How Does Otigo Work - Chemist Doctor

Key Takeaways: How Otigo Ear Drops Work

Dual Action: Combines anti-inflammatory (phenazone) and anaesthetic (lidocaine) effects
Primary Target: Treats acute middle ear inflammation without eardrum perforation
Chemical Effect: Phenazone inhibits prostaglandin synthesis reducing inflammation
Pain Relief: Lidocaine blocks sodium channels in nerve endings stopping pain signals
Localised Action: Works directly at the application site with minimal systemic absorption
Rapid Onset: Lidocaine provides quick pain relief within minutes of application

Otigo ear drops work through a dual-action mechanism that combines anti-inflammatory effects with local anaesthetic action. The phenazone component reduces inflammation in the middle ear, while lidocaine provides immediate pain relief by blocking nerve signals.

Important Medical Advice

If you experience severe ear pain, discharge from the ear, hearing loss, dizziness, or high fever with ear symptoms, seek immediate medical attention. Do not use Otigo if you have a perforated eardrum or after ear surgery.

Chemical Composition & Molecular Structure

Otigo ear drops contain two active pharmaceutical ingredients working synergistically to provide both anti-inflammatory and analgesic effects for middle ear conditions.

Active Ingredient Specifications

Formulation

40 mg phenazone / 10 mg lidocaine HCl per gram

This specific ratio provides optimal anti-inflammatory and analgesic effects for middle ear conditions.

Presentation

Ear drops solution

Clear, colourless to yellow-brown solution packaged in 15ml brown glass bottles with dropper applicator.

Excipients

Sodium thiosulfate, ethanol, glycerol, water

These support drug stability, preservation, and appropriate viscosity for ear application.

Chemical Properties of Active Ingredients

Ingredient	Chemical Class	Solubility	Molecular Weight
Phenazone	Pyrazolone derivative	Freely soluble in water and ethanol	188.23 g/mol
Lidocaine HCl	Amide-type local anaesthetic	Very soluble in water, soluble in ethanol	270.80 g/mol

🗒️ Pharmaceutical Insight: The combination of phenazone (anti-inflammatory) and lidocaine (anaesthetic) in Otigo creates a synergistic effect where inflammation reduction enhances pain relief, and pain reduction reduces inflammation-associated discomfort. This dual approach addresses both the cause and symptom of middle ear inflammation.

Dual-Action Mechanism: How Otigo Relieves Ear Pain and Inflammation

Otigo works through two complementary pharmacological actions that target different aspects of middle ear pathology.

Simultaneous Action Pathways

Inflammation Reduction: Phenazone inhibits cyclooxygenase enzymes, reducing prostaglandin production and inflammatory mediators
Pain Signal Blockade: Lidocaine blocks voltage-gated sodium channels in nerve fibres, preventing pain signal transmission
Vasodilation Control: Reduced inflammation decreases blood vessel dilation and swelling in middle ear tissues
Nerve Sensitivity Reduction: Local anaesthetic action decreases hypersensitivity of inflamed nerve endings
Synergistic Effect: Reduced inflammation enhances pain relief, while pain reduction decreases inflammation-associated discomfort

Step-by-Step Action Timeline

Time After Application	Primary Action	Clinical Effect
1-3 minutes	Lidocaine begins blocking sodium channels in superficial nerve endings	Initial numbness and pain reduction at application site
15-30 minutes	Phenazone inhibits COX enzymes, reducing prostaglandin synthesis	Inflammation begins to decrease, reducing pressure and swelling
1-2 hours	Lidocaine fully penetrates tissue, blocking deeper nerve fibres	Maximum anaesthetic effect achieved
3-4 hours	Anti-inflammatory effects peak, inflammatory mediators significantly reduced	Noticeable reduction in redness, swelling, and discomfort

🗒️ Pharmacological Insight: The dual mechanism is particularly effective for middle ear conditions because inflammation and pain often create a vicious cycle. Inflammation causes pain through pressure on nerves and tissue swelling, while pain can exacerbate inflammation through stress responses and reduced healing.

Phenazone's Anti-inflammatory Action: Enzyme Inhibition Process

Phenazone, also known as antipyrine, works by inhibiting key enzymes in the inflammatory cascade, specifically targeting the arachidonic acid pathway.

Enzyme Inhibition Characteristics

Primary Target

Cyclooxygenase (COX) Enzymes

Phenazone non-selectively inhibits both COX-1 and COX-2 enzymes, reducing prostaglandin synthesis.

Chemical Class

Pyrazolone Derivative

Belongs to the same chemical family as other non-steroidal anti-inflammatory drugs (NSAIDs).

Action Type

Reversible Inhibition

Competitively binds to COX enzyme active sites, blocking substrate access temporarily.

Inflammatory Pathway Disruption

Inflammatory Mediator	Normal Production	Phenazone Effect	Clinical Result
Prostaglandin E2 (PGE2)	High during inflammation	70-80% reduction	Decreased pain sensitivity and fever
Prostaglandin I2 (PGI2)	Causes vasodilation	Significant reduction	Reduced redness and swelling
Thromboxane A2	Promotes platelet aggregation	Moderate reduction	Decreased micro-clot formation in inflamed tissue
Bradykinin Sensitisation	Enhances pain perception	Reduced sensitisation	Lower pain intensity from inflammatory stimuli

🗒️ Biochemical Insight: Unlike systemic NSAIDs, phenazone in Otigo works locally with minimal systemic absorption. This localised action provides anti-inflammatory effects where needed while minimising the risk of systemic side effects like gastrointestinal irritation or kidney effects associated with oral NSAIDs.

