Mometamax Otic Suspension
Antibacterial - Antifungal - Anti-Inflammatory
Mometamax Otic Suspension is indicated for the treatment of canine otitis externa in dogs caused by susceptible strains of yeast (Malassezia pachydermatis) and bacteria (Pseudomonas spp. [including. aeruginosa], coagulase-positive staphylococci, Enterococcus faecalis, Proteus mirabilis, and beta-hemolytic streptococci).
Mometamax Suspension (Gentamicin-Mometasone-Clotrimazole): By virtue of its three active ingredients, MOMETAMAX Otic Suspension has antibacterial, anti-inflammatory, and antifungal activity. MOMETAMAX Otic Suspension was effective in the treatment of otitis externa associated with bacteria and Malassezia pachydermatis. MOMETAMAX Otic Suspension reduced discomfort, redness, swelling, exudate, and odor.
CONTRAINDICATIONS If hypersensitivity to any of the components occurs, treatment should be discontinued and appropriate therapy instituted. Concomitant use of drugs known to induce ototoxicity should be avoided. Do not use in dogs with known perforation of eardrums.
DESCRIPTION:
Each gram of MOMETAMAX Otic Suspension contains gentamicin sulfate 3 mg, mometasone furoate 1 mg, clotrimazole 10 mg..
PHARMACOLOGY
Gentamicin:
Gentamicin sulfate is an aminoglycoside antibiotic active against a wide
variety of gram-negative and gram-positive bacteria. Gentamicin is bactericidal and acts by inhibiting
normal protein synthesis in susceptible microorganisms, including - Pseudomonas (including P. aeruginosa),
coagulase-positive staphylococci,
Enterococcus faecalis, Proteus mirabilis and beta-hemolytic
streptococci.
Mometasone: Mometasone
furoate monohydrate is a synthetic adrenocorticoid, which have
shown to possess high topical potency.
Clotrimazole: Clotrimazole
is a broad-spectrum antifungal agent that is used for the treatment of
dermal infections caused by various species of dermatophytes and yeast. The
primary action of clotrimazole is against dividing and growing organisms.
Clotrimazole exhibits fungistatic and fungicidal activity against isolates
of Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton
floccosum, Microsporum canis, Candida spp., and Malassezia
pachydermatis. Resistance to clotrimazole is very rare among the fungi
that cause superficial mycoses.
WARNINGS The use of these
components has been associated with deafness or partial hearing loss in a
small number of sensitive dogs (eg, geriatric). The hearing deficit is
usually temporary. If hearing or vestibular dysfunction is noted during the
course of treatment, discontinue use of MOMETAMAX Otic Suspension
immediately and flush the ear canal thoroughly with a nonototoxic solution.
Corticosteroids administered to dogs,
rabbits, and rodents during pregnancy have resulted in cleft palate in
offspring. Other congenital anomalies including deformed forelegs,
phocomelia, and anasarca have been reported in offspring of dogs that
received corticosteroids during pregnancy.
Field and experimental data have
demonstrated that corticosteroids administered orally or parenterally to
animals may induce the first stage of parturition if used during the last
trimester of pregnancy and may precipitate premature parturition followed by
dystocia, fetal death, retained placenta, and metritis.
PRECAUTIONS Before
instilling any medication into the ear, examine the external ear canal
thoroughly to be certain the tympanic membrane is not ruptured in order to
avoid the possibility of transmitting infection to the middle ear as well as
damaging the cochlea or vestibular apparatus from prolonged contact.
Administration of recommended doses of
MOMETAMAX Otic Suspension beyond 7 days may result in delayed wound healing.
If overgrowth of nonsusceptible
bacteria or fungi occurs, treatment should be discontinued and appropriate
therapy instituted.
Avoid ingestion. Adverse systemic
reactions have been observed following the oral ingestion of some topical
corticosteroid preparations. Patients should be closely observed for the
usual signs of adrenocorticoid overdosage which include sodium retention,
potassium loss, fluid retention, weight gain, polydipsia, and/or polyuria.
Prolonged use or overdosage may produce adverse immunosuppressive effects.
Use of corticosteroids, depending on
dose, duration, and specific steroid, may result in endogenous steroid
production inhibition following drug withdrawal. In patients presently
receiving or recently withdrawn from corticosteroid treatments, therapy with
a rapidly acting corticosteroid should be considered in especially stressful
situations.
ADVERSE REACTIONS
Gentamicin:
While aminoglycosides are absorbed poorly from skin, intoxication may occur
when aminoglycosides are applied topically for prolonged periods of time to
large wounds, burns, or any denuded skin, particularly if there is renal
insufficiency. All aminoglycosides have the potential to produce reversible
and irreversible vestibular, cochlear, and renal toxicity.
Mometasone:
ALP (SAP) and ALT (SGPT) enzyme elevations, weight loss, anorexia,
polydipsia, polyuria, neutrophilia, and lymphopenia have occurred following
the use of parenteral, high-dose, and/or prolonged or systemic synthetic
corticosteroids in dogs. Cushing's syndrome in dogs has been reported in
association with prolonged or repeated steroid therapy.
Clotrimazole:
The following have been reported occasionally in humans in connection with
the use of clotrimazole: erythema, stinging, blistering, peeling, edema,
pruritus, urticaria, and general irritation of the skin not present before
therapy.
MOMETAMAX Otic Suspension:
In field studies following once-daily treatment with MOMETAMAX Otic
Suspension, ataxia, proprioceptive deficits, and increased water consumption
were observed in less than 1% of 164 dogs. In a field study following
twice-daily treatment with MOMETAMAX Otic Suspension, inflammation of the
pinna and diarrhea were observed in less than 1% of 141 dogs.
DOSAGE AND ADMINISTRATION
The external ear canal should be
thoroughly cleaned and dried before treatment. Verify that the eardrum is
intact. For dogs weighing less than 30 lbs, instill 4 drops from the 7.5 g,
15 g, and 30 g bottles (2 drops from the 215 g bottle) of MOMETAMAX Otic
Suspension once daily into the ear canal. For dogs weighing 30 lbs or more,
instill 8 drops from the 7.5 g, 15 g, and 30 g bottles (4 drops from the 215
g bottle) once daily into the ear canal. Therapy should continue for 7
consecutive days.
HOW SUPPLIED MOMETAMAX Otic
Suspension is available in 7.5 g (NDC 0061-1246-05), 15 g (NDC
0061-1246-04), 30 g (NDC 0061-1246-01), and 215 g (NDC 0061-1246-02) plastic
bottles.
Merck Animal Health
Store between 2° and 25°C (36° and 77°F). Shake well before use.