Finafloxacin (otic)

Finafloxacin is a prescription-only antibacterial ear drop indicated for the treatment of acute otitis externa or swimmer's ear.


Swimmer's ear, which is otherwise known as otitis externa, is a type of ear infection common in children and adults.

Some of the main warning signs of this condition include a fever, pain in the face, neck or head and swollen lymph nodes. It is estimated that approximately 2.4 million patients are diagnosed with swimmer's ear each year.

Swimmer's ear is painful and hard to ignore. To treat acute otitis externa, your doctor may prescribe Finafloxacin, which is sold and marketed under the US brand name Xtoro.

This prescription-only ear drop is an antibiotic proven to stop and prevent the growth of new fungi or bacteria. In particular, it is effective for the treatment of swimmer's ear caused by:

  • Bacteria Pseudomonas Aeruginosa
  • Staphylococcus Aureus

Finafloxacin is indicated for both adults and children one year of age and older. Most patients respond well to this course of treatment for swimmer's ear, which when left untreated, could cause temporary hearing loss, frequent ear infections, and/or a condition known as malignant otitis externa. This is where damage to the surrounding bone and cartilage occurs.

Conditions Treated?

  • Acute Otitis Externa

Type Of Medicine?

  • Fluoroquinolone Antibiotic, Quinolone Antimicrobial Agent

Side Effects

Finafloxacin may cause a few unwanted side effects to occur. The most commonly reported include:

  • Queasiness
  • Itchy Ears

Rare Side Effects of Finafloxacin

In rare cases, Finafloxacin may also cause:

  • Coughing
  • Hives and Rashes
  • Abnormal Heartbeat
  • Lightheadedness
  • Trouble Breathing or Swallowing
  • A Swollen or Puffy Face
  • Chest Tightness
  • Lethargy


The dosage amounts vary from one patient to the next and are mostly based on the patient's age as well as Xtoro's medicinal strength and the number of times per day needed.

The dosage amounts outlined below are not indicative of the treatment your doctor will prescribe. Do not stop or alter the dosage dispensed by your pharmacists unless you have consulted with your primary healthcare provider.

The average doses include:

  • Infants 12 months and under: Do not use
  • Children 1 years of age and up: 4 drops | 2X daily | for 1 week (for each affected ear)
  • Adults: 4 drops | 2X daily | for 1 week (for each affected ear)

Note: In some cases, an otowick may be prescribed. In these cases, the following dosage amounts are given

  • Infants 12 months and under: Do not use
  • Children 1 years of age and pp: 8 drops initially followed by 4 drops | 2X daily | for 1 week (for each affected ear)
  • Adults: 8 drops initially followed by 4 drops | 2X daily | for 1 week (for each affected ear)

Best practices for use

For best results and to prevent the risk of new infections or reinfections, be sure to wash your hands thoroughly before suspending the ear drops into each ear. Once this is completed:

1. Warm the bottle 'This is highly recommended as colder suspension liquids of Finafloxacin causes dizziness.

2. Shake thoroughly ' To ensure the medicine is evenly distributed, shake it well before each use.

3. Lie down ' Find a flat surface, such as a bed or sofa, for example, to administer the medicine. Tilt the head sideways with the affected ear directed toward the ceiling.

4. Dispense the prescribed dose 'Only dispense the number of drops recommended by your pharmacist and let it sit for at least a minute before administering the medicine into the other ear, if applicable. Avoid touching the skin or ears with the tip of the applicator to prevent reinfections. Instead, dispense a few inches away from the ear in midair.

5. Repeat ' After a minute has passed, complete the above step once again into the next affected ear, this time switching positions so the affected ear faces up.

6. Wash hands ' After dispensing the medicine, be sure to wash your hands thoroughly once more.

7. Recap tightly' To preserve the quality of the medicine, reseal the cap tightly after each use.

Missed doses

If you forget to take Finafloxacin, complete the missed dose as soon as you remember. However, do not double the dose within a 24-hour period.


Due to the localized action of Finafloxacin, very few drug interactions have been found. However, it is still important to inform your doctor of any current medications in use, including OTC drugs, such as vitamins and herbal supplements, for example.


