Gentamicin + Miconazole + Hydrocortisone Aceponate (GMHa) Combination: Otic

What is gentamicin + miconazole + hydrocortisone aceponate (GMHa) combination? 

GMHa (brand name: Easotic®) is a combination antibiotic, antifungal, and corticosteroid anti-inflammatory drug used to treat certain bacterial and yeast ear infections.

Its use in cats to treat bacterial infections in the ears is considered “off label” or “extra label”. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully, as their directions may be significantly different from those on the label.

How is GMHa given?

• GMHa is a suspension used once daily to treat ear infections. 
• This combination medication is applied directly to the ear canal using a pump mechanism. 
• Shake well before use.
• Fill the nozzle of the pump prior to first use, following label instructions.
• DO NOT USE ORALLY.

Wash hands after applying. If human skin contact occurs, wash area thoroughly with water. Avoid contact with eyes.

What if I miss giving my pet the medication or my shipment is late?

If you miss a dose, give it when you remember. However, if it is close to the time for the next dose, skip the dose you missed, give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

GMHa may cause the following side effects:

• Inflammation (redness) of treated area

Rarely, SERIOUS ADVERSE REACTIONS associated with this drug may occur without warning, including:

• loss of hearing
• loss of balance
• head tilt or walking in circles
• increased drinking and urination
• loss of appetite, vomiting or diarrhea
• progressive ear pain

Contact your veterinarian immediately if you notice anything out of the ordinary and ensure all follow-up exams are completed as directed by the veterinarian.

Are there any risk factors for this medication?

GMHa SHOULD NOT BE USED in patients: 

• with a history of hypersensitivity or allergy to it 
• with a damaged tympanic membrane
• used for breeding, are pregnant, or lactating

GMHa SHOULD BE USED WITH CAUTION in patients:

• with liver or kidney disease
• with chronic ear infections

 Are there any drug interactions I should be aware of?

Although drug interactions have not been noted with topical use of GMHa at this time, it is recommended to avoid using it at the same time as medications that have potential ototoxicity (causing hearing or balance problems). 

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is any monitoring needed with this medication?

No specific monitoring is needed while your pet is taking this medication. Your pet should be rechecked to ensure this medication has been effective.

How do I store GMHa?

• GMHa should be stored at room temperature between 20°C and 25°C (68°F-77°F).
• Store compounded formulations of this medication according to label directions.
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.