Amikacin/KETOconazole/Triamcinolone clEARmix Thermo Gel Otic (3mL Syringe)

How to Use clEARmix Thermo Gel Otic (Ear Medication)

This is a liquid ear medication that turns into a gel once it warms up in your pet’s ear, helping it stay in place and work effectively. It comes in a soft-tipped syringe for easy use.

Step-by-Step:

1. Keep it cool – Store in the fridge if instructed. Before using, hold the syringe in your hands for a minute so it’s not too cold, but don’t warm it too much.
2. Get your pet ready – Have them sit comfortably and gently lift the ear flap. A second person can help hold them still if needed.
3. Clean the ear (if advised) – Use a vet-approved ear cleaner and cotton ball. Wipe out any debris and let the ear dry.
4. Apply the medication – Take off the cap. Gently insert just the tip into the ear opening (not deep), and slowly press the plunger to deliver the full dose.
5. Massage the ear – Rub the base of the ear for 30 seconds. The liquid will turn into a gel as it warms, and massaging helps it spread inside the ear.
6. Let them shake it out – It’s normal! Wipe away any extra gel you see near the ear opening.
7. Reward your pet – Offer praise or a treat to keep the experience positive.
8. Store and clean up – Recap the syringe and refrigerate if needed. Wash your hands afterward.

This compounded formulation combines three active ingredients from different drug classes: amikacin, an aminoglycoside antibiotic; ketoconazole, an azole antifungal; and triamcinolone, a corticosteroid. In compounding practice, clinicians may consider a combination like this for a localized, multi-targeted approach. Your veterinarian determines whether it is appropriate based on your animal's diagnostic findings and culture or cytology results.

Each ingredient acts through a distinct mechanism: amikacin binds to the 30S bacterial ribosomal subunit to interfere with bacterial protein synthesis; ketoconazole inhibits fungal ergosterol synthesis, affecting the fungal cell membrane; and triamcinolone binds cytoplasmic glucocorticoid receptors to modulate inflammatory mediators.

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.

Because this preparation contains an antibiotic, an antifungal and a corticosteroid, your veterinarian will tailor it to your animal's specific situation and monitor the response. Give your veterinarian a complete list of your pet's other medications so interactions can be considered. Follow the application instructions carefully and contact your veterinarian if the area worsens or does not respond.