Comprehensive medication guide to Ciprofloxacin/Fluocinolone including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$10–$60 copay for covered plans at Tier 2–3; prior authorization may be required by some plans; step therapy requiring trial of ofloxacin or Ciprodex generic may apply.
Estimated Cash Pricing
$361–$395 retail for brand Otovel; generic (ciprofloxacin-fluocinolone acetonide PF) available for as low as $257–$272 with GoodRx or SingleCare coupons for a 14-vial (7-day) course.
Medfinder Findability Score
60/100
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Ciprofloxacin/fluocinolone — sold under the brand name Otovel — is a prescription combination ear drop that was FDA-approved on April 29, 2016. It combines ciprofloxacin hydrochloride 0.3% (a fluoroquinolone antibiotic) with fluocinolone acetonide 0.025% (a medium-strength corticosteroid) in a sterile, preservative-free otic solution.
The medication is approved specifically for acute otitis media with tympanostomy tubes (AOMT) in pediatric patients aged 6 months and older. AOMT is a middle ear infection that occurs through surgically placed ear tubes, characterized by fluid or purulent discharge (otorrhea) draining from the ear. It is the only FDA-approved combination of ciprofloxacin and fluocinolone acetonide in a preservative-free single-dose vial formulation.
A generic version — ciprofloxacin-fluocinolone acetonide PF — is available and contains the same active ingredients at the same concentrations. The medication is manufactured by Laboratorios Salvat S.A. and has been distributed in the U.S. through various pharmaceutical partners including Arbor Pharmaceuticals, WraSer Pharmaceuticals, and Key Therapeutics.
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Ciprofloxacin/fluocinolone works through two distinct mechanisms that together address both the bacterial infection and the inflammation causing ear drainage in AOMT.
Ciprofloxacin is a fluoroquinolone antibiotic that kills bacteria by inhibiting two critical enzymes — DNA gyrase (topoisomerase II) and topoisomerase IV — that bacteria need to replicate and repair their DNA. Without these enzymes, the bacteria cannot survive. Applied directly to the ear, ciprofloxacin achieves concentrations at the infection site far exceeding what could be safely given systemically, with negligible systemic absorption.
Fluocinolone acetonide is a medium-strength corticosteroid that reduces inflammation by inhibiting local prostaglandin biosynthesis and stabilizing cell membranes. This reduces swelling, redness, and the volume of otorrhea (ear drainage). In clinical trials with 662 pediatric patients, the combination cleared otorrhea in a median of 2.9 days — compared to 4.4 days for ciprofloxacin alone and 3.6 days for fluocinolone alone — demonstrating that both components contribute meaningfully to clinical outcomes.
0.3%/0.025% — otic solution (single-dose vials)
Each single-dose vial delivers 0.25 mL of solution containing ciprofloxacin 0.75 mg and fluocinolone acetonide 0.0625 mg. One vial instilled into the affected ear(s) twice daily for 7 days. A course includes 14 single-dose vials.
Ciprofloxacin/fluocinolone (Otovel) is not in a declared FDA drug shortage as of 2026, but it is a specialty pediatric product that is not routinely stocked at every pharmacy. Many families report difficulty filling this prescription at their local pharmacy, requiring calls to multiple locations before finding one that has it in stock.
The availability challenges stem from the drug's narrow indication (AOMT only), specialty single-dose vial packaging, relatively high cost ($361–$395 per course retail), and variable insurance coverage that depresses fill rates — all of which reduce pharmacy incentives to maintain standing stock. Large chain pharmacies (CVS, Walgreens, Walmart, Costco) and children's hospital pharmacies are most likely to carry it.
Instead of spending hours calling pharmacies yourself, use medfinder — a service that calls pharmacies near you to check which ones have your medication in stock and texts you the results.
Ciprofloxacin/fluocinolone (Otovel) is not a controlled substance and can be prescribed by any licensed prescriber who is authorized to diagnose and treat ear infections. There are no DEA scheduling requirements or special prescribing restrictions beyond a standard prescription license.
The most common prescribers for ciprofloxacin/fluocinolone include:
Otolaryngologists (ENTs): The specialists who perform tympanostomy tube placement and manage AOMT complications
Pediatricians: Often the first point of contact for AOMT episodes in children with ear tubes
Family medicine physicians: Can diagnose and treat AOMT in pediatric patients in their practice
Nurse practitioners (NPs) and physician assistants (PAs): Working in pediatric practices, urgent care, or ENT offices; can prescribe independently in most states
Telehealth prescribing is generally not standard for AOMT, as the diagnosis requires physical examination of the ear (otoscopy) to confirm tympanostomy tube status and middle ear involvement. An in-person visit is typically required to receive a prescription for ciprofloxacin/fluocinolone.