Lidocaine's Anaesthetic Action: Nerve Signal Blockade Mechanism

Lidocaine hydrochloride provides rapid pain relief by blocking the transmission of pain signals from the middle ear to the brain.

Sodium Channel Blockade Process

Membrane Stabilisation

Primary Effect: Prevents nerve depolarisation

Mechanism: Binds to voltage-gated sodium channels in nerve membranes

Result: Action potentials cannot propagate along nerve fibres

Use-Dependent Blockade

Primary Effect: More effective on firing nerves

Mechanism: Preferentially binds to sodium channels in active state

Result: Particularly effective for pain signals (high-frequency firing)

Localised Action

Primary Effect: Minimal systemic effects

Mechanism: Limited absorption from ear canal

Result: Anaesthesia confined to application area

Nerve Blockade Characteristics

Nerve Fibre Type	Function	Lidocaine Sensitivity	Clinical Effect in Ear
C Fibres	Transmit dull, aching pain	Highly sensitive	Relief of deep ear ache
Aδ Fibres	Transmit sharp, acute pain	Moderately sensitive	Reduction of stabbing ear pain
Autonomic Fibres	Control blood vessel tone	Less sensitive	Minimal effect on ear circulation
Proprioceptive Fibres	Sense position and movement	Least sensitive	Preserved balance and coordination

Metabolic Effects & Elimination from the Body

Due to minimal systemic absorption, Otigo has limited metabolic effects but understanding its pharmacokinetics helps explain its safety profile.

Absorption and Distribution Profile

Local Absorption

Extent: Minimal through intact tympanic membrane

Rate: Slow, localised to ear tissues

Peak Levels: Very low systemic concentrations

Tissue Distribution

Ear Canal: High local concentration

Middle Ear: Moderate penetration if eustachian tube patent

Systemic: Negligible distribution beyond ear

Metabolic Fate

Phenazone: Hepatic oxidation if absorbed

Lidocaine: Hepatic metabolism via CYP enzymes

Excretion: Renal elimination of metabolites

Safety Considerations for Special Populations

Population	Consideration	Precaution
Children under 12	Ear anatomy differences, potential for increased absorption	Use only as directed by doctor, monitor for side effects
Elderly patients	Possible thinner tympanic membrane, altered metabolism	Regular ear examination recommended during treatment
Pregnancy	Minimal systemic absorption reduces fetal exposure risk	Can be used if necessary after medical consultation
Breastfeeding	Negligible transfer to breast milk due to minimal absorption	Generally considered safe with proper application

🗒️ Clinical Insight: The minimal systemic absorption of Otigo is both a therapeutic advantage and a safety feature. It allows effective local treatment of middle ear conditions without exposing the entire body to drug effects, reducing the risk of systemic side effects while maximising local benefits.

Clinical Efficacy in Middle Ear Conditions

Otigo's dual mechanism translates to proven effectiveness for specific ear conditions when used according to medical guidance.

Approved Indications and Efficacy Data

Condition	Mechanism Relevance	Expected Improvement	Treatment Duration
Acute otitis media (middle ear inflammation)	Reduces inflammation and pain simultaneously	Pain relief within 15-30 minutes, inflammation reduction within 24-48 hours	Typically 3-7 days as directed
Post-influenza otitis	Addresses viral-induced inflammation with secondary pain	Symptomatic relief while underlying viral infection resolves	Until symptoms resolve, usually 5-7 days
Barotraumatic otitis (pressure damage)	Reduces inflammation from pressure changes, relieves pain	Pain relief rapid, inflammation reduction supports healing of traumatised tissue	Until pressure normalises and symptoms resolve

Optimal Use Guidelines Based on Mechanism

Appropriate Cases: Only for middle ear conditions WITHOUT tympanic membrane perforation
Dosage: 4 drops, 2-3 times daily into affected ear canal as directed
Application Technique: Warm vial between hands first, lie on side with affected ear upward
Monitoring: If no improvement within 7 days or worsening occurs, consult doctor
Contraindications: Do not use with perforated eardrum, after ear surgery, or with known allergies to ingredients

🗒️ Prescribing Insight: Otigo is particularly valuable because it provides symptomatic relief while addressing the inflammatory component of middle ear conditions. This dual approach can reduce the need for systemic analgesics and antibiotics in appropriate cases, though bacterial infections may still require antibiotic treatment.

Otigo Mechanism FAQs

How quickly does Otigo start working after application?

Lidocaine provides initial pain relief within 1-3 minutes, while phenazone's anti-inflammatory effects begin within 15-30 minutes. Maximum combined effect typically occurs within 1-2 hours after application.

Why is Otigo not recommended for perforated eardrums?

With a perforated eardrum, the drops can enter the middle ear directly, potentially causing side effects like dizziness, hearing changes, or irritation to delicate middle ear structures.

How does Otigo differ from antibiotic ear drops?

Otigo treats inflammation and pain but doesn't kill bacteria. Antibiotic drops target bacterial infections. They're sometimes used together if bacterial infection accompanies inflammation.

Can Otigo be used for earwax removal or outer ear infections?

No, Otigo is specifically formulated for middle ear conditions. For earwax or outer ear infections, different treatments are needed as these involve different ear structures.

Why does Otigo contain two active ingredients instead of one?

The combination addresses both cause (inflammation with phenazone) and symptom (pain with lidocaine) simultaneously. This dual approach often provides better relief than single-ingredient products.

Need Treatment for Middle Ear Inflammation?

If you're experiencing ear pain and inflammation symptoms and want to understand if Otigo ear drops could be an appropriate treatment option, speak with a UK-registered doctor through a confidential online consultation.