Alternatives for Garasone (ear inflammation)

It appears this exceptional medication might no longer be produced:

The authorization holder for Garasone eye and ear drops (gentamicin, betamethasone), Merck & Dohme, has notified the FDA regarding the discontinuation of supply for this medication within the United States.

The reason this product is being withdrawn from the American market is due to a decision by the manufacturer, Schering-Plough, based in Heist-op-den-Berg, Belgium, to cease both production and global distribution. Apparently, this was driven by commercial considerations, as the manufacturing process itself has become unsustainable.

Does anyone know if there is an adequate substitute?

If you happen to be in the area, maybe try that pharmacy near the Dolac Market upstairs? They used to handle imports from overseas quite often. I remember back in 2008, I had to order Marivarin for my mom because it had been discontinued here, and at that time, the new replacement, Martefarin, hadn't even hit the US market yet. Back then, I think you just needed to show up with your medical history to get things sorted. Another option might be heading over to a pharmacy in a nearby town across the border—we actually managed to get a few boxes of Marivarin through an acquaintance who lived just across the line, and he was kind enough to bring them back when he visited us in the city.

Look, you’ve basically got the same thing with Maxitrol—it’s just a corticosteroid paired with an antibiotic. There's really no reason to let those folks at the Dolac Market rip you off.🙂

My doctor prescribed Maxitrol for me as well. Honestly, isn't the combination of antibiotics and corticosteroids in this one actually more effective than Garison?

mistyjackal842 said:If you happen to be in the area, maybe try that pharmacy near the Dolac Market upstairs? They used to handle imports from overseas quite often. I remember back in 2008, I had to order Marivarin for my mom because it had been discontinued here, and at that time, the new replacement, Martefarin, hadn't even hit the US market yet. Back then, I think you just needed to show up with your medical history to get things sorted. Another option might be heading over to a pharmacy in a nearby town across the border—we actually managed to get a few boxes of Marivarin through an acquaintance who lived just across the line, and he was kind enough to bring them back when he visited us in the city.

Well, it's stated pretty clearly that they are phasing out production worldwide.

And honestly, the local supplies are probably tapped out by now.
It’s just like how we ran completely out of Maxitrol right after the Garison shortage hit.
Thankfully, Maxitrol finally showed up in stock yesterday.🙂

It was the exact same thing back in 2008 with Marivarin; they pulled it from the market, but they didn't release Martefarin right away. You really don't need to warn me about that. He never actually said this new drug was available immediately. I just assumed he needed the old one urgently.

I use Maxitrol to handle most of my issues, so honestly—the fact that they aren't making Garasone drops anymore doesn't bother me one bit.🙂

mistyjackal842 said:It was the exact same thing back in 2008 with Marivarin; they pulled it from the market, but they didn't release Martefarin right away. You really don't need to warn me about that. He never actually said this new drug was available immediately. I just assumed he needed the old one urgently.

I'm not quite sure why you took my post as some kind of warning.🤷

Maxitrol isn't some brand-new discovery; it’s been available here in the US for years. It's just that Garison used to be the go-to recommendation from doctors more often.
Once production for Garison stopped and the existing stock dried up, doctors started switching over to Maxitrol. Because of that sudden surge, the local supplies were wiped out, which is why it’s been impossible to find it for the last three weeks.
As a result, patients ended up without the right treatment, forced to pick a third option that isn't covered by Medicare and comes with the full retail price tag.

As far as I understand, Tobradex is also a combination drop containing both an antibiotic and a corticosteroid. Since Tobramycin serves as a powerful antibiotic reserve when other treatments fail, wouldn't these be considered quite effective drops?

One is Marivarin, while the others are just ear and eye drops.🙂

Garasone eye and ear drops -containing gentamicin and betamethasone.

Maxitrol -with neomycin, polymyxin B, and dexamethasone

Tobradex -tobramycin and dexamethasone)

Tobrex-just tobramycin.

Maxidex--dexamethasone.

Some of you might remember Dexamethasone-Neomycin drops from about 8 to 10 years ago. They’ve pretty much become a thing of the past, and ☕Garasone has basically taken over their spot in most prescriptions.

I remember using Dex Neomycin drops back in the day—I used them for outer ear inflammation—but these days we’ve got Maxitrol, which actually has a slightly broader spectrum against microbes than the old Dex Neomycin did.

swiftbear86 said:Garasone eye and ear drops -containing gentamicin and betamethasone.

Maxitrol -with neomycin, polymyxin B, and dexamethasone

Tobradex -tobramycin and dexamethasone)

Tobrex-just tobramycin.

Maxidex--dexamethasone.

Some of you might remember Dexamethasone-Neomycin drops from about 8 to 10 years ago. They’ve pretty much become a thing of the past, and ☕Garasone has basically taken over their spot in most prescriptions.

If my memory serves me right, those ones had that specific little tip design and a super short shelf life once you cracked the seal (but honestly, that’s just how it goes with most eye drops anyway. 😬 ))

I have to say, Maxitrol is just awful for me; I’ve never dealt with dermatitis in my entire life, but as soon as I used this, it flared up immediately. If you look at medical sites, they mention that the neomycin contained
in Maxitrol causes dermatitis in about 15% of patients plus a massive amount of skin flakes that end up in my ear after using Maxitrol, leaving everything feeling terribly dry 👎 ,
and honestly, corticosteroids are just a nightmare—take Beloderm ointment, for instance, which doctors love to prescribe for dermatitis; it feels even worse later on because steroids basically
just provide temporary relief before making things worse, such as when steroid dermatitis itself becomes a side effect of using the steroids. 🙂 Everyone on this forum seems to hate Beloderm because the side effects
are just dreadful. 😲

Now, I completely understand that if you're dealing with a severe infection like Otitis externa, then Maxitrol or Tobradex is almost essential, since the steroids quickly bring down the swelling and inflammation while
the antibiotics kill off the bacteria, but you could also use acetic acid, like in Otomar drops, or even if it's a minor issue, a 3% Boric acid solution is
actually excellent because it restores the ear's natural acidity without causing many side effects.

A very effective therapeutic component in ear drops is an acidic non-specific component, and most often in local treatments, you'll see
boric or acetic acid being used. It's important to realize that usually, no single antibiotic covers every possible pathogen, which is why
you often see combinations of different preparations on the market. Interestingly, several major studies have shown that using acidic non-specific components, combined with thorough micro-cleaning, can be just as effective as using a combination of antibiotic and corticosteroid.

My right ear has been aching, stinging, and itching for over a year now; it all started when my primary care doctor handed me two bottles of Maxitrol, and the dermatitis appeared instantly.
I'm convinced I would have fared much better with Boric acid or Otomar, especially since it was just a mild infection in the ear canal caused by a fingernail scratch; I've been to the ENT
a million times, and the diagnosis was always ear canal dermatitis (chronic skin inflammation).

I don't get dermatitis on my hands, my feet, or anywhere else; it's all Maxitrol's fault. I'm 35 years old, and I never had any skin issues prior to that treatment
with corticosteroids.

There's actually a video here explaining how antibiotics and steroids in ear drops can trigger dermatitis and secondary infections.



A highly respected ENT specialist confirmed to me that using antibiotics and steroids in drops can easily lead to eczema because they dry out the skin so aggressively, so they
should really only be used as a last resort. 🧐

Just to be clear, I'm not talking about Otitis media, because I've never had that, not even as a kid; I know that for that, you'd need nasal drops, systemic antibiotics, or drops like Maxitrol,
Tobrex/Tobradex—I am strictly talking about Otitis externa, ear canal dermatitis, and various skin issues within the ear.