Gentamicin + Miconazole + Hydrocortisone Aceponate (GMHa) Combination Otic

What is gentamicin + miconazole + hydrocortisone aceponate (GMHa) combination otic?

GMHa (brand name: EasOtic®) is a combination antibiotic, antifungal, and corticosteroid anti-inflammatory drug used to treat certain bacterial and yeast ear infections in dogs.

Its use in cats to treat bacterial infections in the ears is considered off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. 

“Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How do I give my pet GMHa?

• GMHa is a suspension used once daily to treat ear infections.
• GMHa is applied directly to the ear canal using a pump mechanism. Shake well before use.
• Fill the nozzle of the pump prior to first use, following label instructions.
• DO NOT USE ORALLY.
• Wash your hands after applying. If human skin contact occurs, wash the area thoroughly with water. 
• Avoid contact with eyes.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects?

GMHa may cause the following side effects:

• Inflammation (redness) in the treated area

Serious adverse reactions may occur. If any of the following signs develop, stop giving GMHa and contact your veterinarian immediately:

• Loss of hearing
• Loss of balance
• Head tilt or walking in circles
• Increased drinking and urination
• Loss of appetite, vomiting or diarrhea
• Progressive ear pain

Are there any risk factors for this medication?

DO NOT USE GMHa in:

• Pets with a history of hypersensitivity or allergy to it
• Pets with a damaged tympanic membrane
• Pets that are pregnant, lactating, or used for breeding

USE WITH CAUTION in:

• Pets with liver or kidney disease
• Pets with chronic ear infections

Are there any drug interactions I should be aware of?

There are no documented drug interactions for this medication. However, it is recommended to avoid using it at the same time as medications that may cause hearing or balance problems (ototoxicity). Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any treatment.

Is any monitoring needed with this medication?

• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects. 
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store GMHa?

• Store GMHa sh at room temperature, between 68°F and 77°F (20°C and 25°C).
• Store compounded formulations of this medication according to the label.
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms. Report any adverse effects to the FDA or Health Canada.