Claro (florfenicol, terbinafine, mometasone)

Claro is a prescription veterinary medication specifically developed for the treatment of otitis externa, commonly known as ear infections, in dogs. This innovative product represents a significant advancement in veterinary otology by combining three powerful active ingredients, florfenicol, terbinafine, and mometasone furoate, in a single-dose formulation that is administered directly into the ear canal by a veterinarian. The unique delivery system eliminates the need for daily at-home ear treatments, which can be challenging for both pet owners and dogs, particularly those who are resistant to ear handling. Claro received FDA approval for veterinary use and has become a popular choice for treating canine ear infections due to its convenience and comprehensive antimicrobial coverage.

The three active ingredients in Claro work synergistically to address the multiple components typically involved in canine otitis externa. Florfenicol is a broad-spectrum antibiotic belonging to the amphenicol class that inhibits bacterial protein synthesis, providing activity against many common bacteria associated with ear infections including Staphylococcus and Streptococcus species. Terbinafine is an antifungal agent from the allylamine class that interferes with fungal cell membrane synthesis by inhibiting the enzyme squalene epoxidase, effectively targeting Malassezia pachydermatis, the yeast most commonly implicated in canine ear infections. Mometasone furoate is a potent corticosteroid that reduces inflammation, swelling, and itching within the ear canal, providing rapid symptomatic relief while the antimicrobial components address the underlying infection.

Claro is formulated as a gel-like otic solution designed to remain in the ear canal and release medication gradually over approximately thirty days. This extended-release formulation allows a single veterinary-administered treatment to maintain therapeutic drug levels throughout the treatment period, eliminating the need for daily at-home dosing. The vehicle system keeps the medication in contact with the ear canal tissues where it can exert its therapeutic effects, while the gradual release prevents the peaks and troughs associated with intermittent dosing. This sustained release contributes to both the efficacy and convenience that distinguish Claro from traditional ear medications.

Because Claro is administered exclusively by veterinary professionals during an office visit, its use ensures proper diagnosis before treatment, correct placement of medication, and appropriate patient selection. Your veterinarian will examine your dog's ears, obtain samples for cytology to confirm the presence of infection and identify the organisms involved, and determine whether Claro is the appropriate treatment choice. This professional oversight helps ensure that more serious ear conditions requiring different treatment approaches are not missed, and that the medication reaches its intended location within the ear canal. Following treatment, your veterinarian will schedule a recheck appointment to evaluate the response and determine whether additional therapy is needed.

Claro is FDA-approved for the treatment of otitis externa in dogs caused by susceptible strains of bacteria and yeast. Otitis externa, inflammation and infection of the external ear canal, is one of the most common reasons dogs visit veterinarians, affecting approximately ten to twenty percent of dogs at some point in their lives. The condition causes significant discomfort including itching, pain, head shaking, ear scratching, and discharge, and can progress to more severe complications if left untreated. Claro addresses the bacterial, fungal, and inflammatory components of otitis externa simultaneously, making it particularly effective for the mixed infections that commonly occur in canine ear disease.

The primary indication for Claro is acute otitis externa involving bacterial and yeast organisms susceptible to florfenicol and terbinafine. The most common bacteria targeted include coagulase-positive staphylococci, including Staphylococcus pseudintermedius, which is the predominant bacterial pathogen in canine skin and ear infections. Malassezia pachydermatis, a lipophilic yeast that thrives in the warm, moist environment of the ear canal, is effectively targeted by the terbinafine component. Many cases of otitis externa involve both bacterial and yeast overgrowth, making Claro's dual antimicrobial coverage particularly valuable for comprehensive treatment in a single application.

Claro may also be selected for dogs with ear infections that have been difficult to treat with traditional medications due to compliance issues. Daily ear drops require owner administration over a period of one to two weeks or longer, which can be challenging when dogs resist ear handling or when owners have difficulty with proper application technique. Some dogs become increasingly resistant to ear treatment over time as they associate the process with discomfort. The single professional application of Claro eliminates these compliance concerns, ensuring that the full course of treatment is delivered regardless of at-home treatment challenges.

