Cortisporin Vs. Cortisporin-TC: What Is The Difference?

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.