Surolan Ear Drops and Cutaneous Suspension Species: Cats, Dogs Therapeutic indication: Pharmaceuticals: Antimicrobials: Topical preparations: Ear/eye/nose, Skin, Pharmaceuticals: Antimicrobials: Antifungal products, Pharmaceuticals: Anti-inflammatory preparations: Topical Active ingredient: Miconazole Nitrate, Polymyxin B, Prednisolone Product:Surolan® Ear Drops and Cutaneous Suspension Product index: Surolan Ear Drops and Cutaneous Suspension Qualitative and quantitative composition Active substances: Miconazole Nitrate 23 Prednisolone Acetate 5 Polymyxin B Sulfate 0.5293 For a full list of excipients, see Pharmaceutical particulars. Pharmaceutical form Ear drops suspension and cutaneous suspension. White suspension Clinical particulars Target species Dogs and cats Indications for use, specifying the target species For the topical treatment of otitis externa and skin infections caused by Gram-positive bacteria e.g. Staphylococcus aureus and Streptococcus spp. and Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa. For the topical treatment of otitis externa and skin infections caused by fungi and yeasts: Trichophyton spp., Microsporum spp., Malassezia pachydermatis, Candida spp. For the topical treatment of otitis externa caused by the ear mite Otodectes cynotis. The product also has anti-inflammatory and anti-pruritic activity. Contraindications Do not use in animals with perforated ear drums since Polymyxin B is known to be a potential ototoxic agent. Do not use in cases of known hypersensitivity to the active substances or to any of the excipients. Special warnings for each target species As the product is a prescription only medicine, treatment should be closely supervised by a veterinary practitioner. Special precautions for use Special precautions for use in animals For external use only. Due to the likely variability (temporal, geographical) in the emergence of bacterial resistance to polymyxin B, bacteriological sampling and sensitivity testing (antibiogram) is recommended. If there is overgrowth of resistance bacteria and/or fungi, treatment with this product should be discontinued and treatment with an appropriate alternative should be initiated. Special precautions to be taken by the person administering the veterinary medicinal product to animals Do not handle the product if you are allergic to the ingredients in the product. Accidental spillage on the skin should be washed off immediately with soap and water. Wash hands after use. Corticosteroids may produce irreversible effects in the skin. They can be absorbed and may have harmful effects, especially with frequent and extensive contact or in pregnancy. Always wear single use disposable gloves when applying the product to animals. Adverse reactions (frequency and seriousness) Deafness and impaired hearing (mainly in elderly dogs) have been reported very rarely. If this occurs, treatment should be stopped. Decreased hearing or deafness is generally temporary in nature. Prolonged use of topical steroids can cause skin discoloration and delay wound healing. The conventional adverse effects of corticosteroids can occur (disturbance of biochemical parameters, such as increased cortisol and hepatic enzyme levels). The frequency of adverse reactions is defined using the following convention: ∙ very common (more than 1 in 10 animals treated displaying adverse reaction(s)) ∙ common (more than 1 but less than 10 animals in 100 animals treated) ∙ uncommon (more than 1 but less than 10 animals in 1,000 animals treated) ∙ rare (more than 1 but less than 10 animals in 10,000 animals treated) ∙ very rare (less than 1 animal in 10,000 animals treated, including isolated reports) Use during pregnancy, lactation or lay Corticosteroids are not recommended for use in pregnant animals. Interaction with other medicinal products and other forms of interaction Do not use concomitantly with medicines that induce ototoxicity. Amounts to be administered and administration route This product is for topical administration. Shake the bottle vigorously and ensure the product is fully resuspended before use. At the beginning of treatment, hair surrounding or covering the lesions must be clipped; this should be repeated during treatment if necessary. Ears: Clean the auditory canal and place a few drops of the product into the ear twice daily. For infections caused by Otodectes cynotis, instill five drops twice daily for 14 days. Massage the ear and the auditory canal gently but thoroughly to ensure proper distribution. Skin: Having ensured the area to be treated is clean, apply a few drops of the product (depending on lesion size) twice a day and rub well. Treatment should be continued until a few days after complete disappearance of the clinical symptoms. In some obstinate cases, treatment may be required for 2 to 3 weeks (see also Adverse Reaction section). Where ear mite infestation is present, consideration should be given to treating both ears even if infestation is only apparent in one ear. Overdose (symptoms, emergency procedures, antidotes), if necessary Topical use. In case of accidental ingestion by licking, no toxic effects were observed. Withdrawal period(s) Not applicable. Legal Category: POM-V