From the Guidelines
Ciprodex ear drops typically begin to relieve pain from otitis externa within 48 to 72 hours of starting treatment. The complete treatment course is usually 7 days, with the standard dosage being 4 drops instilled into the affected ear(s) twice daily. For maximum effectiveness, patients should lie with the affected ear upward for 1-2 minutes after application and avoid getting the ear wet during treatment. Ciprodex works through a dual-action mechanism: ciprofloxacin (an antibiotic) kills the bacteria causing the infection, while dexamethasone (a steroid) reduces inflammation and swelling in the ear canal, which helps alleviate pain and discomfort.
Key Points to Consider
- Most people feel better within 48 to 72 hours and have minimal or no symptoms by 7 days 1.
- Pain medicine is especially important to use for relief in the first few days, until the eardrops begin working 1.
- Eardrops should be used for at least 7 days, even if you feel better sooner, to prevent relapse of infection 1.
- If pain persists beyond 3-4 days of treatment or worsens at any point, patients should contact their healthcare provider as this may indicate a need for additional treatment or a different approach.
Additional Considerations
- Patients should avoid scratching or touching the ear and do not insert anything into the ear canal, including cotton-tipped swabs 1.
- Cover the opening of ear canal with an earplug or cotton (with petroleum jelly) prior to showering or hair washing to minimize water entry 1.
- Check with your doctor regarding swimming or other water activities that may take place during, or soon after, your infection 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Time to Relieve Pain in Otitis Externa with Ciprodex Drops
- The time it takes for Ciprodex drops to relieve pain in otitis externa can vary, but studies have shown significant improvements in pain relief within a short period of treatment 2.
- A study comparing ciprofloxacin/dexamethasone with neomycin/polymyxin/hydrocortisone for otitis externa pain found that Ciprodex-treated patients had relief of severe pain over time, with a significant decrease in pain within the first 12 hours of treatment 2.
- Another study evaluating the efficacy and safety of topical ciprofloxacin/dexamethasone versus neomycin/polymyxin B/hydrocortisone for otitis externa found that clinical cure rates were higher with Ciprodex at Day 18, and the clinical response was significantly better with Ciprodex than with the comparator at Days 3 and 18 3.
- The exact time to relieve pain may depend on individual patient factors and the severity of the infection, but overall, Ciprodex drops have been shown to provide effective pain relief in patients with otitis externa 2, 3.
Comparison with Other Treatments
- A study comparing ciprofloxacin plus fluocinolone acetonide with ciprofloxacin alone in the treatment of diffuse otitis externa found that the combination of ciprofloxacin and fluocinolone acetonide was more effective in reducing symptoms and eradicating the infection 4.
- Another study evaluating the efficacy and tolerability of oral ciprofloxacin in the comprehensive treatment of external bacterial otitis found that oral ciprofloxacin was clinically and microbiologically effective, but the study did not specifically evaluate the time to relieve pain 5.
- A systematic review of antibiotic prescription for acute otitis externa found that topical antibiotics, including Ciprodex, were commonly prescribed and effective in treating the infection, but the review did not provide specific information on the time to relieve pain 6.