Maxitrol Side Effects: What to Expect and When to Call Your Doctor

Maxitrol (neomycin/polymyxin B/dexamethasone ophthalmic) is generally well-tolerated when used as prescribed, but like all medications, it can cause side effects. Understanding the difference between common, expected effects and warning signs that require immediate medical attention is important for safe use. Here's a complete breakdown.

Common Side Effects of Maxitrol (Usually Not Concerning)

The following side effects are common and typically mild. They usually go away on their own as your eye adjusts to the medication:

Temporary blurred vision: Especially just after applying the eye drops or ointment. This clears within a few minutes. Do not drive or operate machinery if your vision is blurred.

Stinging or burning: A brief stinging or burning sensation upon application is normal and usually lasts only a few seconds.

Itching or redness: Mild irritation of the eye or eyelid is common, particularly early in treatment. This is usually mild and temporary.

Eyelid discomfort: Some patients experience minor eyelid swelling or discomfort when first starting Maxitrol.

Crusting (ointment): Maxitrol ointment can cause some crusting around the eyelid, which is expected given its thick consistency.

Serious Side Effects of Maxitrol (Call Your Doctor Right Away)

Some side effects require prompt medical attention. Contact your prescriber or eye doctor immediately if you experience any of the following:

New or worsening eye pain: If your eye pain increases while using Maxitrol rather than improving, stop use and call your doctor.

Significant vision changes: Blurred vision that doesn't clear, tunnel vision, halos around lights, or any sudden vision loss are serious signs. These could indicate elevated eye pressure (a known risk with dexamethasone).

Increased discharge or worsening redness: If your symptoms are getting worse after 2 days of use rather than improving, re-evaluation is needed. The infection may be resistant, fungal, or viral in nature — none of which Maxitrol can treat.

Signs of allergic reaction: Hives, difficulty breathing, swelling of the face, lips, or tongue — though rare with ophthalmic use, an allergic reaction is an emergency. Call 911 or seek emergency care immediately.

Neomycin sensitization (skin reaction): Neomycin is one of the most common causes of allergic contact dermatitis. If you develop itching, redness, or swelling of the eyelid or surrounding skin that gets progressively worse, you may be developing neomycin sensitization. Tell your doctor.

Long-Term Risks: What Happens With Prolonged Use

Maxitrol is intended for short-term use, typically 7 to 10 days. Using it for extended periods carries additional risks:

Elevated intraocular pressure (IOP): Dexamethasone can raise eye pressure in susceptible patients, increasing the risk of glaucoma and optic nerve damage. IOP should be monitored if Maxitrol is used for 10 days or more.

Cataracts: Long-term corticosteroid use is associated with posterior subcapsular cataract formation.

Secondary infections: Prolonged antibiotic use can lead to overgrowth of non-susceptible organisms, including fungi or viruses. The steroid component can also suppress the immune response, potentially masking a new infection.

Corneal or scleral thinning: In rare cases, prolonged use can thin the cornea or sclera, potentially leading to perforation.

Special Warnings: Who Is at Higher Risk?

Certain groups face higher risk from Maxitrol side effects and need extra monitoring:

Patients with glaucoma or a family history of glaucoma (dexamethasone-related IOP elevation is more likely in "steroid responders")

Patients with a history of neomycin allergy or aminoglycoside sensitivity

Pregnant women (use only if clearly needed, as dexamethasone has shown teratogenicity in animal studies)

Children under 2 years old (safety and efficacy of the suspension not established below age 2)

Tips to Minimize Side Effects

Use exactly as prescribed — don't use more drops or use it longer than directed

Wash hands before applying; avoid touching the dropper tip to your eye or any surface

Do not wear contact lenses while using Maxitrol

Apply gentle pressure to the inner corner of your eye (nasolacrimal duct) for 1-2 minutes after each drop to reduce systemic absorption

For information on what other medications can interact with Maxitrol, see our companion article on Maxitrol drug interactions.