The corticosteroid component of Claro, mometasone furoate, provides important anti-inflammatory effects that go beyond comfort alone. Inflammation of the ear canal contributes to narrowing of the canal lumen, increased ceruminous secretions, and changes in the ear environment that perpetuate infection. By reducing inflammation, mometasone helps normalize the ear canal environment, improving drainage and ventilation while reducing the substrate for microbial growth. The rapid relief of itching and pain also reduces head shaking and ear scratching behaviors that can traumatize the ear canal and potentially lead to complications such as aural hematoma.

While Claro is highly effective for appropriate cases, it is not suitable for all ear conditions. Your veterinarian will perform a thorough otoscopic examination and cytological evaluation before recommending treatment. Dogs with ruptured or compromised tympanic membranes (eardrums) should not receive Claro, as the medication could cause damage to middle and inner ear structures. Additionally, chronic, recurrent, or refractory ear infections may require investigation into underlying causes such as allergies, anatomical abnormalities, or foreign bodies, and may need different or additional treatment approaches. Your veterinarian will determine whether Claro is the appropriate choice based on examination findings and the specific characteristics of your dog's ear infection.

Claro is administered exclusively by veterinary professionals, distinguishing it from most other ear medications that are dispensed for at-home use. The single-dose treatment protocol involves administration of one tube of medication into each affected ear during a veterinary office visit. This professional-only administration ensures proper technique, appropriate patient selection, and confirms that the tympanic membrane is intact before treatment. Pet owners do not need to purchase the medication or perform any at-home ear treatments following the veterinary visit, although some veterinarians may recommend at-home ear cleaning once the active infection has resolved.

Before administering Claro, the veterinarian will perform a thorough examination of both ears, including otoscopic visualization of the ear canals and tympanic membranes. Cytological examination of ear debris, typically involving microscopic evaluation of a swab sample, confirms the presence of bacteria and/or yeast organisms and helps guide treatment selection. The veterinarian must verify that the tympanic membrane is intact and that no contraindications exist before proceeding with Claro administration. If the ear canals contain excessive debris or cerumen that would prevent medication contact with the canal epithelium, cleaning may be performed before treatment, though this decision is made on a case-by-case basis.

The actual administration involves instilling the contents of one single-dose tube into the ear canal. The tube tip is inserted into the ear canal opening and the entire contents are expressed into the ear. After instillation, the veterinarian will typically massage the base of the ear briefly to help distribute the medication throughout the horizontal and vertical ear canal. This massage may produce a squelching sound indicating the medication is being distributed. The gel-like formulation adheres to the ear canal lining, where it will gradually release the active ingredients over approximately thirty days.

Following Claro administration, your veterinarian will provide aftercare instructions. Generally, the ears should not be cleaned by the owner for thirty days following treatment to avoid removing the medication from the ear canal. Water should also be kept out of the ears during this period, so precautions during bathing or swimming may be necessary. Some veterinarians recommend using cotton balls to protect the ears during bathing. The medication will gradually be absorbed and naturally eliminated from the ear canal as the treatment period progresses.

A follow-up examination is typically scheduled approximately thirty days after Claro administration to evaluate treatment response. At this recheck visit, the veterinarian will examine the ears, assess for resolution of infection and inflammation, and determine whether additional treatment is needed. If the infection has resolved, discussion may include strategies for preventing recurrence, such as regular ear cleaning or addressing underlying factors like allergies. If residual infection remains, additional treatment with Claro or alternative medications may be recommended. Some dogs with chronic or recurrent ear problems require ongoing management strategies that extend beyond a single treatment episode.

Claro is administered once per ear per treatment episode. If a dog has bilateral ear infections, both ears are treated simultaneously. The manufacturer's guidelines indicate that treatment may be repeated once if needed, but repeated treatments should be administered under veterinary supervision with appropriate re-evaluation of the ear condition. Frequent recurrence of ear infections despite treatment suggests underlying factors that require investigation and management beyond antimicrobial therapy alone.

