Comparative Pharmacology
Head-to-head clinical analysis: KERLEDEX versus MAXITROL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: KERLEDEX versus MAXITROL.
KERLEDEX vs MAXITROL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Kerledex is a selective serotonin reuptake inhibitor (SSRI) that potentiates serotonergic activity in the CNS by inhibiting the reuptake of serotonin at the presynaptic neuronal membrane.
Maxitrol is a combination of dexamethasone (corticosteroid), neomycin (aminoglycoside antibiotic), and polymyxin B (polymyxin antibiotic). Dexamethasone suppresses inflammation by inhibiting phospholipase A2, reducing prostaglandin and leukotriene synthesis. Neomycin binds to bacterial 30S ribosomal subunit, causing misreading of mRNA and inhibiting protein synthesis. Polymyxin B disrupts bacterial cell membrane integrity by binding to lipopolysaccharides.
Intravenous: 500 mg every 6 hours; Oral: 250 mg every 8 hours.
1-2 drops or 0.5-1 inch strip of ointment into the conjunctival sac every 4-6 hours; in severe cases, every 2-4 hours. Frequency may be reduced after improvement.
None Documented
None Documented
Terminal half-life 12 hours (range 10–14) in normal renal function; extended to 30–50 hours in severe renal impairment (CrCl <30 mL/min); 6–8 hours in hepatic cirrhosis.
Neomycin: 2–3 h (topical) but prolonged in renal impairment. Polymyxin B: 6–7 h (topical). Dexamethasone: 3–4 h (topical). Clinical: systemic absorption minimal with intact epithelium; half-life may be prolonged with corneal abrasion or inflammation.
Renal: 70% unchanged; fecal/biliary: 20% as metabolites; 10% as minor metabolites. Total renal clearance 180 mL/min, active tubular secretion accounts for 60% of renal elimination.
Renal: neomycin 30–50%; polymyxin B <1%; dexamethasone <1%. Fecal: neomycin >50% (unabsorbed); polymyxin B >99% (unabsorbed); dexamethasone <5%. Biliary: negligible for all components.
Category C
Category C
Corticosteroid/Antibiotic Combination
Ophthalmic Corticosteroid/Antibiotic Combination