Amikacin/Dexamethasone/Polymyxin B clEARmix Lanolin Otic (3mL Syringe)

How to Use clEARmix Lanolin Otic (Ear Medication)

This is a thick ear ointment used to treat ear infections. It comes in a pre-filled syringe with a soft tip, making it easier to apply and designed to stay in your pet’s ear longer.

Step-by-Step: 1. Warm the syringe – If it’s cold, hold it in your hands for a minute to soften the ointment. Do not microwave. 2. Position your pet – Have them sit in a comfy spot. You may need someone to gently help hold them. Lift their ear flap straight up. 3. Clean the ear (if needed) – Only if your vet told you to. Use a vet-approved ear cleaner and cotton ball—never a Q-tip deep in the ear. Let the ear dry. 4. Apply the medication – Remove the cap, then gently insert just the tip of the syringe into the ear opening. Don’t push in deep. 5. Dispense slowly – Press the plunger gently to apply the full dose or the amount your vet prescribed. 6. Massage the ear – Rub the base of the ear for about 30 seconds to help the medication spread. 7. Let them shake – It’s normal! Wipe off any excess with a tissue or cloth. 8. Reward your pet – Give them praise and maybe a treat to make it a positive experience. 9. Store the rest – If there’s more medication left, recap the syringe and store at room temp. Wash your hands after use.

This compounded formulation combines active ingredients from different drug classes: amikacin, an aminoglycoside antibiotic; dexamethasone, a corticosteroid; and polymyxin B, a polymyxin antibiotic. In compounding practice, clinicians may consider a multi-ingredient preparation like this to address more than one aspect of a patient's physiology at once. Your veterinarian determines whether it is appropriate based on your animal's diagnostic findings.

At a pharmacological level, this medication functions through three distinct pathways. Amikacin and polymyxin B provide a broad spectrum of antibacterial activity; amikacin irreversibly binds to the 30S subunit of the bacterial ribosome. Dexamethasone, a glucocorticoid, acts by binding to intracellular receptors to inhibit the synthesis of inflammatory mediators, such as prostaglandins and leukotrienes. Together, these actions work through their separate mechanisms — the antibacterial components on their targets and the corticosteroid on localized inflammation such as redness, swelling and itching. Your veterinarian will determine the clinical appropriateness of this combination based on your pet’s diagnostic findings and previous response to other medications.

This description reflects the general pharmacology of the active ingredient's drug class; your veterinarian determines whether this approach is appropriate for your animal.

Prescription only. Use only under the direction of a licensed veterinarian. This information is not a substitute for veterinary diagnosis, prescribing or monitoring. Compounded drugs are not approved by the FDA for safety or effectiveness.

Commonly observed effects of amikacin/dexamethasone/polymyxin B administration are primarily localized, though owners should watch for increased redness or sensitivity at the application site. Because aminoglycosides like amikacin have been associated with ototoxicity (damage to hearing or balance) if they enter the middle ear, your veterinarian will evaluate the integrity of the eardrum before prescribing this for an ear infection. Additionally, prolonged use of corticosteroids like dexamethasone can lead to localized skin thinning or systemic effects such as increased thirst and urination. Owners should monitor for any loss of balance, head tilting or unusual behavioral shifts and contact their veterinarian promptly if these occur.

This medication is typically used with extra caution or avoided in patients with a ruptured tympanic membrane (eardrum) or known hypersensitivity to any of the components. It is also carefully evaluated in pregnant or lactating animals, as systemic absorption of corticosteroids can influence fetal development. Before starting a protocol, ensure your veterinarian has a complete history of all other prescriptions your pet is receiving, as concurrent use of other steroids or aminoglycosides may increase the risk of adverse effects. Your veterinarian is the right person to provide guidance on the necessary duration of use and the proper application technique to ensure the management approach remains suitable for your pet's individual health status.