Claro is generally well-tolerated by dogs, with the most commonly observed side effects being local reactions at the treatment site. Clinical studies conducted for FDA approval demonstrated that most dogs experienced improvement in their ear condition without significant adverse effects. However, as with any medication, some dogs may experience unwanted reactions, and awareness of potential side effects allows owners to monitor appropriately and seek veterinary attention if concerns arise.

The most frequently reported side effect in clinical trials was discharge from the treated ear. This discharge may represent normal clearing of infectious debris as the infection resolves, increased cerumen production, or reaction to the medication vehicle. Mild discharge that is not accompanied by signs of worsening infection or discomfort is generally not cause for concern and typically resolves as the treatment period progresses. However, discharge that is purulent, malodorous, or accompanied by increased head shaking, scratching, or signs of pain should be evaluated by your veterinarian.

Local irritation or sensitivity reactions, while uncommon, can occur following Claro administration. Some dogs may show increased scratching at the treated ear, head shaking, or apparent discomfort in the hours or days following treatment. Mild transient discomfort may be a normal response to the medication in the ear canal, but significant or persistent signs of irritation warrant veterinary evaluation. In rare cases, dogs may experience an adverse reaction to one of the medication components, presenting with more severe inflammation, swelling around the ear, or other signs of hypersensitivity.

Because Claro contains a corticosteroid component, potential systemic effects of corticosteroids should be considered, although significant systemic absorption from properly administered otic medication is generally minimal. Signs of systemic corticosteroid effects could theoretically include increased thirst and urination, increased appetite, panting, or other symptoms typically associated with steroid administration. These effects are uncommon with topical otic administration but may be more likely in small dogs, with bilateral treatment, or if the medication were to be ingested. Dogs should be prevented from licking the ears of treated housemates.

Serious adverse effects are rare when Claro is used appropriately in dogs with intact tympanic membranes. However, if the eardrum is ruptured or becomes compromised, the medication components could potentially access the middle and inner ear, causing more serious complications including hearing loss or vestibular dysfunction (balance problems). Signs of inner ear involvement include head tilt, circling, nystagmus (abnormal eye movements), incoordination, or difficulty walking. These signs require immediate veterinary attention. Pre-treatment otoscopic examination to verify tympanic membrane integrity is specifically performed to prevent this complication. If any concerning symptoms develop following Claro treatment, contact your veterinarian promptly for evaluation and guidance.

Several contraindications exist for Claro use, and understanding these helps ensure appropriate patient selection and prevents potential complications. The most critical contraindication is a known or suspected ruptured tympanic membrane. The tympanic membrane, or eardrum, separates the external ear canal from the middle ear structures. If this membrane is compromised, medication instilled into the ear canal can access the middle and inner ear, potentially causing serious damage including hearing loss and vestibular dysfunction. Your veterinarian will perform otoscopic examination specifically to evaluate tympanic membrane integrity before administering Claro.

Dogs with known hypersensitivity to any of Claro's active ingredients (florfenicol, terbinafine, or mometasone) or to any components of the formulation should not receive this medication. If your dog has had previous adverse reactions to any amphenicol antibiotics, allylamine antifungals, or corticosteroid medications, inform your veterinarian. While allergic reactions to these ingredients are relatively uncommon, they can occur and may present as severe local inflammation, generalized allergic symptoms, or other adverse effects. Previous use of these medication classes without incident suggests tolerance, but each medication decision should be made in consultation with your veterinarian.

Claro is contraindicated in dogs with otitis media, infection of the middle ear space behind the tympanic membrane. While otitis media may coexist with otitis externa, particularly in chronic cases, the middle ear requires different treatment approaches, often including systemic antibiotics and potentially myringotomy (intentional eardrum puncture) for drainage. Signs that may suggest middle ear involvement include severe or prolonged ear disease, head tilt, facial nerve paralysis, or hearing loss. Your veterinarian will evaluate for middle ear involvement as part of the pre-treatment examination and may recommend imaging studies such as skull radiographs or CT scanning if middle ear disease is suspected.

