Dexamethasone Otic

What is dexamethasone otic?

Dexamethasone otic is a steroid medication used off-label in pets or in a veterinary-compounded formulation to treat topical inflammation of the ears, often with other medications such as antibiotics. There are no veterinary brands of dexamethasone otic.

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 dexamethasone otic given?

• Dexamethasone otic comes as a liquid solution that is used topically within the ear canal of pets when prescribed by a veterinarian for this purpose. 
• Follow your veterinarian’s directions for application and measure drops of the liquid solution carefully.
• Wash your hands after applying.
• Do not handle if you have a known sensitivity to dexamethasone or other drugs like it (e.g., prednisone).

This medication should take effect within 1-2 hours and improvement in clinical signs should follow.

What if I miss giving my pet the medication? 

If you miss an application of dexamethasone otic, 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 applications at once.

Are there any potential side effects?

Dexamethasone otic may cause the following side effects:

• redness or inflammation at the site of application. 

The following reactions are rare. If they occur, contact your veterinarian immediately:

• ear inflammation or infection that does not respond to treatment, does not appear to be healing, or is getting worse.
• worsening ear pain
• vomiting, diarrhea, or loss of appetite
• weight loss
• development of sores in or around the mouth
• increased thirst (i.e., frequent drinking of large quantities of water) and frequent urination.
• thinning of the skin
• progressive hair loss 
• increased skin tears
• throat swelling or difficulty breathing (indicates a severe allergic reaction)

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?

Dexamethasone otic should NOT BE USED in: 

• pets that are allergic to it or drugs like it.
• birds, as they are very sensitive to steroids

Dexamethasone otic should be USED WITH CAUTION in:

• pets that are diabetic
• pets with renal disease
• animals that are pregnant or nursing

Prolonged use of glucocorticoids such as dexamethasone, 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 dexamethasone otic and so it is important to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is using before starting any new treatment. 

Do not give other corticosteroids (e.g., prednisone) with dexamethasone otic unless instructed by your veterinarian.

Is any monitoring needed with this medication?

• At home, monitor for any side effects such as those noted above. If any side effects occur, discontinue the medication and contact your veterinarian. 
• If redness, irritation, or swelling persists or increases, discontinue use and consult a 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 dexamethasone otic?

• Store this medication in the original prescription bottle at room temperature (68°F to 77°F, or 20°C to 25°C). 
• Protect from light.
• If your veterinarian has made (compounded) a special formulation for your pet, follow the storage recommendations and expiration date for the product.
• Keep away from children and other animals.
• 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.