Clioquinol + Flumetasone Pivalate

This combination is indicated for the treatment of external ear inflammation and infections (otitis externa) and fungal infections of the outer ear (otomycosis).

Flumetasone Pivalate is a potent difluorinated glucocorticoid designed for local application. It exerts an anti-inflammatory, anti-allergic, vasoconstrictive and anti-proliferative effect. In inflammatory skin diseases of the external auditory meatus it affords prompt relief and eliminates symptoms such as pruritus and also reduces swelling.

Clioquinol is a halogenated hydroxyquinoline derivative which exerts bacteriostatic action. It is active against a broad spectrum of microorganisms including fungi (e.g., Candida, Microsporum, Trichophyton) and Gram-positive bacteria (e.g. Staphylococci). It is also effective against Gram-negative bacteria.

For adults and children (aged 2 years and over): The recommended dose is 2 to 3 drops twice daily for the prescribed period of time (usually not longer than 10 days). Before you apply the medication, you should warm the ear drops to body temperature by holding the bottle in the palm of your hands. Do not heat it above body temperature.

Topical use of clioquinol may increase the amount of protein-bound iodine (PBI) in patients with normal thyroid function and therefore may interfere with some thyroid function tests (such as PBI, radioactive iodine and butanol-extractable iodine). These tests should not be performed within a period shorter than 1 month following the use of this ear drop. Other tests, such as the T3 resin sponge test or the T4 determination test, are unaffected by clioquinol.

This medication is contraindicated in patients with: Punctured eardrum, Pre-existing tuberculosis of the skin, Fungal or viral infections of the skin(Chickenpox, Herpes simplex, Herpes zoster), Known hypersensitivity to corticosteroids, Iodine, Clioquinol, Flumetasone pivalate, Hydroxyquinolones or Quinolone derivatives or any of the ingredients of this formulation.

Burning sensation, itching, skin rashes may occur at the site of application.

The safety of this medication during pregnancy or lactation has not been established.

Prior to the beginning of therapy, the ear-drum should be checked by the physician. If there is a risk that perforation of the ear-drum may occur, this ear drops should not be used. If no improvement occurs within about 1 week, the therapy should be discontinued. It is then advisable to identify the pathogens and to institute an appropriate treatment. This ear drop should not be allowed to come in contact with the conjunctiva.

Application to extensive or eroded areas of skin may lead to increased PBI values within 1 week. If signs and symptoms resembling those of thyrotoxicosis occur, the preparation should be withdrawn at once.

Aural steroid & antibiotic combined preparations, Ophthalmic steroid - antibiotic combined preparations

Keep out of the reach of children. Store in a cool, dry place, away from heat and direct light. Do not use more than 4 weeks after opening.