Question
Posted on: January 9 2019Bacicoline ear drops for middle ear
An ear doctor asks for Bacicoline ear drops. I wanted to counterfeiting this and came up with the following formula:
Polymixin B 100000 IU
Bacitracin 2500 IU
Hydrocortisone Acetate 50 mg
Boron acid/borax buffer pH 6.8 (i.e. 1.8 g boric acid + 0.13 g per 100 ml) Propylene glycol 1 ml (to rub powders) water AD 5 ml
For the stability of Polymyxin was opted for the buffer solution with pH 6.8.
However, this formula is only suitable for the external auditory canal, given the use of propylene glycol (ototoxic, therefore, only outer ear) and for the sake of hydrocortisone acetate (does not dissolve in water).
For use in the middle ear, a sterile, isotonic solution (no suspension) is required, free of propylene glycol. Therefore, this formula is not suitable for this. How best to solve this?
Answer
When consulting this website
https://www.dizziness-and-balance.com/disorders/bilat/ototoxic_drops.htm
Then we notice that various medicines, which occur in the mentioned composition, are given up as Ototoxissch.
Of course it depends on the duration of the use and can optionally be used a custom formula of Bacicoline for the middle ear for a short period.
The replacement of hydrocortisone acetate by Prednisolone Naphosphate allows to prepare a solution, which can be filtered by a sterilized membrane filter in a sterilised vial. Propylene glycol can be omitted.