Aurimic Ear Drops and Cutaneous Suspension for Dogs and Cats

Composition

Each ml (40 drops) contains:

Active substances:

Miconazole nitrate 23.0 mg

(equivalent to 19.98 mg miconazole)

Prednisolone acetate5.0 mg

(equivalent to 4.48 mg prednisolone)

Polymyxin B sulfate 0.5293 mg

(equivalent to 5500 IU polymyxin B sulfate)

Excipients:

Qualitative composition of excipients and other constituents

Silica, colloidal anhydrous

Paraffin liquid

White suspension

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Pharmacological properties

4.1 ATCvet code: QS02CA01

4.2 Pharmacodynamics

Miconazole belongs to the group of N-substituted imidazole derivatives and inhibits ergosterol de novo synthesis. Ergosterol is an essential membrane lipid and must be synthesised by fungi. Ergosterol deficiency impedes numerous membrane functions, eventually leading to the cell’s death. The spectrum of activities covers nearly all fungi and yeasts of relevance to veterinary medicine as well as Gram-positive bacteria. Practically no development of resistance has been reported. Miconazole has a fungistatic mode of action, but high concentrations are also observed to produce fungicidal effects.

Polymyxin B belongs to the polypeptide antibiotics which are isolated from bacteria. It is only active against Gram-negative bacteria. The development of resistance is chromosomal in nature and the development of resistant Gram-negative pathogens is a relatively rare event. However, all Proteus species share a natural resistance to polymyxin B.

Polymyxin B binds to phospholipids in the cytoplasmic membrane to disturb membrane permeability. This results in autolysis of the bacteria, thus achieving bactericidal activity.

Prednisolone is a synthetic corticosteroid and is used for its anti-inflammatory, anti- pruritic, anti- exudative and anti-proliferative effects. The anti-inflammatory activity of prednisolone acetate results from reduction of the permeability of capillaries, improved blood flow and inhibition of fibroblast action.

The exact mechanism of the acaricidal effect is unclear. It is assumed that the mites are suffocated or immobilised by the oily excipients.

4.3 Pharmacokinetics

Following topical application of polymyxin B, there is virtually no absorption of the compound through intact skin and mucous membranes, but significant absorption via wounds.

After topical application of miconazole, there is virtually no absorption of the compound through intact skin or mucous membranes.

When applied topically to intact skin, prednisolone is subject to limited and delayed absorption. Greater absorption of prednisolone should be expected in cases of compromised skin barrier function (e.g. skin lesions).

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Target species

Dogs and cats

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Indications

For the treatment of otitis externa and small localised superficial skin infections in dogs and cats caused by infections with the following bacteria and fungi:

• Gram-positive bacteria - Staphylococcus spp. - Streptococcus spp.

• Gram-negative bacteria - Pseudomonas spp. - Escherichia coli

• Fungi

- Malassezia pachydermatis - Candida spp. - Microsporum spp. - Trichophyton spp.

Treatment of Otodectes cynotis (ear mites) infestations where there is concurrent infection with miconazole and polymyxin B sensitive pathogens.

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Dosage

For auricular and cutaneous use.

Shake well before use. Any contamination of the dropper should be strictly avoided.

At the beginning of treatment, hair surrounding or covering the lesions must be clipped; this should be repeated during treatment if necessary.

Infections of the external auditory canal (otitis externa):

Clean the external ear canal and auricle and place 5 drops of the veterinary medicinal product into the external auditory canal twice a day. Massage the ear and the auditory canal thoroughly to ensure proper distribution of the active substances, but gently enough to avoid causing pain to the animal.

Treatment should be continued without interruption until a few days after complete disappearance of the clinical symptoms, at least for 7 - 10 days up to 14 days. The success of the treatment should be verified by a veterinarian before discontinuing treatment.

Skin infections (small localised superficial):

Apply a few drops of the veterinary medicinal product to the skin lesions to be treated twice a day and rub well.

Treatment should be continued without interruption until a few days after complete disappearance of the clinical symptoms, up to 14 days.

In some persistent cases (ear or skin infections), treatment may need to be continued for 2 to 3 weeks. In cases where prolonged treatment is necessary repeated clinical examinations including a re- assessment of the diagnosis are required.

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Contraindications

Do not use: - in cases of hypersensitivity to the active substances, as well as to other corticosteroids, to other azole antifungal agents, or to any of the excipients, - in animals with perforation of the tympanic membrane, - in animals, where resistance of causative agents to polymyxin B and/or miconazole is known, - on the mammary glands of lactating bitches and queens.

