Adult: Each mL of ear drops solution contains flumetasone 200 mcg and clioquinol 10 mg
For eczematous inflammation and mild bacterial or fungal infections in otitis externa: Instil 2-3 drops into the auditory canal of the affected ear(s) bid for 7-10 days. Patient should be seated or lying down with the treated ear turned upwards for instilling; remain in this position for at least 1-2 minutes after application. Discontinue treatment if there is no response or improvement within 1 week. Child: ≥2 years Same as adult dose.
Contraindications
Hypersensitivity to flumetasone, clioquinol or other quinoline derivatives. Viral skin infections (e.g. herpes simplex, herpes zoster, varicella), syphilitic skin infections, tuberculosis of the skin; suspected or verified perforation of the tympanic membrane. Children <2 years.
Special Precautions
Avoid long-term continuous use. Children (≥2 years). Pregnancy and lactation.
Adverse Reactions
Significant: May stain skin, hair, and nails. Flumetasone: May cause hypercortisolism or HPA axis suppression that may lead to adrenal crisis (due to systemic absorption, particularly in younger children or use of high doses for prolonged periods); blurred vision or other visual disturbances. Clioquinol: May markedly increase protein-bound iodine (PBI). General disorders and administration site conditions: Burning sensation, irritation, rash, and pruritus at the application site. Immune system disorders: Hypersensitivity reactions. Nervous system disorders: Paraesthesia. Skin and subcutaneous tissue disorders: Skin atrophy.
Patient Counseling Information
Avoid contact with the eyes. This drug may stain skin, nails, hair, and clothing. Discontinue treatment if severe irritation or sensitisation occurs.
Monitoring Parameters
Monitor the affected area for signs of increased irritation.
Drug Interactions
Increased risk of systemic corticosteroid adverse effects with CYP3A inhibitors (including cobicistat-containing agents).
Lab Interference
Clioquinol: May markedly increase PBI; hence, may interfere with certain thyroid function tests (e.g. PBI, radioactive iodine, butanol-extractable iodine). May cause false-positive ferric chloride test for phenylketonuria.
Action
Description: Overview: Flumetasone is a moderately potent glucocorticoid that exhibits anti-inflammatory, antipruritic, and vasoconstrictive effects.
Clioquinol, a halogenated hydroxyquinoline, is a broad-spectrum antibacterial and antifungal agent. Mechanism of Action: Flumetasone may suppress the formation, release, and activity of endogenous inflammatory mediators (e.g. kinins, histamine, liposomal enzymes, prostaglandins) by inducing phospholipase A2 inhibitory proteins (lipocortins) and subsequently inhibiting the release of arachidonic acid.
Clioquinol chelates the bacterial surface and trace metals necessary for bacterial growth.
Chemical Structure
Flumetasone Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 16490, Flumethasone. https://pubchem.ncbi.nlm.nih.gov/compound/Flumethasone. Accessed Jan. 28, 2026.
Clioquinol Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 2788, Clioquinol. https://pubchem.ncbi.nlm.nih.gov/compound/Clioquinol. Accessed Jan. 28, 2026.
S02CA02 - flumetasone and antiinfectives ; Belongs to the class of combinations of corticosteroids and antiinfectives used in the treatment of ear diseases.
References
Brayfield A, Cadart C (eds). Clioquinol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 18/11/2025.Brayfield A, Cadart C (eds). Flumetasone Pivalate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 18/11/2025.Clioquinol and Flumethasone. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 18/11/2025.Joint Formulary Committee. Flumetasone Pivalate with Clioquinol. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 18/11/2025.Locorten Vioform Ear Drops (Amdipharm UK Limited). MHRA. https://products.mhra.gov.uk. Accessed 18/11/2025.Paediatric Formulary Committee. Flumetasone Pivalate with Clioquinol. BNF for Children [online]. London. BMJ Group, Pharmaceutical Press, and RCPCH Publications. https://www.medicinescomplete.com. Accessed 18/11/2025.
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