The manufacturer's labeling states that the safe use of Claro has not been evaluated in dogs used for breeding purposes or in pregnant or lactating dogs. While the topical otic route generally limits systemic absorption, the effects of the medication components on reproduction have not been specifically studied. If your dog is pregnant, nursing, or intended for breeding, discuss the risks and benefits with your veterinarian, who may recommend alternative treatments with more established safety profiles during reproduction. Similarly, the safety of Claro has not been specifically evaluated in puppies, and use in very young dogs should be undertaken with appropriate caution and veterinary guidance.

Drug interactions specifically involving Claro are relatively limited because the medication is administered topically into the ear canal with restricted systemic absorption. However, certain considerations apply regarding other medications your dog may be receiving, and complete disclosure of all current treatments to your veterinarian ensures comprehensive assessment of potential interactions. Inform your veterinarian of any other ear medications, systemic medications, supplements, or topical treatments your dog is currently receiving.

Other topical ear medications should generally not be used concurrently with Claro. The single-dose extended-release formulation is designed to maintain therapeutic drug levels in the ear canal for approximately thirty days, and adding other products could interfere with this delivery system. Additional ear drops or otic ointments could dilute the Claro formulation, alter the release characteristics, or introduce incompatible ingredients. If previous ear medications were being used, your veterinarian will determine appropriate timing for transitioning to Claro treatment. After Claro administration, no additional ear medications should be applied during the treatment period unless specifically directed by your veterinarian.

Systemic medications are less likely to interact directly with topically administered Claro, but certain considerations exist. If your dog is receiving systemic corticosteroids for any condition, additive corticosteroid effects could theoretically occur, although significant systemic absorption of mometasone from otic administration is minimal. Dogs receiving systemic antifungal medications would have additive antifungal effects with the terbinafine in Claro, which is generally beneficial rather than problematic. Similarly, systemic antibiotic therapy would provide complementary effects to the florfenicol component.

Ear cleaning products and ear cleaners may affect Claro's effectiveness if used during the treatment period. Most veterinarians recommend avoiding ear cleaning for thirty days following Claro administration to prevent removal of the medication from the ear canal. If ear cleaning is necessary before treatment due to excessive debris, your veterinarian will perform this in the clinic and allow appropriate drying time before administering Claro. Some ear cleaning solutions contain ingredients that could potentially interact with medication components or alter the ear canal environment in ways that affect treatment.

The extended-release formulation of Claro provides continuous medication delivery over approximately thirty days, during which time drug concentrations in the ear canal are maintained at therapeutic levels. This sustained presence of medication eliminates the timing considerations that apply to intermittently administered products. Your veterinarian will consider the timing of Claro administration relative to any other ear treatments that may have been recently used and will provide guidance on any other medications or products that should be avoided or adjusted during the treatment period.

Several precautions and warnings apply to Claro use, and attention to these ensures the safest and most effective treatment outcome. First and foremost, Claro should only be administered by or under the direct supervision of a licensed veterinarian. The professional-administration requirement exists because proper patient selection, tympanic membrane evaluation, and correct medication placement are essential for safe and effective treatment. Do not attempt to obtain or administer this medication without proper veterinary examination and diagnosis.

Dogs with a history of aminoglycoside antibiotic ototoxicity should be treated with caution, as they may be more susceptible to additional otic medication-related complications. While florfenicol is not an aminoglycoside and has a different ototoxicity profile, dogs that have experienced hearing loss or vestibular effects from previous ear treatments warrant careful evaluation. Similarly, dogs with chronic, recurrent, or long-standing ear disease may have subclinical tympanic membrane damage or middle ear involvement that could affect treatment safety. Your veterinarian will consider your dog's complete ear disease history when making treatment decisions.

