Ciprofloxacin and fluocinolone acetonide (Otic route)

Pronunciation:

sip-roe-FLOX-a-sin, floo-oh-SIN-oh-lone a-SEET-oh-nide

Classifications:

Pharmacologic—

Fluocinolone

Chemical—

Fluoroquinolone

Uses of This Medicine:

Ciprofloxacin and fluocinolone acetonide combination ear drops is used to treat middle ear infections (also called otitis media) in children 6 months of age and older with tympanostomy tubes.

Ciprofloxacin belongs to the class of medicines known as fluoroquinolone antibiotics. It works by killing the bacteria causing the infection. Fluocinolone acetonide is a steroid medicine that is used to relieve the redness, itching, and swelling caused by ear infections.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of Otovel® ear drops in children. However, safety and efficacy have not been established in children younger than 6 months of age.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Otovel® ear drops in the elderly.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Agomelatine
Bepridil
Cisapride
Desmopressin
Dronedarone
Eliglustat
Fezolinetant
Flibanserin
Levoketoconazole
Mesoridazine
Pimozide
Piperaquine
Saquinavir
Sparfloxacin
Terfenadine
Thioridazine
Tizanidine
Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acalabrutinib
Acarbose
Acecainide
Adagrasib
Albiglutide
Alfentanil
Alfuzosin
Alogliptin
Alosetron
Alprazolam
Amiodarone
Amisulpride
Amitriptyline
Amoxapine
Anagrelide
Apomorphine
Aprepitant
Aripiprazole
Aripiprazole Lauroxil
Arsenic Trioxide
Artemether
Asenapine
Aspirin
Astemizole
Atazanavir
Avapritinib
Azimilide
Azithromycin
Bemiparin
Bendamustine
Benzhydrocodone
Betamethasone
Bosutinib
Bretylium
Brigatinib
Budesonide
Buprenorphine
Bupropion
Buserelin
Canagliflozin
Capivasertib
Carbamazepine
Ceritinib
Chlorpromazine
Chlorpropamide
Cholera Vaccine, Live
Cilostazol
Citalopram
Clarithromycin
Clofazimine
Clomipramine
Clothiapine
Clozapine
Codeine
Colchicine
Corticotropin
Cortisone
Cosyntropin
Crizotinib
Cyclobenzaprine
Cyclosporine
Dabrafenib
Dapagliflozin
Daridorexant
Dasatinib
Deflazacort
Degarelix
Delamanid
Desipramine
Deslorelin
Deutetrabenazine
Dexamethasone
Dexmedetomidine
Dihydrocodeine
Disopyramide
Dofetilide
Dolasetron
Domperidone
Donepezil
Doxorubicin
Doxorubicin Hydrochloride Liposome
Droperidol
Dulaglutide
Duloxetine
Efavirenz
Elacestrant
Elexacaftor
Empagliflozin
Encorafenib
Entrectinib
Erlotinib
Ertugliflozin
Erythromycin
Escitalopram
Etrasimod
Exenatide
Fenfluramine
Fentanyl
Fexinidazole
Finerenone
Fingolimod
Flecainide
Fluconazole
Fludrocortisone
Fluocortolone
Fluoxetine
Formoterol
Fosaprepitant
Foscarnet
Fostemsavir
Gatifloxacin
Gemifloxacin
Gepirone
Glasdegib
Glimepiride
Glipizide
Glyburide
Gonadorelin
Goserelin
Granisetron
Halofantrine
Haloperidol
Histrelin
Hydrocodone
Hydrocortisone
Hydroxychloroquine
Hydroxyzine
Ibrutinib
Ibutilide
Ifosfamide
Iloperidone
Imipramine
Infigratinib
Inotuzumab Ozogamicin
Insulin
Insulin Aspart, Recombinant
Insulin Bovine
Insulin Degludec
Insulin Detemir
Insulin Glulisine
Insulin Lispro, Recombinant
Ivacaftor
Ivosidenib
Ketoconazole
Lapatinib
Larotrectinib
Lefamulin
Leflunomide
Lemborexant
Lenvatinib
Leuprolide
Levofloxacin
Linagliptin
Liraglutide
Lixisenatide
Lofexidine
Lopinavir
Lumateperone
Lumefantrine
Lurasidone
Lurbinectedin
Macimorelin
Magnesium Sulfate
Mavacamten
Mefloquine
Meperidine
Metformin
Methadone
Methotrexate
Methylprednisolone
Metronidazole
Midazolam
Mifepristone
Miglitol
Mirtazapine
Mitapivat
Mobocertinib
Moricizine
Moxifloxacin
Mycophenolate Mofetil
Nadroparin
Nafarelin
Naloxegol
Nateglinide
Nilotinib
Nirogacestat
Nitisinone
Norfloxacin
Nortriptyline
Octreotide
Ofloxacin
Olanzapine
Olaparib
Oliceridine
Omaveloxolone
Ondansetron
Osilodrostat
Osimertinib
Oxaliplatin
Oxycodone
Ozanimod
Pacritinib
Paliperidone
Palovarotene
Panobinostat
Paroxetine
Pasireotide
Pazopanib
Pemigatinib
Pentazocine
Pexidartinib
Phenobarbital
Pimavanserin
Pioglitazone
Pirfenidone
Pitolisant
Pomalidomide
Ponesimod
Porfimer
Posaconazole
Pralsetinib
Pramlintide
Prednisolone
Prednisone
Primidone
Procainamide
Prochlorperazine
Promethazine
Propafenone
Protriptyline
Quetiapine
Quinidine
Quinine
Quizartinib
Ranolazine
Rasagiline
Relugolix
Repaglinide
Repotrectinib
Ribociclib
Rimegepant
Roflumilast
Rosiglitazone
Sargramostim
Saxagliptin
Selpercatinib
Selumetinib
Semaglutide
Sematilide
Sertraline
Sevoflurane
Simeprevir
Simvastatin
Siponimod
Sirolimus Protein-Bound
Sitagliptin
Sodium Phosphate
Sodium Phosphate, Dibasic
Sodium Phosphate, Monobasic
Solifenacin
Somatrogon-ghla
Sonidegib
Sorafenib
Sotalol
Sparsentan
Sufentanil
Sulpiride
Sunitinib
Suvorexant
Tacrolimus
Tasimelteon
Tazemetostat
Tedisamil
Telavancin
Telithromycin
Teriflunomide
Tetrabenazine
Tezacaftor
Theophylline
Tolazamide
Tolbutamide
Tolvaptan
Toremifene
Tramadol
Trazodone
Triamcinolone
Triclabendazole
Trifluoperazine
Trimipramine
Triptorelin
Ubrogepant
Vandetanib
Vardenafil
Vemurafenib
Venetoclax
Venlafaxine
Vilanterol
Vinflunine
Voclosporin
Voglibose
Voriconazole
Warfarin
Zanubrutinib
Zolpidem
Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aceclofenac
Aminolevulinic Acid
Amlodipine
Chloroquine
Diclofenac
Dutasteride
Fosphenytoin
Itraconazole
Lanthanum Carbonate
Phenytoin
Probenecid
Rifapentine
Ropinirole
Ropivacaine
Sildenafil

