Betamethasone/KETOconazole clEARmix Lanolin Otic (3mL Syringe)
Betamethasone/KETOconazole is a compounded formulation containing Betamethasone, KETOconazole, prepared by Mixlab for veterinary use. Available by prescription.
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 betamethasone, a corticosteroid, with ketoconazole, an azole antifungal — two different drug classes. In compounding practice, clinicians may consider a combination like this for a multi-targeted approach. Your veterinarian determines whether it is appropriate based on your animal's diagnostic findings.
At a pharmacological level, this medication functions through two distinct pathways. Betamethasone is a glucocorticoid that acts by inducing lipocortins, which inhibit the enzyme phospholipase A2. This may help address the release of arachidonic acid and the subsequent synthesis of inflammatory mediators like prostaglandins and leukotrienes, leading to a reduction in localized swelling and itching. Ketoconazole acts by inhibiting the fungal enzyme cytochrome P450 14-alpha-demethylase. This inhibition may help address the conversion of lanosterol to ergosterol, an essential component of the fungal cell membrane. The resulting loss of membrane integrity manages the growth and spread of the fungal population. Your veterinarian will determine the clinical appropriateness of this combination based on results from skin cytology or fungal cultures.
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 following the administration of betamethasone/ketoconazole include localized redness or a temporary increase in sensitivity at the application site. Because corticosteroids can be absorbed systemically through the skin, owners should watch for behavioral shifts such as increased thirst (polydipsia) or increased urination (polyuria), particularly with long-term use over large surface areas. It is important may be considered in the context of your pet concerns licking the area immediately following application to avoid accidental ingestion and ensure the medication remains in contact with the skin as intended.
This medication is typically used with extra caution or avoided in patients with known hypersensitivity to any of the active ingredients or in those with pre-existing viral or parasitic skin infections. It is also carefully evaluated in pregnant or lactating animals due to the potential for systemic absorption. Before starting a protocol, ensure your veterinarian has a complete history of all other topical prescriptions or supplements your pet is receiving to avoid localized interactions. Your veterinarian is the right person to provide guidance on the necessary duration of use and the most commonly considered way to monitor your pet's recovery and skin health.
Yes. Betamethasone/ketoconazole is a combination prescription medication and can only be dispensed by a licensed pharmacy upon receipt of a valid authorization from a licensed veterinarian. Mixlab verifies all authorizations before any medication is prepared or shipped to your home.
Yes. While these active ingredients appear in various commercial products, Mixlab specializes in compounding them into customized strengths and flavored or specialized vehicles—such as topical sprays, ointments or lotions—if your veterinarian determines a customized preparation better suits your pet's needs. The decision between a commercial and compounded product rests with the prescribing veterinarian.
Veterinarians may consider combining these ingredients so the preparation can act through more than one mechanism at once — here, it brings together antifungal and anti-inflammatory actions in one preparation. Your veterinarian determines whether this multi-targeted approach is appropriate for your pet.
If your pet licks the application site, you should contact your veterinarian for guidance, as ingestion of topical steroids can sometimes cause stomach upset or shifts in thirst and urination. To help reduce this, your veterinarian may recommend using a protective collar or engaging your pet with a toy or activity for several minutes after application to allow the medication to absorb.
