Nystatin, Neomycin Sulfate, Thiostrepton, Triamcinolone - Topical

How is this medication useful?

Combination topical treatments contain multiple active ingredients, making it easier to treat bacterial, fungal, and inflammatory skin conditions.

• Nystatin, an antifungal, is used to treat ringworm (dermatophytosis) and other yeast infections of the skin.

• Neomycin sulfate, an antibiotic, treats superficial bacterial infections of the skin.

• Triamcinolone, a steroid, is a cortisone-like medicine that relieves itching and inflammation.

The FDA (U.S. Food & Drug Administration) has approved this topical medicine combination for use in dogs and cats to treat infectious and inflammatory conditions of the skin, ears, and anal glands. The FDA allows veterinarians to prescribe and use human products containing these drugs in animals in certain situations. You and your veterinarian can discuss why this drug is the most appropriate choice.

What should I tell my veterinarian to see if this medication can be safely given?

Many things might affect how well this medicine will work in your animal. Be sure to discuss the following with your veterinarian so together you can make the best treatment decisions.

• Other medicines can interact with this medication, so be sure to tell your veterinarian and pharmacist what medications (including other topical medicines, vitamins, supplements, herbal therapies, or other topical medicines) you give your animal, including the amount and time you give each.

• Tell your veterinarian about any conditions or diseases your animal may have now or has had in the past.

• If your animal has been treated for the same disease or condition in the past, tell your veterinarian about the treatment and how well it did or didn’t work.

• If your animal is pregnant or nursing, talk to your veterinarian about the risks of using this drug.

• Tell your veterinarian and pharmacist about any medication side effects (including allergic reactions, lack of appetite, diarrhea, itching, hair loss) your animal has developed in the past.

How long until I will know if this medication is working, and how long will the effects of this medication last?

This medication should start having effects within 1 to 2 hours; however, you may not see the effects of this medication outwardly. Your animal should begin feeling better within 1 to 2 days. The effects of this medication are moderate in duration, meaning they may last fora few days, although the benefits may be prolonged if your animal has decreased kidney and/or liver function.

When should this medication not be used or be used very carefully?

No drug is 100% safe in all patients, but your veterinarian will discuss with you any specific concerns about using this drug in your animal.

This medicine SHOULD NOT be used in animals:

• That are allergic to any of the ingredients found in the prescribed drug combination product.

• That have tuberculosis infections of the skin.

• With a confirmed or suspected ruptured ear drum.

This medicine should be used WITH CAUTION in patients:

• With small body size (eg, toy breeds).

• That require treatment of large areas.

• With recurring ear infections.

If your animal has any of these conditions, talk to your veterinarian about the potential risks versus benefits.

What are the side effects of this medication?

In dogs and cats, this medicine is typically well tolerated.

Side effects that usually are not serious include:

• Redness or discomfort at the site of application.

You don’t have to be overly concerned if you see any of these signs unless they are severe, worsen, or continue to be a problem. Contact your veterinarian if this happens.

Side effects that may be serious or indicate a serious problem:

• Infections that do not respond to treatment, do not appear to be healing, or are getting worse.

• Loss of appetite, vomiting, or diarrhea.

• Sudden hearing loss.

• Progressive ear pain.

• Head tilt or walking in circles.

• Development of sores around the mouth.

• Increased thirst (eg, frequent drinking of large quantities of water) and frequent urination.

• Thinning of the skin, progressive hair loss and skin redness, increased skin tears, or infections at the application site.

If you see any of these signs, contact your veterinarian immediately.

If my animal gets too much of this medication (an overdose), what should I do?

An overdose could occur if your animal eats the topical medication, if the treatment area covers a large part of your animal’s body, or if too much medicine is applied. If you witness or suspect an overdose, contact your veterinarian or an animal poison control center for further advice. Animal poison control centers that are open 24 hours a day include Pet Poison HELPLINE (855-764-7661) and ASPCAAnimal Poison Control Center (888-426-4435); a consultation fee is charged for these services.

How should this medication be given?

For this medication to work, give it exactly as your veterinarian has prescribed. It’s a good idea to always check the prescription label to be sure you are giving the drug correctly.

• Trim hair at the application site only as necessary.

• This medicine is typically prescribed to apply to affected areas twice daily.

• When treating skin infections, daily to weekly baths with a medicated shampoo may be prescribed; massage shampoo well into fur and leave in contact with skin for at least 10 minutes before rinsing with cool water. Wait for skin and fur to dry before applying ointment.

• Avoid contact with eyes, mouth, and nose.

• Do not allow animal to lick or chew at affected sites as this will delay healing and possibly introduce more infection to the area. If necessary, your veterinarian may place a collar on your animal to prevent licking and chewing of the area.

• These medicated products can be given for various lengths of time. Be sure you understand how long your veterinarian wants you to continue giving this medication. Prescription refills may be necessary before the therapy will be complete. Before stopping this medication, talk to your veterinarian, as there may be important reasons to continue its use.

What should I do if I miss giving a dose of this medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time. After that, return to the regular dosing schedule. Do not double-up or give extra doses.

How should I store this medication?

• Store this medication in the original container at room temperature and protected from light.

• If a special formulation has been made by your veterinarian or pharmacist, follow storage recommendations and expiration date.

• Keep away from children and other animals.

Can handling this medication be hazardous to me, my family, or other animals?

It is recommended to wear gloves while applying these medicated products; always wash your hands after applying the medication.

How should I dispose of this medication if I don’t use it all?

• Do not flush the contents of these products down the toilet or wash it down the sink. If a community drug “take-back” program is available, use this option. If there is no take-back program, mix the contents with coffee grounds or cat litter (to make it undesirable to children and animals and unrecognizable to people who might go through your trash), place the mixture in a sealable plastic bag to keep it from leaking out, and throw the bag out with the regular trash.

• Do not save leftover product for future use or give it to others to use.

What other information is important for this medication?

• Topical combination medications may be suitable for infectious and inflammatory skin and ear conditions.

• Some skin infections may resolve completely with use of topical treatments, but others may also require oral medications.

• This medicine may be absorbed across the skin and have effects throughout the body when applied to large areas or areas with open sores; small animals and patients receiving prolonged treatment may also be affected. Effects on the rest of the body can happen with any topically applied medication; however, the risk is greater with steroids.

• Residual activity from steroid-containing products may affect allergy testing. Unless your veterinarian tells you otherwise, stop usingsteroid- or antihistamine-containing products 2 weeks before allergy testing.

• Your veterinarian will recommend follow-up visits to monitor your animal’s condition. Do not miss these important recheck visits.

• Use of this drug may not be allowed in certain animal competitions. Check rules and regulations before entering your animal in a competition while this medication is being administered.

If you have any other questions about this medication, contact your veterinarian or pharmacist.