Cilodex is a combination ear drop preparation containing two active ingredients: ciprofloxacin — a fluoroquinolone antibiotic — and dexamethasone — a potent synthetic corticosteroid. Together, these agents provide both antibacterial and anti-inflammatory treatment for bacterial ear infections.

Ciprofloxacin targets and eliminates the bacteria responsible for ear infections, while dexamethasone reduces the associated inflammation, swelling, pain, and discharge in the ear canal and middle ear. This dual action makes Cilodex particularly effective for conditions where infection and inflammation coexist — notably acute otitis externa (swimmer's ear) and acute otitis media with tympanostomy tubes.

Cilodex is a topical ear drop preparation — it is applied directly into the external ear canal and is not swallowed or applied to any other body part. Because it is topically applied, systemic absorption is minimal, resulting in a highly favourable safety profile compared to oral antibiotics.

Cilodex is a prescription-only medication in the UK. A licensed clinician must assess your ear symptoms and medical history before it can be prescribed — which can now be done quickly and conveniently through a telehealth consultation.

Cilodex is licensed for:

Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic that exerts bactericidal effects by inhibiting bacterial topoisomerase II (DNA gyrase) and topoisomerase IV — enzymes essential for bacterial DNA replication, transcription, and repair. By blocking these enzymes, ciprofloxacin prevents bacteria from copying their DNA, rapidly leading to bacterial cell death. It is highly active against gram-negative organisms including Pseudomonas aeruginosa, which is a common and challenging pathogen in otitis externa.

Dexamethasone is a potent synthetic glucocorticoid that binds to intracellular glucocorticoid receptors, modulating gene transcription to suppress the production of pro-inflammatory cytokines, prostaglandins, and leukotrienes. In the infected ear canal or middle ear, dexamethasone reduces mucosal oedema, vascular permeability, and inflammatory cell infiltration — alleviating pain, swelling, and purulent discharge more rapidly than antibiotic alone.

The combination of bactericidal antibiotic activity with potent anti-inflammatory corticosteroid activity provides rapid symptomatic relief alongside effective infection clearance.

The correct dose depends on the type and severity of infection, age, weight, and kidney function. Always follow your clinician's instructions. The table below is for general reference only.

Warm the drops before use — holding the bottle in your hands for 1 to 2 minutes warms the solution and prevents the dizziness or discomfort that can be caused by cold ear drops stimulating the vestibular system (caloric response).

Administration technique:

1. Lie on your side with the affected ear facing upward, or tilt your head to one side.
2. Pull the outer ear gently backward and upward (in adults) or backward and downward (in young children) to straighten the ear canal.
3. Instil 4 drops directly into the ear canal.
4. Gently press the tragus (the small flap in front of the ear canal) 4 to 5 times to help the drops penetrate into the canal.
5. Remain in the same position for 60 seconds before sitting up.
6. Repeat for the other ear if both are affected.

Do not touch the dropper tip to the ear or any other surface to avoid contamination.

Complete the full 7-day course even if symptoms improve earlier — stopping early may allow bacteria to persist and infection to return.

Do not use in the presence of a perforated eardrum unless you have tympanostomy tubes and have been specifically instructed by your clinician that Cilodex is appropriate in this context.

Cilodex is very well tolerated due to its topical route of administration, which results in minimal systemic absorption. Side effects are predominantly local.

Cilodex is a topical preparation with minimal systemic absorption. Clinically significant systemic drug interactions are therefore unlikely at standard doses. However:

Getting advice no longer means sitting in a waiting room. Through The GP Service, you can consult with a licensed clinician in minutes — from home, on your lunch break, or wherever works for you. If treatment is clinically appropriate, your clinician can issue a prescription during the consultation. A consultation does not guarantee a prescription.