Adult Dosing

Acute Otitis Externa

• 3 drops in infected ear bid x 7 days

Pediatric Dosing

Acute Otitis Externa

• Child >1 yr: 3 drops in infected ear bid x 7 days

[Outline]

• Adult Dosing
• Pediatric Dosing

• Acute otitis externa

• Hypersensitivity to any of the ingredients of the product
• Tympanic membrane perforation
• Viral infections of the external canal including varicella and herpes simplex infections

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• For otic use only; not for ophthalmic use
• Suspend therapy at the first appearance of a skin rash or any other sign of hypersensitivity
• Institute immediate emergency treatment if serious acute hypersensitivity reactions occur
• It may result in overgrowth of nonsusceptible organisms, including yeast and fungi
• If no therapeutic response is observed in a week of treatment, obtain cultures to guide further treatment

Pregnancy Category:C

Breastfeeding: Safety unknown; topical hydrocortisone has not been studied during breastfeeding. Short-term application would pose a risk to the breastfed infant by passage into breastmilk. This information is based upon lactmed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 16 December 2010). Ciprofloxacin is compatible with breastfeeding; no observable change was seen in the nursing infant while the mother was ingesting ciprofloxacin. This information is based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776/T6 last accessed 16 December 2010 ). According to the manufacturer data, it is not known whether ciprofloxacin is excreted in human milk following topical otic administration. Due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of drug, taking into account the importance of the drug to the mother.

• CNS: Headache, migraine, hypesthesia
• DERM: Pruritus, fungal dermatitis, rash, urticaria, alopecia
• MISC: Secondary infection

Ciprofloxacin

• Fluoroquinolone antibiotic; interfere with the enzyme DNA gyrase, which is needed for the synthesis of bacterial DNA
• Peak plasma concentration is less then 5 ng/mL
• Metabolism: Unknown; CYP450: Unknown
• Excretion: Unknown
• Half-life: Unknown

Hydrocortisone

• Corticosteroid; suppresses inflammation and the normal immune response
• Slow but complete absorption after otic administration
• Metabolized in the liver by CYP3A4
• Renally excreted
• Half-life: 8-12 hrs

US Trade Name(s)

• Cipro HC

US Availability

Cipro HC (ciprofloxacin/hydrocortisone)

• SUSP: 0.2%/1%

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• Ciproxin HC Ear Drops

Australian Availability

Ciproxin HC Ear Drops (ciprofloxacin/hydrocortisone)

• SUSP: 0.2%/1%

[Outline]

Antimicrobials

Otic Agents; Topical

Antimicrobials (+/- Steroid) Antimicrobials

ENT

Otic Agents; Topical

Antimicrobials (+/- Steroid) Antimicrobials

Infectious Disease

Otic Agents; Topical

Antimicrobials (+/- Steroid) Antimicrobials

Pricing data from www.DrugStore.com in U.S.A.

• Cipro HC 0.2-1 % SUSP [Bottle] (ALCON VISION)
  10 % = $148.27
  30 % = $417.56

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.