Is Polymyxin B / Colistin safe?
Boxed warning; kidney and nerve toxicity known
Kidney injury is the main problem. The polymyxin B label carries a boxed warning for kidney and nerve toxicity. Doctors must dose the drug to kidney function. They must check kidney tests daily. Nerve effects start with tingling around the mouth and dizzy spells. Rarely, they reach paralysis of the breathing muscles from neuromuscular blockade. That is why the label warns against combining polymyxins with other drugs that harm nerves or kidneys. The AIDA trial used colistin. Failure and death rates were high. The drug played a part. But the patients were also very sick. 12
No. Intact skin does not absorb topical polymyxin B in useful amounts. So the kidney and nerve toxicity that limit the injectable form do not apply. 2
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Citations
- Paul 2018, Lancet Infect Dis: colistin alone versus colistin plus meropenem for carbapenem-resistant Gram-negative infections (AIDA) doi.org
- Polymyxin B for injection prescribing information drugs.com
- openFDA Drugs@FDA: Coly-Mycin M (NDA 050108) approval record api.fda.gov
Reference information only, not medical advice. Drawn from the Polymyxin B / Colistin article, fact-checked against the cited sources. No dosing anywhere on this site.