Before using Finafloxacin, read the insert label carefully to reduce the risk of unwanted side effects. Some of the top precautions for using this medicine include:

For in-ear use only
Finafloxacin is an ear drop that should only be administered into the ears. It is important to never dispense the medicine into the eyes or nose. Moreover, do not swallow Finafloxacin. In the event of an accidental dosage by mouth, contact 911 or the American Association of Poison Control Centers at 1-800-222-1222 right away.

Take the medicine as prescribed

For best results and to decrease the risk of side effects, you should take Finafloxacin exactly as prescribed. Small drops of the suspension liquid contain potent doses of fluoroquinolone antibiotic. Using more of the medicine or continuing to use it after the treatment period has expired increases the chances of developing antibacterial resistance.

Additionally, do not stop taking this medicine if you begin to feel better. Bacterial infections that are treated with antibiotics are generally eliminated when the full course of treatment is applied.

Worsening or persistent symptoms

If your symptoms do not clear up or get worse, contact your medical provider as soon as possible. An alternative medicine may be prescribed and/or additional tests needed to confirm the presence of swimmer's ear.


This medicine may also cause a serious allergic reaction to occur. Discontinue use and seek medical help right away if you have trouble breathing, hives and rashes, a fast heartbeat, and/or a swollen face or eyelids.

To reduce the risk of an allergic reaction, tell your doctor if you have a history of hypersensitivities.

Antibacterial resistance

To prevent the risk of antibacterial resistance or the overgrowth of non-susceptible organisms including yeast and fungi, for example, do not use this medicine for longer than prescribed.

Tips for best results

To help your infection clear up faster and to prevent worsening symptoms, it is important to keep the ears dry and clean at all times.

In most cases, swimmer's ear is caused by water getting into the ears. When excess moisture is present in the outer ear canal, this offers the perfect breeding ground for bacteria and fungi to multiply, hence causing an infection.

As a result, some of the top recommendations by pharmacists for aiding with the treatment of swimmer's ear include:

  • Avoid swimming activities ' Unless your doctor has provided consent to do so.
  • Keep the ears dry ' May a concerted effort to keep the ears dry during bath time. A hair dryer or towel can also be used to wipe away excess liquid after bathing.
  • Do not use cotton swabs' Do not clean your ears with cotton swabs. Consult your medical provider for the best way to clean earwax.


Patients can safely store this medicine at temperatures ranging from 2-25°C (36-77°F). Finafloxacin can be left at room temperatures or stored in a refrigerator, for example. Do not, however, place in direct sunlight, heat or freezing temperatures.

Recap the dispenser tightly after each use and keep out of the reach of children and pets. Any leftovers should be discarded appropriately. Doctors generally recommend returning unused portions of prescription drugs to a local pharmacy where safe l disposal programs are in effect.


Finafloxacin, which is marketed and sold under the trade name Xtoro, is used to treat acute otitis externa (AOE) or swimmer's ear. It is indicated for both children and adults, except for infants 12-months-old and younger.

Swimmer's ear is a common condition that plagues individuals of all ages. It is predominantly caused by water getting into the ears and bacteria reproducing into this space. In some cases, swimmer's ear may also be caused by excess earwax.

Doctors generally prescribe a round of Finafloxacin lasting seven days to effectively clear up strains of susceptible bacteria, including Pseudomonas aeruginosa and Staphylococcus aureus. Four drops are generally dispensed into each affected ear twice daily, but this amount may be increased if the patient if using an otowick. Consult your healthcare provider for more details.

The medicine should be taken as prescribed' never more or less. Discontinuing the medicine prematurely, even if you feel better, could increase the risk of developing swimmer's ear again. For best results and to prevent dizziness, do not dispense the medicine when it is cold. Instead, warm the bottle by wrapping both hands around the bottle for 1-2 minutes each time.

Finafloxacin features few side effects, compared to other medicines and no contraindications have been found. As a result, it is one of the preferred prescription medicines of choice for treating acute swimmer's ear.