|Therapeutic Area||Formulary Choices||Cost for 28|
(unless otherwise stated)
|Rationale for decision / comments|
|BNF Chapter 12: Ear, nose, and oropharynx|
|12.1 Drugs acting on the ear|
also see Chapter 5
|Acetic acid |
|2% spray: £4.10 (5ml)||See Infection management guidance for appropriate clinical indications. Available OTC.
Cure rates similar at 7 days for topical acetic acid or antibiotic +/- steroid.
|Second line:||Betamethasone with Neomycin |
|Drops: £2.39 (10ml)|
|Otitis media||Topical products not recommended for Otitis media||See Infection management guidance for appropriate clinical indications.|
|Removal of wax||For all preparations used in removal of ear wax patients should be advised to lie with affected ear uppermost for 5 minutes after administration to ensure penetration of the ear canal.|
|Olive Oil - suitable for self-care||Simple oils such as olive (or almond) oil should be used first line.
|Docusate Sodium |
- suitable for self-care
|0.5% drops: £1.95 (10ml)||Available OTC|
|Otovent nasal balloon has been removed from drug tariff as manufacturer significantly increased the price||Recommended by NICE MIB59 as demonstrates improved outcomes for children with middle ear / glue ear problems. Little evidence to support use in adults. (PAMM April 2016)|