| Therapeutic Area | Formulary Choices | Cost for 28 (unless otherwise stated) | Rationale for decision / comments |
|---|---|---|---|
| BNF Chapter 12: Ear, nose, and oropharynx | |||
| 12.1 Drugs acting on the ear | |||
| Otitis Externa also see Chapter 5 First line: | Acetic acid as EarCalm® | 2% spray: £4.10 (5ml) | See infection management guidance for appropriate clinical indications Available OTC. Cure rates similar at 7 days for topical acetic acid or antibiotic +/- steroid. |
| Second line: | Betamethasone with Neomycin as Betnesol-N® | Drops: £2.39 (10ml) | |
| Otitis media | Topical antimicrobial products are not recommended for otitis media | See infection management guidance for appropriate clinical indications | |
| Phenazone/Lidocaine as Otigo® | 40mg/10mg/g ear drops: £8.92 (15ml with dropper applicator) | Otigo is intended for local symptomatic treatment and relief of pain in the following diseases of the middle ear without tympanic perforation: - acute, congestive otitis media; - otitis in influenza, the so called viral bullous otitis; - barotraumatic otitis. Contraindicated in infectious or traumatic perforation of the tympanic membrane (including myringotomy). |
|
| Removal of wax | For all preparations used in removal of ear wax patients should be advised to lie with affected ear uppermost for 5 minutes after administration to ensure penetration of the ear canal. | ||
 Olive Oil - suitable for self-care | Simple oils such as olive (or almond) oil should be used first line. Available OTC |
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| Docusate Sodium as Waxsol® - suitable for self-care | 0.5% drops: £1.95 (10ml) | Available OTC | |
| Device | |||
| Otovent® auto inflation device | £6.69 (1 device) | Recommended by NICE MIB59 as demonstrates improved outcomes for children with middle ear / glue ear problems. Little evidence to support use in adults. (PAMM April 2016) | |