Breeds with the MDR1 (ABCB1) gene mutation require mention in the context of any medication discussion, though the clinical relevance for topically administered otic medications is less clear than for systemic drugs. The MDR1 gene affects drug transport across cell membranes and is prevalent in Collies, Australian Shepherds, Shetland Sheepdogs, and related herding breeds. While otic medications have limited systemic absorption in dogs with intact ear canal epithelium, dogs with significant ear inflammation or erosion might have increased absorption potential. If your dog belongs to an MDR1-affected breed, inform your veterinarian.

After Claro administration, owners should monitor their dogs for any signs of adverse effects and report concerns to their veterinarian. Watch for signs of worsening ear discomfort such as increased head shaking, scratching, head tilt, loss of balance, or unusual discharge. While mild ear discharge during the treatment period may be normal, significant changes warrant evaluation. Prevent the treated dog from getting water in the ears for the duration of the treatment period by using cotton balls during bathing and avoiding swimming. Also prevent other pets in the household from licking the treated dog's ears, which could result in ingestion of medication.

Claro contains benzyl alcohol as an inactive ingredient. While the concentration in the otic formulation is low and intended for ear canal administration only, this should be considered for any dog with known sensitivity to benzyl alcohol. The product should not be allowed to contact the eyes, as irritation could occur. If accidental eye exposure occurs, flush the eye thoroughly with water and seek veterinary attention if irritation persists. Human handlers should wash hands after any contact with the medication and avoid getting the product in their own eyes or mucous membranes.

Claro is supplied in single-dose tubes intended for professional veterinary use, so home storage by pet owners is not typically necessary. The medication is stored at the veterinary clinic until administered during your dog's appointment. However, understanding storage requirements helps explain why veterinary-supervised administration is important and provides relevant information should any medication be temporarily in the owner's possession.

The manufacturer specifies that Claro should be stored at controlled room temperature, typically defined as 68 to 77 degrees Fahrenheit (20 to 25 degrees Celsius), with excursions permitted to 59 to 86 degrees Fahrenheit (15 to 30 degrees Celsius). The medication should be protected from excessive heat and kept away from direct sunlight. Freezing should be avoided, as this could affect the formulation's consistency and drug release characteristics. Veterinary clinics maintain appropriate storage conditions for all medications, ensuring product stability and effectiveness.

The single-dose tube packaging is designed for one-time use. Each tube contains the appropriate amount of medication for one ear treatment, and the entire contents should be administered at once. Partially used tubes should not be saved for later use, as sterility cannot be maintained after opening and the precise dosing would be compromised. Any unused medication remaining after treatment should be disposed of according to veterinary facility protocols for pharmaceutical waste.

If for any reason an owner temporarily has custody of Claro medication (such as transport between veterinary facilities), it should be stored as directed, kept out of reach of children and pets, and maintained in its original packaging until used. The medication should not be transferred to other containers. Do not use Claro beyond its labeled expiration date, as medication stability and effectiveness cannot be guaranteed after this time. Any concerns about medication integrity, such as unusual appearance, leaked packaging, or potential temperature exposure, should be reported to the veterinary facility.

Disposal of unused medication should follow local regulations for pharmaceutical waste. Many veterinary facilities participate in drug take-back programs or have established protocols for safe pharmaceutical disposal. Do not flush medications down toilets or drains unless specifically instructed, as this can contribute to environmental contamination. Do not place in regular household trash where children or animals might access it. Your veterinary facility can provide guidance on appropriate disposal if needed.

Claro can be used in dogs of all breeds when appropriately indicated, though certain breed characteristics warrant consideration in the context of ear infections and their treatment. Some breeds have anatomical features that predispose them to ear infections, making products like Claro particularly valuable in their care. Other breeds may have genetic factors affecting drug metabolism that require mention, though the clinical significance for topically administered otic medications is generally limited.

Breeds with pendulous ears, narrow ear canals, or excessive ear hair are particularly prone to otitis externa due to decreased air circulation and moisture accumulation in the ear canal. Cocker Spaniels, Basset Hounds, Bloodhounds, Beagles, Labrador Retrievers, Golden Retrievers, and Springer Spaniels are among the breeds most commonly affected by chronic or recurrent ear infections. For these dogs, Claro's single-application convenience is particularly advantageous because repeated at-home treatments can be challenging and may not provide consistent medication delivery. Dogs that have become resistant to ear handling due to previous painful infections or treatment attempts also benefit from the single professional administration approach.

