Quadruple Topical Ointment
Anti-Inflammatory, Antipruritic, Antifungal &
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.
Actions: By virtue of its four
active ingredients, the ointment provides four therapeutic effects including
anti-inflammatory, antipruritic, antifungal and antibacterial. Triamcinolone
acetonide is a synthetic corticosteroid providing rapid and prolonged
symptomatic relief upon topical administration. Inflammation, edema and pruritus
subside and lesions are permitted to heal. Nystatin is the first well-tolerated
antifungal antibiotic of dependable efficacy for the treatment of cutaneous
infection 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. Activity is not exhibited against bacteria.
Thiostrepton has 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 bacterial. Together they provide comprehensive therapy against
organisms responsible for most superficial bacterial infections.
Quadruple Topical Ointment is intended for local therapy in a variety of cutaneous disorders of
cats and dogs; it is especially useful in disorders caused, complicated or
threatened by bacterial and/or candidal (monilial) infections.
Warning: 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.
Corticosteroids administered to dogs, rabbits, and
rodents during pregnancy have resulted in cleft palate in the offspring.
In dogs, other congenital anomalies have resulted
including deformed forelegs, phocomelia and anasarca.
Precautions: Quadruple 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.
Quadruple Ointment (nystatin-neomycin sulfate-thiostrepton-triamcinolone
acetonide ointment) has been well-tolerated. Cutaneous reactions attributable to
its use have been rare. The occurrence of systemic reaction is rarely a problem
with topical administration.
There is evidence that corticosteroids can be absorbed
after topical application and cause systemic effects. Therefore, an animal
Quadruple Ointment therapy should be observed closely for signs such
as polydipsia, polyuria, and increased weight gain.
Quadruple Ointment is not
generally recommended for the treatment of deep or puncture wounds, or serious
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 out of the
reach of children.
Avoid ingestion. Oral or parental use of corticosteroids
(depending upon the dose, the duration of use, and the specific steroid) may
result in the inhibition of endogenous steroid production following drug
Side Effects: SAP and SGPT (ALT)
enzyme elevations, polydipsia and polyuria, vomiting, and diarrhea (occasionally
bloody) have been observed following the parenteral or systemic use of synthetic
corticosteroids in dogs.
Cushing's syndrome has been reported in association with
prolonged or repeated steroid therapy in dogs. Temporary hearing loss has been
reported in conjunction with treatment of otitis with products containing
corticosteroids. However, regression usually occurs following withdrawal of the
drug. If hearing dysfunction is noted during the course of treatment with
Quadruple Ointment, discontinue its use.
Caution: Before instilling any
medication into the ear, examine the external ear canal thoroughly so that the
tympanic membrane is not ruptured, avoiding the possibility of transmitting an
infection into 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
Dosage and Administration: The
frequency of administration depends upon the severity of the condition.
For mild inflammations, the application may range from
once a day to once a week.
For severe conditions Quadruple Ointment may be applied
two to three times a day, if necessary. The frequency of the treatment may be
decreased as improvement occurs.
Wear gloves during the administration of the ointment or
wash hands immediately after the application.
Otitis: Clean the ear canal of
impacted cerumen. Inspect the canal and remove any foreign bodies such as grass
awns, ticks, etc. Instill three to five drops of
Quadruple Ointment. Preliminary
use of a local anesthetic such as Proparacaine Hydrochloride Ophthalmic Solution
may be advisable.
Infected Anal Glands, Cystic Areas, etc:
Drain the gland or cyst and then fill it with
Other Dermatologic Disorders: Clean
the affected areas, removing any encrusted discharge or exudate. Apply
thiostrepton-traimcinolone acetonide ointment sparingly in a thin film.
Active Ingredients per ml:
- Nystatin . . . 100,000 units
- Neomycin sulfate (equivalent to neomycin base) . . . 100,000 units
- Thiostrepton . . . 2,500 units
- Triamcinolone acetonide . . . 1.0 mg
Quadruple Ointment is formulated with a nonirritating vehicle - a polyethylene and mineral oil gel base
Storage: 240 mL bottle: Do not store
above 86°F. 7.5 mL, 15 mL and 30 mL tubes: Store at room temperature and avoid
excessive heat (104°F).
How Supplied: Quadruple Ointment is
supplied in the following sizes: 7.5 mL tube, 7.5 mL tube x 144 units, 15 mL
tube, 15 mL tube x 72 units, 30 mL tube, 240 mL tube applicator bottle.
Federal law restricts this drug to use by or on
the order of a licensed veterinarian
Rx Medication Sold Only To Licensed Veterinarians & Pharmacies. Current License Must Be On File Prior To Shipping.