What is orbifloxacin + posaconazole + mometasone?
Orbifloxacin + posaconazole + mometasone (Posatex®) is a combination topical ear medication that is used to treat bacterial and/or yeast ear infections in dogs.
It may be used off label (extra label) for other purposes in dogs and to treat ear infections in other species. 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 is orbifloxacin + posaconazole + mometasone given?
Orbifloxacin + posaconazole + mometasone comes as a liquid suspension.
- The liquid suspension is applied topically to the affected ear once every day.
- Your veterinarian will need to examine the affected ear to ensure that the eardrum is intact before you give this medication.
- Your veterinarian may wish to perform a culture of the affected ear prior to starting treatment.
- Ensure the ears are clean and dry prior to use. Any excessive hair in the ears should be trimmed.
- Instill the exact amount as prescribed by your veterinarian into the affected ear. Massage the external ear canal carefully to ensure the medication is distributed well.
- This medication is usually given for 7 consecutive days.
- Ideally, apply this medication at the same time every day.
This medication should take effect within 1 to 2 hours and improvement in clinical signs should follow.
Precautions for humans exposed to orbifloxacin + posaconazole + mometasone:
- Do not handle this medication if you have known hypersensitivity to any of the medicines found in it.
- Avoid contact with the eyes.
- Avoid ingestion; contact your physician immediately if accidental ingestion occurs.
- It is recommended to wear gloves when applying these medicated products; always wash your hands after applying the medication.
What if I miss giving my pet the medication?
If you miss a dose of orbifloxacin + posaconazole + mometasone, give it as soon as you remember, and then continue with the regular dosing schedule. However, 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?
Orbifloxacin + posaconazole + mometasone may cause the following side effects:
- Redness or discomfort at the site of application.
The following reactions are rare. If they occur, contact your veterinarian immediately:
- infections that do not respond to treatment, do not appear to be healing, or are getting worse
- loss of appetite, vomiting, or diarrhea
- weight loss
- sudden hearing loss
- worsening ear pain
- head tilt or walking in circles
- development of sores around the mouth
- increased thirst (i.e., frequent drinking of large quantities of water) and frequent urination
- thinning of the skin, increased skin tears, skin redness
- progressive hair loss
- infections at the application site
Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment. Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately.
This moderate-acting medication should stop working within a few days, although the effects can be longer in pets with liver or kidney disease.
Are there any risk factors for this medication?
This medication should NOT BE USED in dogs who:
- are allergic to it
- have a confirmed or suspected ruptured eardrum
- that have tuberculosis infections of the skin as diagnosed by your veterinarian
- are receiving other medications that are potentially toxic to the ears
This medication should be USED IN CAUTION in dogs who:
- have recurring ear infections
- have a small body size
- have liver or kidney disease
- are geriatric (old), frail, or sick
- are pregnant, nursing, or used for breeding
Prolonged use of glucocorticoids such as mometasone, both orally and topically, can suppress the hypothalamic–pituitary axis (HPA) which may lead to the development of diseases of the pituitary and adrenal gland such as Cushing’s disease (Hyperadrenocorticism).
Are there any drug interactions I should be aware of?
Certain medications may interact with orbifloxacin + posaconazole + mometasone, so it is important to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your dog is taking before starting any new treatment.
Some medications should be used with caution when given with orbifloxacin + posaconazole + mometasone, including:
- medications containing gentamicin: using this drug concurrently with mometamax may increase the risk of hearing loss (ototoxicity)
- corticosteroids: do not give other corticosteroids with mometamax unless instructed by your veterinarian
Is any monitoring needed with this medication?
- Ear cytology (a microscopic evaluation of the ear flora) should be performed to monitor for successful treatment of the ear infection.
- Avoid repeated use or extension of treatment duration, as long-term use of topical ear corticosteroids like mometasone has been associated with conditions such as Cushing’s disease in dogs.
- At home, monitor for any side effects such as those noted above. If any side effects occur, discontinue the medication and contact your veterinarian.
- Your veterinarian will let you know when they want to reassess your pet to ensure the medication is working and not causing side effects.
How do I store orbifloxacin + posaconazole + mometasone?
- Store this medication in the original, tightly sealed container.
- Store at room temperature, between 36°F and 86°F (2°C and 30°C).
- Shake well before using.
- Keep the container out of reach of children and pets.
Ask your veterinarian for specific disposal instructions. Do not flush medicines down the sink or toilet unless instructed to do so.
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.