Breeds with narrow or stenotic ear canals, including many brachycephalic breeds such as Bulldogs and Shar-Peis, may present additional considerations for otic medication administration. Severely narrowed ear canals can make otoscopic examination and medication placement challenging, and may indicate chronic changes that require investigation beyond treatment of the acute infection. Shar-Peis are particularly prone to severe ear canal stenosis and often require comprehensive ear disease management that may extend beyond what Claro alone can address. Your veterinarian will evaluate ear canal anatomy as part of the pre-treatment examination.

Breeds with the MDR1 (ABCB1) gene mutation, primarily herding breeds including Collies, Australian Shepherds, Shetland Sheepdogs, Old English Sheepdogs, and Border Collies, have altered drug transport across cell membranes that can affect the handling of certain medications. While the clinical significance of MDR1 status for topically administered otic medications like Claro is not well established, particularly in dogs with intact ear canal epithelium, it remains prudent to inform your veterinarian if your dog belongs to an affected breed. Dogs with significant ear canal inflammation or erosion might have increased systemic absorption, making breed-related drug sensitivity potentially more relevant.

Size variation across breeds affects practical aspects of ear examination and treatment. Very small dogs with tiny ear canals may require extra care during medication administration to ensure appropriate placement without trauma. Very large dogs with correspondingly larger ear canals may have different medication distribution patterns. Regardless of size, the professional administration protocol allows the veterinarian to adapt technique appropriately for each individual patient. Dogs of all sizes can be effectively treated with Claro when the medication is indicated based on examination and diagnostic findings.

Several alternative and complementary medications exist for the treatment of canine otitis externa, providing options when Claro is contraindicated, unavailable, or when different therapeutic approaches are preferred. Traditional multi-dose ear medications remain widely used and offer flexibility in treatment duration and ability to adjust therapy based on response. These products require daily administration by pet owners, typically for one to four weeks depending on the specific medication and severity of infection.

Easotic is another single-application otic medication for dogs that combines hydrocortisone aceponate, miconazole nitrate, and gentamicin sulfate. Like Claro, Easotic is administered by a veterinarian as a single treatment and provides extended-release medication delivery. The antibiotic component differs (gentamicin versus florfenicol), and the antifungal component differs (miconazole versus terbinafine), providing an alternative option when different antimicrobial coverage is desired or when a dog has previously not responded to one formulation. Your veterinarian will select the most appropriate product based on cytological findings and previous treatment history.

Traditional multi-dose otic medications include numerous combinations of antibiotics, antifungals, and corticosteroids. Products containing gentamicin, neomycin, or polymyxin B provide antibacterial coverage. Miconazole, clotrimazole, and ketoconazole are common antifungal components. Various corticosteroids including betamethasone, dexamethasone, triamcinolone, and hydrocortisone provide anti-inflammatory effects. These products require owner administration once to twice daily and offer the advantage of owner observation of ear condition during the treatment period. For dogs that tolerate ear handling well and owners who are comfortable with administration technique, traditional medications remain effective options.

Systemic medications may be necessary for severe ear infections, infections involving the middle ear, or cases where topical treatment alone is insufficient. Oral antibiotics such as cephalexin, cefpodoxime, or fluoroquinolones may be prescribed for bacterial otitis with suspected extension beyond the external ear canal. Oral antifungals such as ketoconazole or itraconazole may be used for severe or refractory yeast infections. Systemic corticosteroids may be indicated for severely inflamed or stenotic ear canals to reduce swelling and allow topical medication access. Your veterinarian will determine whether systemic medications are needed in addition to or instead of topical treatment based on the severity and extent of your dog's ear disease. Comprehensive management of chronic or recurrent ear infections often requires addressing underlying factors such as allergies through appropriate systemic therapy.