No. Ciprofloxacin/fluocinolone (Otovel) is not a controlled substance and is not scheduled by the DEA. Any licensed prescriber — including pediatricians, family medicine physicians, ENTs, nurse practitioners, and physician assistants — can prescribe it without special DEA registration or additional documentation requirements.
There are no refill restrictions based on controlled substance scheduling. A prescriber may issue refills as clinically appropriate. However, if AOMT episodes recur frequently (two or more episodes within 6 months), clinical guidelines recommend further evaluation to exclude underlying conditions that may require different management.
Because ciprofloxacin/fluocinolone is applied directly in the ear and is negligibly absorbed systemically, side effects are primarily local. The following were reported in 1% or more of patients in clinical trials:
Otorrhea (ear drainage) — often overlaps with the infection itself
Excessive granulation tissue
Ear infection (can represent persistence or new infection)
Ear pruritus (itching)
Tympanic membrane disorder
Auricular swelling
Balance disorder or dizziness (often from cold solution — warm the vial before use)
Serious side effects:
Severe allergic reactions / anaphylaxis (rash, hives, swelling of face/lips/throat, difficulty breathing, cardiovascular collapse) — stop use and seek emergency care immediately
Secondary microbial overgrowth (fungal or resistant bacterial infections with prolonged use)
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Ciprodex (ciprofloxacin/dexamethasone)
Same antibiotic (ciprofloxacin 0.3%) with dexamethasone steroid instead of fluocinolone; FDA-approved for AOMT and otitis externa; widely available as a generic for $30–$80. Most commonly used alternative.
Ofloxacin Otic Solution
Fluoroquinolone antibiotic without a steroid; FDA-approved for AOMT in patients with tympanostomy tubes; antibiotic monotherapy; generic costs $10–$40; most affordable option.
Ciprofloxacin Otic Solution
Antibiotic-only formulation approved for AOMT and otitis externa; same antibiotic as Otovel without the steroid component; generic available at $20–$60.
Cipro HC Otic (ciprofloxacin/hydrocortisone)
Ciprofloxacin with hydrocortisone steroid — approved for otitis externa ONLY, not AOMT. Not sterile and should not be used with tympanostomy tubes.
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NSAIDs (ibuprofen, naproxen)
minorSystemic fluoroquinolones combined with NSAIDs can increase CNS side effect risk (tremors, seizures). Due to negligible systemic absorption of the otic formulation, clinically significant interaction is unlikely. Acetaminophen is preferred for pain relief during treatment.
Other otic medications
moderateDo not use concurrently — may dilute concentration, create incompatibilities, or introduce preservatives into the ear canal. Use only as directed.
Systemic corticosteroids
minorTheoretical additive steroid burden. Not clinically significant at standard otic dosing due to negligible systemic absorption of fluocinolone from the ear drops.
IV aminoglycosides (gentamicin, tobramycin)
moderateConcurrent systemic aminoglycosides carry independent ototoxicity risk. Ciprofloxacin/fluocinolone otic drops do not appear to add to this risk, but audiology monitoring is appropriate when both are used.
Ciprofloxacin/fluocinolone (Otovel) is a clinically proven, FDA-approved treatment for AOMT that combines the bactericidal power of ciprofloxacin with the anti-inflammatory effect of fluocinolone acetonide. In randomized controlled trials, it cleared ear drainage faster than either component alone — making it a preferred choice for many ENTs and pediatricians managing AOMT.
The main challenges with this medication are practical rather than clinical: it is not routinely stocked at all pharmacies, and the retail price ($361–$395) can be a barrier for families without adequate insurance coverage. A generic version (ciprofloxacin-fluocinolone acetonide PF) is available and significantly more affordable with discount coupons. If cost or availability is a barrier, effective alternatives like generic Ciprodex ($30–$80) or ofloxacin otic ($10–$40) are FDA-approved for AOMT and widely available.
If you're having trouble finding ciprofloxacin/fluocinolone at a pharmacy near you, medfinder can help. medfinder calls pharmacies near you to check which ones have your exact medication in stock, then texts you the results — saving you hours of phone calls.
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