What are the instructions for using Ciprodex (ciprofloxacin and dexamethasone) ear drops?

Ciprodex (Ciprofloxacin/Dexamethasone) Ear Drop Instructions

Lie down with the affected ear facing upward, instill 4 drops into the ear canal, and remain in this position for at least 1 minute (or 3-5 minutes for optimal penetration) to ensure the medication reaches the infection site. 1, 2

Before You Start

• Have someone else administer the drops if possible, as only 40% of patients who self-administer do so correctly during the first 3 days of treatment 3
• Wash your hands thoroughly with soap and water before handling the medication 1
• Warm the bottle by rolling it between your hands for 1-2 minutes, then shake well before each use 1

Step-by-Step Administration Technique

Positioning and Drop Instillation

• Lie down on your side with the affected ear facing upward 1, 2
• Hold the bottle between your thumb and index finger, placing the tip close to your ear without touching it 1
• Instill 4 drops into the ear canal (enough to fill it completely) 1, 2
• Do not touch the bottle tip to your ear, fingers, or any other surface to prevent contamination 1, 3

After Instillation

• For outer ear canal infections (acute otitis externa): Gently pull the outer ear lobe upward and backward to allow drops to enter the canal, then remain on your side for 1 minute 1
• For optimal effectiveness, the American Academy of Otolaryngology-Head and Neck Surgery recommends staying in position for 3-5 minutes to allow adequate penetration 2, 3
• Gently pump the tragus (the small cartilage flap in front of your ear canal) in and out to help distribute the medication 3

Dosing Schedule and Duration

• Use 4 drops twice daily for 7 days, even if you feel better sooner 1, 2
• Most patients experience improvement within 48-72 hours, but completing the full course prevents relapse 2, 3
• If symptoms persist beyond 7 days, notify your doctor and continue drops until symptoms resolve (maximum 7 additional days) 2

Critical Precautions During Treatment

Keep the Ear Dry

• Cover the ear canal opening with an earplug or cotton with petroleum jelly before showering or hair washing 2, 3
• Avoid swimming or water activities unless cleared by your doctor 2

Avoid Ear Trauma

• Do not scratch or touch the ear 2, 3
• Never insert cotton-tipped swabs or any objects into the ear canal, as this can push debris deeper and worsen the infection 2, 3

What to Expect and When to Call Your Doctor

Expected Timeline

• Pain should improve within 48-72 hours with appropriate pain medication during the first few days 2
• Minimal or no symptoms should be present by 7 days 2

Warning Signs Requiring Medical Attention

• If you taste the eardrops, this indicates a hole or perforation in your eardrum—inform your doctor immediately if you haven't already disclosed this 2, 3
• Pain or symptoms that fail to respond within 48-72 hours 2
• The drops become painful or you develop unexpected symptoms 2
• Local rash, itching, or irritation severe enough to interfere with treatment (though this is rare) 2, 3

Storage and Disposal

• Store at room temperature (68-77°F), protected from light 1
• Do not freeze 1
• Discard any remaining medication after completing your treatment course 1
• Keep out of reach of children 1

Common Pitfalls to Avoid

• Failing to stay in position long enough (minimum 1 minute, ideally 3-5 minutes) is the most common error that reduces effectiveness 2, 3
• Stopping treatment early once symptoms improve leads to relapse 2, 3
• Allowing water to enter the ear during treatment can worsen the infection 2, 3
• Self-administering when assistance is available—having someone else administer significantly improves proper technique 3