Understanding Ciprofloxacin/Hydrocortisone Side Effects

If your doctor prescribed Ciprofloxacin/Hydrocortisone ear drops (brand name: Cipro HC Otic) for swimmer's ear, you're probably wondering what side effects to watch for. The good news is that because this medication is applied directly into the ear canal, it has very little systemic absorption — meaning side effects tend to be mild and localized. But it's still important to know what's normal and what's not.

This guide breaks down the common side effects, the rare but serious ones, and when you should contact your doctor.

What Is Ciprofloxacin/Hydrocortisone?

Ciprofloxacin/Hydrocortisone is a prescription ear drop that combines two active ingredients: Ciprofloxacin, a fluoroquinolone antibiotic that kills the bacteria causing your ear infection, and Hydrocortisone, a corticosteroid that reduces inflammation, swelling, and pain. It's FDA-approved to treat acute otitis externa (swimmer's ear) in adults and children aged 1 year and older.

For more details about this medication, see our full guide: What Is Ciprofloxacin/Hydrocortisone?

Common Side Effects

Most people tolerate Ciprofloxacin/Hydrocortisone well. The side effects reported in clinical trials were generally mild and included:

• Headache — The most commonly reported side effect in clinical studies.
• Ear discomfort or pain — Some stinging or discomfort when applying the drops, especially if the ear canal is inflamed or swollen. This usually goes away within a few minutes.
• Itching (pruritus) — Mild itching in or around the ear after application.

These side effects are typically temporary and resolve on their own as your ear heals. They are not a reason to stop using the medication unless they become severe or persistent.

Serious Side Effects

Serious side effects from Ciprofloxacin/Hydrocortisone ear drops are rare because the medication is applied topically with minimal absorption into the bloodstream. However, you should be aware of these potential reactions:

Allergic Reactions

Although uncommon, some people may have an allergic reaction to Ciprofloxacin or Hydrocortisone. Seek immediate medical attention if you experience:

• Rash or hives
• Difficulty breathing or swelling of the face, lips, tongue, or throat
• Severe dizziness

If you have a known allergy to fluoroquinolone antibiotics (such as Levofloxacin, Moxifloxacin, or Ofloxacin), tell your doctor before using this medication.

Superinfection

Prolonged use of any antibiotic — including Ciprofloxacin/Hydrocortisone — can lead to superinfection, where resistant bacteria or fungi overgrow. Signs include:

• New or worsening ear discharge
• Increased pain after initial improvement
• White or discolored patches in the ear canal (may indicate fungal infection)

This is why it's important to use the drops only for the prescribed 7-day course and not longer unless directed by your doctor.

A Note About Systemic Fluoroquinolone Warnings

You may have heard about serious side effects linked to fluoroquinolone antibiotics, including tendon damage and nerve problems. These warnings apply to systemic (oral and IV) fluoroquinolones. The otic (ear drop) formulation of Ciprofloxacin has minimal systemic absorption and does not carry the same boxed warning. That said, always follow your doctor's instructions and report any unusual symptoms.

Specific Populations

Children

Ciprofloxacin/Hydrocortisone is approved for children 1 year of age and older. It has not been studied in infants under 1 year. Side effects in children are similar to those in adults.

Pregnant and Breastfeeding Women

This medication is classified as Pregnancy Category C, meaning animal studies have not ruled out risk. It should be used during pregnancy only if the potential benefit justifies the potential risk. It's unknown whether the drug passes into breast milk, so breastfeeding women should use it with caution and discuss risks with their doctor.

People with Perforated Eardrums

Ciprofloxacin/Hydrocortisone is indicated for otitis externa (outer ear infections). If you have a perforated eardrum, your doctor may choose a different medication, such as Ciprodex, which is specifically approved for use with tympanostomy tubes.

How to Manage Side Effects

Here are practical tips for minimizing discomfort while using Ciprofloxacin/Hydrocortisone:

• Warm the drops — Hold the bottle in your hands for 1 to 2 minutes before applying. Cold drops can cause dizziness or discomfort.
• Stay lying down — After instilling the drops, remain on your side for 30 to 60 seconds to let the medication reach deep into the ear canal.
• Don't insert objects — Avoid cotton swabs, fingers, or earbuds in the treated ear. This can worsen irritation or push debris deeper.
• Complete the full course — Even if you feel better after a few days, finish all 7 days of treatment to prevent the infection from returning.
• Keep the ear dry — Avoid swimming and keep water out of the affected ear during treatment.
• Over-the-counter pain relief — If ear pain is significant, ask your doctor if Acetaminophen (Tylenol) or Ibuprofen (Advil) is appropriate.

When to Call Your Doctor

Contact your healthcare provider if you experience any of the following:

• Symptoms that don't improve after 3 to 4 days of treatment
• Symptoms that get worse at any point
• New symptoms such as fever, facial swelling, or hearing changes
• Signs of an allergic reaction (rash, hives, breathing difficulty)
• Signs of superinfection (new discharge, worsening pain, fungal patches)

Your doctor may need to reassess your condition, perform a culture, or switch you to a different treatment.

Final Thoughts

Ciprofloxacin/Hydrocortisone ear drops are generally well tolerated, with most side effects being mild and temporary. Serious reactions are rare, especially since the medication stays localized in the ear canal. The most important things you can do are follow the dosing instructions carefully, complete the full 7-day course, and contact your doctor if anything feels off.

If you're having trouble finding this medication at your pharmacy, Medfinder can help you locate it in stock nearby.