Quadruple Topical Ointment for Cats & Dogs (7.5 mL)

Quadruple Topical Ointment is an antibiotic/anti-inflammatory combination of nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide. Used for the local therapy of a variety of cutaneous disorders of cats and dogs. Quadruple Ointment is useful in the treatment of acute and chronic otitis of varied etiologies, in interdigital cysts in cats and dogs, and in anal gland infections in dogs.

Quadruple Ointment is also indicated in the management of dermatologic disorders characterized by inflammation and dry or exudative dermatitis, particularly those caused, complicated, or threatened by bacterial or candidal (Candida albicans) infections. It is also indicated in eczematous dermatitis, contact dermatitis, and seborrheic dermatitis, and for use as an adjunct in the treatment of dermatitis due to parasitic infection.

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By virtue of its four active ingredients, the ointment provides four basic therapeutic effects: anti-inflammatory, antipruritic, antifungal and antibacterial. Triamcinolone acetonide is a potent synthetic corticosteroid providing rapid and prolonged symptomatic relief on topical administration. Inflammation, edema, and pruritis promptly subside and lesions are permitted to heal. Nystatin is the first well tolerated anti-fungal antibiotic of dependable efficacy for the treatment of cutaneous infections caused by Candida albicans (monilia). Nystatin is fungistatic in vitro against a variety of yeast and yeast-like fungi including many fungi pathogenic to animals. No appreciable activity is exhibited against bacteria. Thiostrepton has a high order of activity against gram-positive organisms, including many which are resistant to other antibiotics; neomycin exerts antimicrobial action against a wide range of gram-positive and gram-negative bacteria. Together they provide comprehensive therapy against those organisms responsible for most superficial bacterial infections.

Key Benefits

• Generic for Panalog
• ContainsNystatin-Neomicin Sulfate-Thiostrepton -Triamcinolone Acetonide
• Useful in the treatment of acute and chronic otitis of varied etiologies
• Useful in the treatment of interdigital cysts in cats & dogs
• Useful in the treatment of anal gland infections in dogs
• Also indicated in the management of dermatolocial disorders characterized by inflammation and dry or exudative dermatitis caused by bacterial or candidal infections.
• For use in cats and dogs

How It Works

Quadruple ointment contains four active ingredients that are antibacterial, antipruritic, antifungal, and anti-inflammatory. When applied topically, relief can be prolonged due to a synthetic corticosteroid known as triamcinolone acetonide. Healing then can come to lesions along with reduction in edema and inflammation and subsiding of pruritus.

For treating cutaneous infections from Candida albicans (also known as monilia), Nystatin is the first antibiotic antifungal that is effective and tolerated well by animals. In vitro, Nystatin is shown to be fungistatic when used for yeast-like and yeast fungi as well as fungi shown to be pathogenic with animals. When used for bacteria, this activity was not shown.

For gram-positive organisms, Thiostrepton has been shown to be effective. This includes antibiotic resistant organisms, gram-negative and gram-positive, and other antimicrobial actions. Combined, these treatments can assist in the treatment of bacterial infection that is superficial to prevent the organisms that are responsible.

Indications

Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment is particularly useful in the treatment of acute and chronic otitis of varied etiologies, in interdigital cysts in cats and dogs, and in anal gland infections in dogs. The preparation is also indicated in the management of dermatologic disorders characterized by inflammation and dry or exudative dermatitis, particularly those caused, complicated, or threatened by bacterial or candidal (Candida albicans) infections. It is also of value in eczematous dermatitis; contact dermatitis, and seborrheic dermatitis; and as an adjunct in the treatment of dermatitis due to parasitic infestation.

Frequency of administration is dependent on the severity of the condition. For mild inflammations, application may range from once daily to once a week; for severe conditions nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment may be applied as often as two to three times daily, if necessary. Frequency of treatment may be decreased as improvement occurs.

Wear gloves during the administration of the ointment or wash hands immediately after application.

Otitis Directions:

• Examine the external ear canal to ensure the tympanic membrane is intact.
• Clean the ear canal of impacted wax and remove any ticks or foreign bodies.
• Put on gloves before administering the ointment.
• Instill 3 to 5 drops into each affected ear.
• Wash hands with soap and water immediately after application.

Infected Glands and Cysts Directions:

• Put on gloves.
• Drain the infected gland and clean gently.
• Fill the gland with ointment.
Wash hands with soap and water immediately after application.

Dermatological Disorders Directions:

• Clean the treatment area and remove any crust or exudate.
• Put on gloves before using the ointment.
• Apply a thin film to the affected areas.
• Wash hands with soap and water.

Cautions:

Before instilling any medication into the ear, examine the external ear canal thoroughly to be certain the tympanic membrane is not ruptured in order to avoid the possibility of transmitting infection to the middle ear as well as damaging the cochlea or vestibular apparatus from prolonged contact. If hearing or vestibular dysfunction is noted during the course of treatment, discontinue the use of nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment.

Warnings:

Clinical and experimental data have demonstrated that corticosteroids administered orally or by injection to animals may induce the first stage of parturition if used during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis.

Additionally, corticosteroids administered to dogs, rabbits and rodents during pregnancy have resulted in cleft palate in the offspring. In dogs, other congenital anomalies have resulted; deformed forelegs, phocomelia, and anasarca.

Precautions:

Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment is not intended for the treatment of deep abscesses or deep-seated infections such as inflammation of the lymphatic vessels. Parenteral antibiotic therapy is indicated in these infections. Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment has been extremely well tolerated. Cutaneous reactions attributable to its use have been extremely rare. The occurrence of systemic reactions is rarely a problem with topical administration.

There is some evidence that corticosteroids can be absorbed after topical application and cause systemic effects. Therefore, an animal receiving nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment therapy should be observed closely for signs such as polydipsia, polyuria, and increased weight gain. Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment is not generally recommended for the treatment of deep or puncture wounds or serious burns.

Sensitivity to neomycin may occur. If redness, irritation or swelling persists or increases, discontinue use. Do not use if pus is present since the drug may allow the infection to spread. Keep this and all medications out of the reach of children.

Avoid ingestion. Oral or parenteral use of corticosteroids (depending on dose, duration of use, and specific steroid) may result in inhibition of endogenous steroid production following drug withdrawal.

Side Effects:

SAP and SGPT (ALT) enzyme elevations, polydipsia/polyuria, vomiting, and diarrhea (occasionally bloody) have been observed following parenteral or systemic use of synthetic corticosteroids in dogs.

Cushing's syndrome has been reported in association with prolonged or repeated steriod therapy in dogs.

Temporary hearing loss has been reported in conjunction with treatment of otitis with products containing corticosteroids. However, regression usually occurred following withdrawal of the drug. If hearing dysfunction is noted during the course of treatment with nystatin, neomycin sulfate,

Storage:

240 mL bottle: Do not store above 86°F. 7.5 mL, 15 mL, 30 mL tubers: Store at room temperature; avoid excessive heat (104°F).