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Caffeine

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Fungal ear infections in the outer ear or
Viral ear infections (including herpes simplex virus) in the outer ear—Should not be used in patients with these conditions.

Proper Use of This Medicine:

Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine should come with patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

This medicine should be used only in the ear. Do not put it in the eyes or nose, and do not take it by mouth or inject it. If this medicine is swallowed by accident or gets in your eyes, call your doctor right away.

To use the ear drops:

Wash hands thoroughly with soap and water.
Gently clean any fluid (discharge) from the outer ear using a clean cloth or tissue. Do not put a cotton swab or any other object in the ear canal.
Remove the medicine from the foil pouch. Do not open the foil pouch until you are ready to use it.
Pull apart 1 single dose vial. Hold the vial in your hands for 1 or 2 minutes to warm the medicine. Cold drops could cause you to become dizzy.
Lie down on your side with your infected ear facing up.
Twist off the vial cap to open. Drop the entire contents of one vial and pump the tragus 4 times.
Keep the ear tilted up for 1 minute.
If necessary, use another vial for the other ear and repeat the same steps.
Throw away the opened vials after use.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For otic dosage form (ear drops):
- For acute otitis media with tympanostomy tubes:
  - Adults and children 6 months of age and older—0.25 milliliter (1 vial) two times a day for 7 days. Each dose should be 12 hours apart.
  - Children younger than 6 months of age—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Upon opening the foil pouch, use the vials within 7 days.

Precautions While Using This Medicine:

If you or your child feel that your symptoms do not improve after 7 days, or if they have become worse, check with your doctor.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, loss of consciousness, or any swelling of your hands, face, or mouth while you are using this medicine.

Call your doctor right away if you have fluid that continues to drain from your ear (otorrhea) after you have finished your treatment with this medicine.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare: Change in hearing; ear drainage; earache or pain in the ear; fever; loss of balance

Incidence not known: Chest pain or discomfort; cold, clammy, pale skin; confusion; dizziness; fast heartbeat; hearing loss; hives or welts, itching, or skin rash; hoarseness; irregular heartbeats; irritation; joint pain, stiffness, or swelling; large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs; loss of consciousness; redness of the skin; ringing or buzzing or other unexplained noise in the ears; trouble breathing or swallowing; weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known: Change in taste; feeling of warmth; headache; loss of taste; redness of the face, neck, arms, and occasionally, upper chest; tingling in the ears; white patches in the mouth or throat or on the tongue; white patches with diaper rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Last Updated: 4/24/2024

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