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12.1 Drugs acting on the ear

12.1.1 Otitis externa

Anti-inflammatory preparations with antibacterial
GREEN       Locorten-Vioform® eardrops   
GREEN      Betnesol® N ear drops
GREEN      Otomize® ear spray    
Chronic/acute otitis media and otitis externa (necrotising) 
RED          Ciprofloxacin 0.3%, dexamethasone 0.1% ear drops (Cilodex®) 
                        - ENT use only - not to be prescribed in Primary Care
RED         Ciprofloxacin/fluocinolone  3mg/ml+ 0.25mg/ml ear drops  (Cetraxal Plus®)
                        -  ENT use only - not to be prescribed in Primary Care
RED         Triamcinolone, Neomycin sulfate, gramicidin, nystatin  (Otocomb® ointment) 
                       -  ENT use only - off license use, not to be prescribed in Primary Care
                 NOTE: Ciprofloxacin eye drops 0.3% should not be prescribed in primary care for the ear
Acute otitis media 
GREEN     Phenazone 40mg/lidocaine hydrochloride 10mg [Otigo® ear drops, solution]
The BNF considers the following product to be less suitable for prescribing. 
GREEN      Sofradex®ear/eye drops     
Anti-infective preparations 
Use of gentamicin is contraindicated in those with perforated ear-drum.  
See BNF section for further advice. 
GREEN      Gentamicin ear/eye drops 0.3% 
RED           Clotrimazole 1% drops (specialist use only)   

12.1.3 Removal of ear wax

Wax can be softened with simple remedies prior to syringing. 
GREEN      Olive Oil 
GREEN      Sodium Bicarbonate 5% ear drops