Can levofloxacin eye drops be used as ear drops?

Author: Department of Pharmacy, Sports New City Campus, Dalian Women and Children's Medical Center Group

Deputy Chief Pharmacist Yu Hong

Can levofloxacin eye drops be used as ear drops?

A few days ago, a patient came to the hospital for otitis media. Because the original ofloxacin ear drops were out of stock, the doctor prescribed levofloxacin eye drops, which aroused the pharmacist at the window. So can levofloxacin eye drops be used as ear drops?

Image source: Self-photographed

Levofloxacin eye drops are suitable for blepharitis, blepharitis, conjunctivitis, dacryocystitis, etc. caused by sensitive bacteria, while ear drops are suitable for external otitis, myringitis and otitis media caused by sensitive bacteria. Although we already know the difference in the design purpose of eye drops and ear drops, whether eye drops can replace ear drops, let's discuss it from the preparation process, concentration, pH, excipients and physiological structure of the ear canal.

381046990 Author: Department of Pharmacy, Sports New Town Campus, Dalian Women and Children's Medical Center Group

Deputy Chief Pharmacist Yu Hong

Can levofloxacin eye drops be used as ear drops?

A few days ago, a patient came to the hospital for otitis media. Because the original ofloxacin ear drops were out of stock, the doctor prescribed levofloxacin eye drops, which aroused the pharmacist at the window. So can levofloxacin eye drops be used as ear drops?

Image source: Self-photographed

Levofloxacin eye drops are suitable for blepharitis, blepharitis, conjunctivitis, dacryocystitis, etc. caused by sensitive bacteria, while ear drops are suitable for external otitis, myringitis and otitis media caused by sensitive bacteria. Although we already know the difference in the design purpose of eye drops and ear drops, whether eye drops can replace ear drops, let's discuss it from the preparation process, concentration, pH, excipients and physiological structure of the ear canal.

381046990 In terms of preparation technology, both eye drops and ear drops are external preparations, but the production process of eye drops is more stringent, as they are sterile preparations and need to be made in a sterile environment. The process requirements for ear drops are relatively less stringent.

381024130 In terms of concentration, the concentration of levofloxacin eye drops is 5ml:24.4mg, while the concentration of ofloxacin ear drops is 5ml:15mg. The concentration of eye drops is lower than that of ear drops, so the therapeutic effect on otitis media is also poor.

1333429845 In terms of pH, the pH value of eye drops is 6.0-7.0, and the pH value of ear drops is 4.5-6.0. Ear drops are more in line with the weak acidity requirement of the external auditory canal.

2286043180 In terms of excipients, eye drops generally contain the minimum effective dose of benzalkonium chloride as an antibacterial agent to prevent microbial contamination and reproduction during use, while the solvent of ear drops sometimes contains ethanol, which can enhance penetration, promote drug absorption, and also has a bactericidal effect, but is more irritating to local areas.

323851270The physiological structure of the ear canal determines that ocular preparations are not completely suitable for the ear canal. Because eye drops are water-soluble and have poor volatility, although they can bring the drug into the deep ear canal in liquid form, they may cause liquid accumulation in the deep ear canal, making the deep ear canal in a relatively humid environment, which is not conducive to drainage. Ear drops are generally made using alcohol as a carrier. Alcohol can evaporate well. After the liquid medicine is brought into the ear, it will not cause excessive irritation to the local area, and it can fully drain, which is conducive to the discharge of pus and the effect of antibiotics in the middle ear.

Image source: Photo Network

Therefore, levofloxacin eye drops are often used to treat conjunctivitis. Although the effect is relatively mild, it is not recommended to be used as ear drops. If there are special ear drops, it is recommended to use ear drops, which are more effective in treating otitis media.

If ear drops are really not available, can eye drops be used instead?

Eye drops can be used to drop into the ears, because the drug concentration contained in eye drops is relatively low, and it will not hurt the ears when dropped into the ears. However, due to its low drug concentration, the efficacy is poor. Due to its high process requirements, eye drops generally have no obvious irritation to the mucous membrane and skin, and there are rarely discomfort symptoms such as pain and itching after ear drops. However, since the antibacterial effect of levofloxacin eye drops is weaker than that ofloxacin ear drops, ofloxacin eye drops should not be used to treat acute otitis media.

So can ear drops be used as eye drops?

Although eye drops can replace ear drops to relieve temporary needs, ear drops are usually not used for eye drops because the concentration of ear drops is relatively high, and using them for eye drops will cause certain irritation and damage to the eyes. In addition, the pH values ​​of the two may be different, and the eyes have higher requirements for pH values. If the pH value is too high or too low, it will cause intolerance to the ocular surface and obvious irritation symptoms will appear, including pain, sore eyes, etc.

Image source: Photo Network

Finally, if inflammation occurs in the ear, it is recommended to go to the hospital to identify the cause before treatment and avoid self-medication. The safest approach is to use medicines designed for the ear under the guidance of a doctor. At the same time, it is also very important to keep the ears clean and dry and avoid irritating the ears with sharp objects. Pay attention to the cleanliness and health of the ears in daily life. It is recommended to clean the ears regularly with warm salt water once or twice a week, which helps to keep the ears clean and prevent infection.