Clinical medicine profile
Neomycin / Gramicidin / Nystatin / Triamcinolone Acetonide
HMG-CoA reductase inhibitor (statin)
- Route
- ORAL
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Use on rosacea acne, peri-oral dermatitis, scabies, leg ulcers, tuberculous, untreated viral, bacterial or fungal infections, reaction to smallpox vaccination, first three months of pregnancy, continous prophylactic use.
Precautions
- Limit use in children or on face to maximum of 5 days.
- It should be withdrawn gradually following prolonged therapy.
- Unless fully unavoidable, potent corticosteroids should not be used on the face as they may precipitate a rosacea-like disorder and aggravate any pre-existing rosacea, avoid use in an occluded area, near the eye, use in the presence of skin infections without concomitant use of anti-microbial, children under 1yr, on weeping foci.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Directions Clean the affected area Apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily May be covered with a sterile bandage.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Some high-intensity agents need dose limits in severe CKD.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Monitor LFTs as labelled; discontinue if persistent significant elevation.
Use, effects & interactions
Indications
- Steroid responsive dermatoses complicated or likely by both fungal and bacterial infections Clinical selection for Neomycin / Gramicidin / Nystatin / Triamcinolone Acetonide should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: HMG-CoA reductase inhibitor (statin).
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- Local irritation e.g burning sensation and itching, erythema rare, dryness of the skin, aggravation of concurrent untreated infections, thinning of the skin (this may be reversible), loss of skin elasticity, folliculitis, change in skin pigmentation, telangiectasia, purpura and steroid acne, increased growth of hair, severe pituitary-adrenal axis suppression and hypercotism, cushoid state, growth retardation, benign intra-cranial hypertension.
Drug interactions
Open multi-drug checker ↗- Fixed-dose/multi-ingredient product.
- Clinical details partially inherited from component monographs: Neomycin / Gramicidin / Nystatin / Triamcinolone Acetonide, Gramicidin, Nystatin, Triamcinolone acetonide.
- Confirm combination SmPC for exact dosing.
Mechanism & disposition
Combination product.
Read complete mechanism
Combination product. Component mechanism (Nystatin): It has both fungicidal and fungi-static properties. It binds to sterols in the cell membrane of the fungus with a resultant change in membrane permeability, allowing leakage of intracellular components and causing cell death.
Lipid effects weeks
Chronic daily therapy
ORAL
Pregnancy, lactation & diet
[From component Gramicidin] Pregnancy: Teratogenic Effects Adequate animal reproductive studies have not been conducted with neomycin, polymyxin B, or gramicidin. It is also not known whether this product can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. This product should be given to a pregnant woman only if clearly needed.
[From component Gramicidin] Nursing Mothers It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when this product is administered to a nursing woman.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| PANDERM CREAM * | Not recorded | 15GM | KES 396.24Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
| PANDERM OINT. * | Not recorded | 15GM | KES 404.24Daima Chemist price-list reference ↗ Source date not recorded · verify current price |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.