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View Diary: Why are "Ototoxic" Eardrops Still on the Market? (82 comments)

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  •  What is the drug in question? n/t (11+ / 0-)

    The word "parent" is supposed to be a VERB, people...

    by wesmorgan1 on Mon Apr 07, 2014 at 03:36:25 PM PDT

    •  have never seen this diarist comment (0+ / 0-)

      however, possibly an aminoglycoside antibiotic such as neomycin.  In any case there is no excuse for prescribing ototoxic eardrops except (possibly) as a last resort:
      http://american-hearing.org/...

      As nontoxic ear drops are currently available [for example, Olfaction (ofloxacin) or ciprofloxin containing products], it would seem prudent in the future to use these agents instead of potentially toxic drugs, when there is a perforation.

      Otic Preparations in Common Use

      The following is a list of otic preparations that are in common use. The percentage use information is from Lundy and Graham, (1993)
      Corticosporin otic solution (COS) — contains polymyxin B (10,000 U), neomycin (3.5 mg), hydrocortisone (10 mg) /ml. (94.5% usage)...

      Thomas (2005) reported the case of a patient who developed total hearing loss after using a cream containing triamcinolone, neomycin, gramicidin and nystatin (Tri-Adcortyl cream)....

      Brummett et al. (1976) examined the effects of neomycin and polymyxin B in the guinea pig and found that AC cochlear potential was decreased and hair cell damage was noted following morphological examination.

      this really should be reformulated.
      •  Yeah, but if the diarist won't give details... (0+ / 0-)

        ...I have a difficult time taking the diary at face value.

        He posted another diary yesterday, criticizing the HMO he supposedly chose through the ACA for its lack of PCPs, a high deductible, etc. - but won't specify which plan, even after numerous folks (including me) posted hard data that contradicted his claims.

        Color me skeptical.

        The word "parent" is supposed to be a VERB, people...

        by wesmorgan1 on Tue Apr 08, 2014 at 10:36:45 AM PDT

        [ Parent ]

      •  I have to say, the quoted advice is TERRIBLE (0+ / 0-)

        Ofloxacin and all flouroquinolones (including ciprofloxacin, basically any drug with 'flox' in the name). ARE NOT SAFE.

        A significant minority of patients will develop flouroquinolone poisoning, causing permanent debilitating problems.

        I personally have a very mild case, thanks to ofloxacin otic & a perforated ear drum, and I basically can't walk unless I regularly take a number of supplements. Flouroquinolone poisoning often results in weak tendons/connective tissue: check the warning labels for cipro or that kind of drug sometime: the "spontaneous tendon rupture" threat is NOT  a joke. If anything, it's severely understated because it does not explain the permanent nature of flouroquinolone poisoning.

        Long story short:

        As nontoxic ear drops are currently available [for example, Olfaction (ofloxacin) or ciprofloxin containing products], it would seem prudent in the future to use these agents instead of potentially toxic drugs, when there is a perforation.
        implies that Ofloxacin is not potentially toxic, which is NOT true. It is potentially highly toxic!
        •  fluoroquinolones (0+ / 0-)

          are notorious for causing tendonitis at regular oral doses. The amount of active ingredient that gets into ears from drops is tiny by comparison, and only a small fraction of that might get absorbed into general circulation.  So I am extremely skeptical that ear drops are a danger.  In any case better this than something ototoxic.

          •  Depends on the ailment. (1+ / 0-)
            Recommended by:
            wilderness voice

            In any case, I get stress injuries from walking unless I take magnesium/glucosamine supplements after an ear infection treated with ofloxacin otic & amoxycillin.

            I realize that the dosage of otic is much smaller than oral doses, and the reasons you mention above are why the warning labels are different. My personal theory is that I'm more susceptible to flouroquinolone poisoning than most. Also, I had a bitter taste in the throat after each dose, so I think quite a bit of what I dripped into my ear was effective ingested.

            But frankly, I have the symptoms of mild flouroquinolone poisoning with no other apparent cause, so while I understand your skepticism, ofloxacin otic IS a danger for the same ailments ototoxic drugs would be.

            As noted in another comment, doing nothing is often better than medicating. Which would have been the case for me, and many who are prescribed flouroquinolones for non-serious infections like ear infections, pinkeye, etc.

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