What are the instructions for using Locacortin Vioform (neomycin and hydrocortisone) ear drops?

Instructions for Using Locacortin Vioform Ear Drops

For optimal effectiveness of Locacortin Vioform ear drops, have someone else administer the drops for you while lying down with the affected ear facing upward, filling the ear canal completely, and remaining in this position for 3-5 minutes to ensure proper penetration of the medication. 1

Proper Administration Technique

• If possible, have someone else administer the drops as this significantly improves adherence to therapy (only 40% of patients who self-medicate do so appropriately during the first 3 days) 1
• Lie down with the affected ear facing upward 1
• Instill enough drops to fill the ear canal completely 1
• Stay in this position for 3-5 minutes (using a timer can be helpful, especially for children) 1
• Use one of these techniques to help distribute the medication:
  • Gently move the ear in a to-and-fro motion to eliminate trapped air 1
  • Alternatively, press with an in/out movement on the tragus (the small piece of cartilage in front of the ear) 1
• After administration, you may get up and resume normal activities 1
• Wipe off any excess drops 1

Important Precautions During Treatment

• Keep the ear dry while using ear drops 1
• Avoid scratching or touching the ear 1
• Do not insert anything into the ear canal, including cotton-tipped swabs 1
• Do not attempt to clean the ear yourself as the ear is tender and you could damage the ear canal or eardrum 1
• Cover the ear canal opening with an earplug or cotton with petroleum jelly before showering or hair washing 1
• Consult your doctor about swimming or other water activities during treatment 1

Special Situations

If a Wick is Placed:

• If drops don't easily run into the ear canal, your doctor may place a wick to help medication delivery 1
• The wick falling out on its own is a good sign indicating reduced inflammation 1
• Do not remove the wick yourself unless specifically instructed to do so by your doctor 1

If You Have Ear Tubes:

• Lie with the affected ear upward and instill the appropriate number of drops 2
• Pump the tragus 4 times to facilitate penetration of drops through the tube into the middle ear 2
• Maintain position for 5 minutes to allow adequate penetration 2

Potential Side Effects

• Ear drops are generally safe and well tolerated 1
• Some patients may experience local rash, itching, irritation, or discomfort, but these rarely require stopping the medication 1
• If you taste the eardrops, it may indicate a hole or perforation in the eardrum - inform your doctor if this occurs 1, 3
• Contact your doctor if the drops become painful or you develop unexpected symptoms 1

Treatment Duration

• Continue using the drops for the full prescribed duration, even if symptoms improve sooner, to prevent relapse 1
• Most patients experience improvement within 48-72 hours of starting appropriate ear drop therapy 3
• If symptoms persist beyond 7 days, notify your doctor and continue the drops until symptoms resolve (for a maximum of 7 additional days) 1

Important Caution

• Locacortin Vioform should not be applied directly into the middle ear as research shows it can cause hearing loss when applied to the middle ear cavity 4