Mometasone Furoate + Gentamicin Sulfate + Clotrimazole Topical Ointment

What is mometasone furoate + gentamicin sulfate + clotrimazole topical ointment?

Mometasone furoate + gentamicin sulfate + clotrimazole topical (Mometamax®, Maxi-otic®, MotaZol®, PattOtic®) is a combination topical ear medication used to treat bacterial and yeast ear infections in dogs.

It may be used off label in other species or for other infections in dogs. 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 very carefully, as their directions may be significantly different from those on the label.

How is mometasone furoate + gentamicin sulfate + clotrimazole topical ointment given?

• Mometasone furoate + gentamicin sulfate + clotrimazole topical ointment comes as a liquid suspension.
• The liquid suspension is applied topically to the affected ear, once daily.
• Your veterinarian will need to confirm that the dog’s eardrum is intact before you can apply this medication.
• Ensure the dog’s ears are clean and dry before applying the medication and trim any excessive hair in the ears.
• Instill the exact amount prescribed by your veterinarian into the affected ear.
• Massage the external ear canal to ensure the medication is distributed well.
• Ideally, apply this medication at the same time every day for the number of days prescribed by your veterinarian.
• Humans with known hypersensitivity to any of the medicines found in this product should not handle it. 
• It is recommended to wear gloves when applying this medication, and always wash your hands after applying it.
• Avoid contact with the eyes.
• Avoid ingestion; contact your physician immediately if you accidentally ingest it.

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

What if I miss giving my pet the medication?

If you miss a dose of mometasone furoate + gentamicin sulfate + clotrimazole topical ointment, 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?

Mometasone furoate + gentamicin sulfate + clotrimazole topical ointment may cause the following side effects:

• Redness or discomfort at the site of application

Serious adverse reactions may occur. If any of the following signs develop, stop giving mometasone furoate + gentamicin sulfate + clotrimazole topical ointment and 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
• Sores around the mouth
• Increased thirst (i.e., frequently drinking large quantities of water) and frequent urination
• Thinning of the skin, progressive hair loss, skin redness, increased skin tears, or infections at the application site

Long-term use of steroids like mometasone have been associated with the onset of Cushing’s disease in dogs, symptoms such as increased thirst and urination, and increase in blood liver enzymes.

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 and notify your veterinarian if you have any concerns. 

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?

DO NOT USE mometasone furoate + gentamicin sulfate + clotrimazole topical ointment in:

• Dogs that are allergic to it
• Dogs with a confirmed or suspected ruptured ear drum

USE WITH CAUTION in 

• Dogs that have recurring ear infections

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with mometasone furoate + gentamicin sulfate + clotrimazole topical ointment, including:

• Medications containing gentamicin; may increase the risk of hearing loss (ototoxicity)
• Corticosteroids (do not use unless instructed by your veterinarian)

Be sure to tell your veterinarian about any medications (including vitamins, supplements, and herbal therapies) that your pet is taking before starting any treatment.

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.
• At home, monitor for any side effects such as those noted above. If any 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 mometasone furoate + gentamicin sulfate + clotrimazole topical ointment?

• Store this medication in the original, tightly sealed container.
• Store at room temperature between 36°F and 77°F (2°C and 25°C).
• This medicine should only be used for 28 days following the first use.
• Shake well before using.
• Keep the container out of reach of children and pets.
• Ask your veterinarian for 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. Report any adverse effects to the FDA or Health Canada.