Indications & Uses
Polymyxin B Sulfate is a drug of choice for acute infections of the urinary tract, meninges and bloodstream caused by susceptible strains of Pseudomonas aeruginosa. It may also be indicated in serious infections caused by susceptible strains of some other organisms, when less potentially toxic drugs are ineffective or contraindicated. These are H. influenzae (specifically meningeal infections), Escherichia coli (specifically urinary tract infections), Aerobacter aerogenes (specifically bacteremia) and Klebsiella pneumoniae (specifically bacteremia).
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
For intravenous use, dissolve Polymyxin B 500,000 units in 300 to 500 ml of solutions for parenteral use, Dextrose injection 5%, and give it as a continuous drip. For intramuscular use, dissolve Polymyxin B 500,000 units in 2 ml of 0.9% Sodium Chloride solution. This route is not recommended routinely because of severe pain at the injection site, particularly in infants and children. For intrathecal use, dissolve Polymyxin B 500,000 units in 10 ml of 0.9% Sodium Chloride solution, which gives a dosage unit of 50,000 units per ml. In meningeal infections, Polymyxin B Sulfate should be given only by the intrathecal route.
For the IV route, adults and children with normal kidney function get a dose of 15,000 to 25,000 units/kg/day, and this should not exceed 25,000. The dosage frequency and duration is that infusions may be given every 12 hours over a period of approximately 60 to 90 minutes. Adults and children with renal impairment get a dose of less than 15,000 units/kg/day, with the same dosage frequency and duration, so infusions may be given every 12 hours over approximately 60 to 90 minutes. Infants with normal kidney function get a maximum of 40,000 units/kg/day.
For the IM route, adults and children get a dose of 25,000 to 30,000 units/kg/day. On dosage frequency and duration, the dose should be reduced in the presence of renal impairment. The dosage may be divided and given at either 4 or 6 hour intervals. Infants with normal kidney function get a maximum of 40,000 units/kg/day.
For the intrathecal route, children under 2 years of age have a dosage frequency and duration of 20,000 units once daily, given intrathecally for 3 to 4 days, or 25,000 units once every other day. Continue with 25,000 units once every other day for at least 2 weeks after cultures of the cerebrospinal fluid are negative and the sugar content has returned to normal. Adults and children over 2 years of age get 50,000 units once daily for 3 to 4 days, then 50,000 units once every other day for at least 2 weeks after cultures of the cerebrospinal fluid are negative and the sugar content has returned to normal.
Side Effects
Clostridium difficile associated diarrhea has been reported with Polymyxin B Sulfate. Kidney (nephrotoxic) reactions include albuminuria, cylinduria, azotemia and rising blood levels. Nerve (neurotoxic) reactions include facial flushing, and dizziness that can progress to ataxia. Drowsiness and peripheral paresthesias (around the mouth, and in a stocking and glove pattern) are also seen. Apnea can occur when Polymyxin B Sulfate is used together with curariform muscle relaxants or other neurotoxic drugs, or after an accidental overdose. When it is given intrathecally, signs of meningeal irritation can appear, for example fever, headache and stiff neck. Other reactions are reported from time to time. These are drug fever, urticarial rash, severe pain at IM injection sites and thrombophlebitis at IV injection sites.
Cautions & Contraindications
Warnings & Precautions
Check the patient's kidney function before starting Polymyxin B Sulfate. While the medicine is being given by injection, keep checking kidney function often, and check the blood levels of the drug as well.
Pregnancy & Breastfeeding
No controlled data exist on the use of Polymyxin B Sulfate in human pregnancy, so its safety during pregnancy has not been established. There is also no recommendation about using it while breastfeeding, and no study has looked at whether it passes into human milk.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
Toxicity from Polymyxin B Sulfate overdose has been reported. Too much of the medicine can cause neuromuscular blockade, which may lead to apnea, muscular weakness, vertigo, transient facial paresthesia, slurred speech, vasomotor instability, visual disturbance, confusion, psychosis and possibly respiratory arrest. It can also cause renal failure, seen as decreased urine output and raised serum concentrations of BUN and creatinine.
There is no specific antidote for Polymyxin B Sulfate overdose. If an overdose happens, the drug should be stopped and symptomatic treatment started. Quick diuresis with IV mannitol may help the kidneys clear the drug faster and so lower serum drug levels. Hemodialysis or peritoneal dialysis may help in managing the renal complications.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Before reconstitution, keep Polymyxin B Sulfate at a temperature not above 30°C, away from light and out of the reach of children. Once it has been reconstituted or diluted, store any unused portion at 2° to 8°C. Throw it away after 72 hours if it hasn't been used.
Drug Interactions
Common questions about Lipoxin B
What is Lipoxin B Injection?
Lipoxin B Injection is a medicine that contains Polymyxin B Sulfate. It is made by Opsonin Pharma Limited. It belongs to the Other antibacterial preparation group of medicines.
What is Lipoxin B used for?
Polymyxin B Sulfate is a drug of choice for acute infections of the urinary tract, meninges and bloodstream caused by susceptible strains of Pseudomonas aeruginosa. It may also be indicated in serious infections caused by susceptible strains of some other organisms, when less potentially toxic drugs are ineffective or contraindicated.
What are the side effects of Lipoxin B?
Clostridium difficile associated diarrhea has been reported with Polymyxin B Sulfate. Kidney (nephrotoxic) reactions include albuminuria, cylinduria, azotemia and rising blood levels.
Can I take Lipoxin B during pregnancy or while breastfeeding?
No controlled data exist on the use of Polymyxin B Sulfate in human pregnancy, so its safety during pregnancy has not been established. There is also no recommendation about using it while breastfeeding, and no study has looked at whether it passes into human milk. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Lipoxin B?
Toxicity from Polymyxin B Sulfate overdose has been reported. Too much of the medicine can cause neuromuscular blockade, which may lead to apnea, muscular weakness, vertigo, transient facial paresthesia, slurred speech, vasomotor instability, visual disturbance, confusion, psychosis and possibly respiratory arrest. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Lipoxin B?
Before reconstitution, keep Polymyxin B Sulfate at a temperature not above 30°C, away from light and out of the reach of children. Once it has been reconstituted or diluted, store any unused portion at 2° to 8°C.
Can I take other medicines with Lipoxin B?
Some medicines can interact with Polymyxin B Sulfate, for example: Cyclosporine, Etodolac, Amikacin, Gentamicin, Ibuprofen, Misoprostol. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Lipoxin B?
Lipoxin B is a prescription (Rx) medicine. Take it as your doctor advises.