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Adverse reactions

Dogs, cats:

Very rare (<1 animal / 10 000 animals treated, including isolated reports): Deafness1

Undetermined frequency (cannot be estimated from the available data): Other immune system disorders2,3; Application site infection2, Application site bleeding2,4; Skin thinning2; Delayed healing2, Systemic disorder2 (e.g. Adrenal gland disorder2,5); Telangiectasia2.

1 Especially in older dogs. In this case treatment should be discontinued.

2 After prolonged and extensive use of topical corticosteroid preparations.

3 Local immunosuppression including increased risk of infections.

4 Increased vulnerability of the skin to bleeding.

5 Suppression of adrenal function.

Reporting adverse events is important. It allows continuous safety monitoring of a veterinary medicinal product. Reports should be sent, preferably via a veterinarian, to either the marketing authorisation holder or the national competent authority via the national reporting system. See the package leaflet for respective contact details.

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Warnings

Special precautions for safe use in the target species:

Use of the veterinary medicinal product should be based on identification and susceptibility testing of the target bacteria and/or fungi isolated from the animal. If this is not possible, therapy should be based on local (regional) epidemiological information and knowledge of susceptibility of the target pathogens.

Use of the veterinary medicinal product should be in accordance with official, national and regional antimicrobial policies.

An antibiotic with a lower risk of antimicrobial resistance selection (lower AMEG category) should be used for first line treatment where susceptibility testing suggests the likely efficacy of this approach.

In cases of persistent infestations with Otodectes cynotis (ear mites) systemic treatment with an appropriate acaricide should be considered.

Before treating with the veterinary medicinal product, the integrity of the tympanic membrane must be verified.

Systemic corticosteroid effects are possible, especially when the veterinary medicinal product is used under an occlusive dressing, on extensive skin lesions, with increased skin blood flow, or if the veterinary medicinal product is ingested by licking. Oral ingestion of the veterinary medicinal product by treated animals or animals having contact with treated animals should be avoided.

Avoid contact with eyes in animals. In case of accidental contact, rinse thoroughly with water.

Special precautions to be taken by the person administering the veterinary medicinal product to animals:

People with known hypersensitivity to prednisolone, polymyxin B or miconazole should avoid contact with the veterinary medicinal product.

The veterinary medicinal product may cause irritation to skin and eyes. Avoid contact with skin or eyes. Always wear single use disposable gloves when applying the veterinary medicinal product to animals. In case of accidental spillage, skin or eyes should be rinsed immediately with plenty of water. Wash hands after use.

Take care to avoid accidental ingestion. In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.

Special precautions for the protection of the environment:

Not applicable.

3.11 Special restrictions for use and special conditions for use, including restrictions on the use of antimicrobial and antiparasitic veterinary medicinal products in order to limit the risk of development of resistance

Not applicable.

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Use during pregnancy, lactation or lay

The safety of the veterinary medicinal product has not been established during pregnancy and lactation.

Pregnancy and lactation:

Absorption of miconazole, polymyxin B and prednisolone through the skin is low, therefore no teratogenic/embryotoxic/foetotoxic and maternotoxic effects are expected in dogs and cats. Oral ingestion of the active substances by treated animals when grooming can possibly occur and appearance of the active ingredients in blood and milk can be expected.

Use only according to the benefit-risk assessment by the responsible veterinarian.

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Interactions

No data available.

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Overdose

No other symptoms than those mentioned in section 3.6 are expected.

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Special warnings

Bacterial and fungal otitis is often secondary in nature. The underlying cause should be identified and treated.

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Withdrawal period

Not applicable.

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Incompatibilities

Not applicable.

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Immediate packaging

Dropper container of white, opaque LDPE with white, opaque HDPE screw cap in a cardboard box.

Pack size: 1 x 20 ml

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Storage

Do not store above 30 °C.

After first opening do not store above 25 °C.

Keep the container in the outer carton.

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Shelf life

Shelf life of the veterinary medicinal product as packaged for sale: 2 years

Shelf life after first opening the immediate packaging: 3 months

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Disposal of unused product

Medicines should not be disposed of via wastewater.

Use take-back schemes for the disposal of any unused veterinary medicinal product or waste materials derived thereof in accordance with local requirements and with any national collection systems applicable to the veterinary medicinal product concerned.

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Additional information

Vm 57446/4004

8 DATE OF FIRST AUTHORISATION

05 March 2015

9 DATE OF THE LAST REVISION OF THE SUMMARY OF THE PRODUCT CHARACTERISTICS

December 2024

10 CLASSIFICATION OF VETERINARY MEDICINAL PRODUCT

Veterinary medicinal product subject to prescription.

Find more product information by searching for the ‘Product Information Database’ on www.gov.uk.

Approved 27 February 2025

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Registration holder

VetViva Richter GmbH

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