.

Pregnancy, breastfeeding, and fertility

If the patient is pregnant or breastfeeding, thinks they may be pregnant, or plans to have a child, they should consult their doctor or pharmacist before using this drug. The drug is not recommended during pregnancy or breastfeeding.

Driving and using machines

Maxitrol has no or negligible influence on the ability to drive and use machines.
For some time after administration of Maxitrol, vision may be blurred. The patient should not drive or operate machines until this symptom subsides.
Maxitrol contains methyl parahydroxybenzoate (E 218) and propyl parahydroxybenzoate
(E 216), which may cause allergic reactions (possible late reactions).
The drug contains lanolin, which may cause local skin reactions (e.g., contact dermatitis).

3. How to use Maxitrol

Maxitrol should always be used as recommended by the doctor. In case of doubts, the doctor or pharmacist should be consulted.
Maxitrol is intended exclusivelyfor administration to the eyes; only one patient should use the drug from one package.
If the patient is using other eye drops or ointments concurrently, a minimum of 5 minutes should be allowed between administrations of consecutive drugs. Eye ointments should be used last.

Recommended dose

Usually, a small amount of ointment (a strip about 1.5 cm long) is instilled into the conjunctival sac of the affected eye (eyes) up to 3 or 4 times a day. The doctor will determine the duration of treatment. Treatment should not be discontinued prematurely.

• 1. Prepare the tube with Maxitrol and a mirror.

• 2. Wash your hands.
• 3. Unscrew the tube.
• 4. Take the tube in your hand, holding it between your thumb and index finger.
• 5. Tilt your head back. Pull the lower eyelid down with a clean finger to form a "pocket" between the eyelid and the eyeball. The ointment strip should be placed in this pocket (Figure 1).
• 6. Bring the tube tip close to the eye, using a mirror to help.
• 7.

Do not touch the eye, eyelids, surrounding surfaces, or other

surfaces with the tube tip.Failure to follow this recommendation may cause infection of the ointment.

• 8. Gently squeeze the tube to expel a strip of ointment (Figure 2).
• 9. After using Maxitrol, release the lower eyelid and blink several times to distribute the drug over the entire eye surface. Gently close your eyelids for a few seconds; this will help prevent systemic absorption of the drug.
• 10. If it is necessary to administer the drug to both eyes, the above steps should be repeated for the second eye.
• 11. The tube should be screwed back on immediately after use.
• 12. Only one tube of the drug should be used at a time.

If the ointment is squeezed out of the eye,an attempt should be made to apply the ointment correctly to the eye again.

Using a higher dose of Maxitrol than recommended

In case of overdose, excess drug can be rinsed from the eye with lukewarm water. The ointment should not be used until the next scheduled dose.

Missing a dose of Maxitrol

If a dose of the drug is missed, the next scheduled dose should be taken. However, if there is little time left before the next dose is due, the missed dose should be skipped and the normal dosing schedule resumed. Do nottake a double dose to make up for a missed dose.
In case of any further doubts about the use of this drug, the doctor or pharmacist should be consulted.

4. Possible side effects

Like all drugs, Maxitrol can cause side effects, although not everybody gets them.
If the patient experiences allergic reactions, including rash, swelling of the face, lips, tongue, and (or)
throat, which may cause difficulty breathing or swallowing, or other severe
side effects, they should discontinue using Maxitrol and consult their doctor or the Emergency Department of the nearest hospital immediately.
During the use of Maxitrol, the following side effects have been observed:
Uncommon(may occur in less than 1 in 100 patients):keratitis, increased intraocular pressure, eye itching, eye discomfort, eye irritation.
Frequency not known(frequency cannot be estimated from the available data):
hypersensitivity, headache, ulcerative keratitis, blurred vision, hypersensitivity to light, pupil dilation, eyelid ptosis, eye pain, eye swelling, foreign body sensation in the eye, eye hyperemia, increased lacrimation, severe skin reactions (Stevens-Johnson syndrome), blurred vision; increased hair growth on the body (especially in women), muscle weakness, and muscle mass loss, purple striae on the skin, increased blood pressure, irregular menstrual periods or amenorrhea, changes in protein and calcium levels in the body, growth retardation in children and adolescents, and swelling and weight gain, especially on the trunk and face (a condition known as Cushing's syndrome) (see section 2 "Warnings and precautions").

Reporting side effects

If any side effects occur, including any side effects not listed in this leaflet, the doctor, pharmacist, or nurse should be informed. Side effects can be reported directly to the Department of Adverse Reaction Monitoring of Medicinal Products, Medical Devices, and Biocidal Products
Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl
Reporting side effects will help gather more information on the safety of the drug.
In case of worsening of any symptoms or occurrence of other side effects not listed in this leaflet, the doctor should be informed.

5. How to store Maxitrol

To avoid infections, the tube with the remaining drug should be discarded after 15 days from
first opening.The date of opening the tube should be noted below.
Date of first opening:
The drug should be stored out of sight and reach of children.
Store at a temperature below 25°C.
Keep the packaging tightly closed.
Do not use this drug after the expiry date stated on the packaging.
The expiry date refers to the last day of the specified month.
Drugs should not be disposed of in the sewage system or household waste containers. The pharmacist should be asked how to dispose of unused drugs. This will help protect the environment.

6. Contents of the packaging and other information

What Maxitrol contains

The active substances of the drug are:
Dexamethasone
1 mg/g
Neomycin sulfate
3500 IU/g
Polymyxin B sulfate
6000 IU/g
The excipients are: methyl parahydroxybenzoate (E 218), propyl parahydroxybenzoate (E 216), lanolin, petrolatum.

What Maxitrol looks like and what the packaging contains

Maxitrol is a thick, semi-transparent or non-transparent, white or slightly yellowish, homogeneous, lump-free ointment.
It is available in 3.5 g tubes in a cardboard box.
For more detailed information, the marketing authorization holder or parallel importer should be consulted.

Marketing authorization holder in France, the country of export:

Novartis Pharma S.A.S.
8-10, rue Henri Sainte-Claire Deville
92500 Rueil-Malmaison
France

Manufacturer:

Novartis Pharma GmbH
Roonstrasse 25
90429 Nuremberg
Germany
Alcon-Couvreur NV
Rijksweg 14
2870 Puurs
Belgium
Siegfried El Masnou S.A.
Camil Fabra, 58
08320 El Masnou
Barcelona
Spain
Novartis Farmaceutica, S.A.
Gran Via De Les Corts Catalanes, 764
08013 Barcelona
Spain

Parallel importer:

Delfarma Sp. z o.o.
ul. Św. Teresy od Dzieciątka Jezus 111
91-222 Łódź

Repackaged by:

Delfarma Sp. z o.o.
ul. Św. Teresy od Dzieciątka Jezus 111
91-222 Łódź
French marketing authorization number: 3400931983569

Parallel import authorization number: 218/15

Date of leaflet approval: 29.04.2025

[Information about the trademark]