Cortisporin Vs. Cortisporin-TC: What Is The Difference?
In our latest question and answer, the pharmacist compares Cortisporin-TC to 'regular' Cortisporin.
My doctor just ordered Cortisporin-TC suspension for an ear infection. I have good insurance but they won’t cover it and it is $200. I have a small hole in my eardrum and have ear wax draining into my outer ear area. In the past, I have taken 10 days of amoxicillin. Which ear drops can I use which aren’t as expensive? Thank you.
Apr 26, 2021- Cortisporin-TC costs over $200 while generic Cortisporin costs less than $25-30 and works just as well for ear infections.
- Cortisporin-TC contains thonzonium, which helps medicine reach infected tissue, but there is not strong evidence that this ingredient actually makes it work better than other options.
- Several less expensive alternatives like Ciprodex and acetic acid with hydrocortisone are available and generally just as effective as Cortisporin-TC.
Thanks for writing us! I'm not too surprised Cortisporin-TC isn't covered under your insurance. Most insurance plans don't pay for it, and if they do, it generally is on a higher tier (which comes with a higher copay). There are a few reasons for this.
First and foremost, it is only available as the brand name (i.e. there is no generic for it) and there are plenty of other, just as effective, and less expensive options, you can use to treat an ear infection. Cortisporin-TC is over $200 while the alternatives are generally less than $25-30 (without insurance).
The most commonly used alternative is Cortisporin (which is available generically and far less expensive).
Difference Between Cortisporin-TC and Cortisporin
Aside from the cost, the difference between these two products is their respective ingredients. Cortisporin contains:
- Hydrocortisone
- Neomycin
- Polymyxin B
Neomycin and polymyxin B are antibiotics while hydrocortisone is a corticosteroid, which helps the pain and inflammation associated with an ear infection.
Cortisporin-TC contains:
- Hydrocortisone
- Colistin
- Neomycin
- Thonzonium
Cortisporin-TC and Cortisporin share two of the same ingredients, neomycin, and hydrocortisone. It also contains colistin, an antibiotic, and thonzonium. The big difference here is the addition of thonzonium.
Thonzonium acts as a detergent/surfactant and improves the tissue contact of the other active ingredients. The prescribing information for Cortisporin-TC states the following:
Thonzonium bromide is a surface-active agent that promotes tissue contact by dispersion and penetration of the cellular debris and exudate.
In other words, thonzonium gets the drug ingredients (neomycin, colistin, hydrocortisone) in the product through all of the junk in your ear that an infection can produce (e.g. excess skin cells/fluid, etc...) and into contact with the actual tissue in the ear.
This sounds good in theory, but there isn't a lot of evidence that products containing thonzonium actually work better than other products, or will resolve an ear infection faster.
In all honesty, from my prior experience in retail pharmacy, most providers that send in Cortisporin-TC do so accidentally and are fine with substituting with 'regular' Cortisporin, especially when the cost is an issue.
Additional Options
In terms of other alternatives to Cortisporin-TC, there are plenty, including:
- Ciprodex (ciprofloxacin; dexamethasone)
- Ofloxacin
- Acetic acid with hydrocortisone
The above are just the topical options. Oral antibiotics can be very effective as well.
So, to answer your question specifically, all of the options I listed above are going to be far less expensive (all are available generically), and generally, are just as effective, as Cortisporin-TC.
None are automatically substitutable, so be sure to talk to your doctor or pharmacist about switching to another option.
Glossary — Terms in This Answer
- Corticosteroid
- A type of anti-inflammatory medication that reduces swelling and pain in the body.
- Antibiotics
- Medications that kill bacteria or stop them from growing to treat infections.
- Generic
- A medication with the same active ingredients as a brand-name drug but usually costs much less.
- Surfactant
- A substance that helps other liquids spread and penetrate through materials more effectively.
- Exudate
- Fluid that has leaked out of blood vessels, typically containing cells and other material from inflammation.
- Topical
- A medication applied directly to the skin or outer surface of the body rather than taken by mouth.
- Copay
- A fixed amount of money you pay for a prescription or medical service covered by your insurance.
- Cellular debris
- Fragments and broken pieces of dead or damaged cells.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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