Hydrocortisone aceponate
Also known as: Cortavance · Easotic · HCA · Hydrocortisone 21-acetate 17-propionate
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Pruritic inflammatory skin disease | 2 pumps of spray per 10 cm x 10 cm square of skin (delivers 1.52 μg/cm2) | topical | q24h | 7 days | 🌍 EU |
| Otitis externa | 1 pump (1 ml) per ear | topical | q24h | 5 days | 🌍 EU |
- Pruritic inflammatory skin disease: Cortavance spray
- Otitis externa: Easotic (combination product)
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| General | Dose not established | topical | unknown | unknown | 🌍 EU |
- General: Safety and efficacy not fully established in cats.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Hydrocortisone aceponate is a potent topical corticosteroid used in veterinary medicine primarily for the management of inflammatory and pruritic dermatoses, as well as acute or recurrent otitis externa.
Clinical Pearl: Because it is formulated as a diester pro-drug, it provides high local anti-inflammatory efficacy in the skin while significantly minimizing systemic absorption and the classic systemic side effects associated with glucocorticoids (such as adrenal suppression or liver enzyme elevation).
Mechanism of action
Hydrocortisone aceponate is a highly lipophilic pro-drug. Upon application, it penetrates the stratum corneum and is biotransformed by local esterases in the epidermis → hydrocortisone 17-propionate (the active form). It binds to local glucocorticoid receptors to inhibit inflammatory pathways, reducing erythema, pruritus, and swelling, while its rapid local metabolism minimizes systemic distribution.
Safety & warnings
Contraindications
- Ulcerated skin
- Perforated tympanic membrane (ear drum)
- Cutaneous ulcers
- Known hypersensitivity to corticosteroids
- Concurrent systemic viral or fungal infections
- Use on large surface areas for prolonged periods without veterinary supervision
Adverse effects
- Epidermal atrophy (with protracted use)
- Aural erythema (otic preparation)
- Transient hearing loss in geriatric dogs (rare, otic preparation)
- Transient local erythema
- Skin thinning or atrophy (rare, usually only with prolonged use)
- Delayed wound healing
- Systemic glucocorticoid effects (extremely rare due to rapid metabolism)
Precautions
Do not use on ulcerated skin or if the ear drum is perforated.
- Growth Warning: Use with caution in dogs <7 months old, as glucocorticoids are known to slow growth.
- Surface Area Limits: The total body surface treated should not exceed a surface corresponding to a treatment of two flanks (from the spine to the mammary chains, including shoulders and thighs).
- Infections: Microbial infections should be treated appropriately prior to use.
- Monitoring: Patients should be monitored appropriately during long-term use to watch for epidermal atrophy or systemic absorption.
Drug interactions
Increased risk of local skin atrophy and potential systemic absorption
Monitoring
- Resolution of pruritus and inflammation
- Signs of epidermal atrophy (skin thinning) with prolonged use
- Liver enzyme activities (during long-term use)
- Cortisol response to ACTH stimulation (during long-term use)
- Resolution of pruritus and erythema
- Signs of local skin thinning or atrophy with prolonged use
Pharmacokinetics
Half-life
Absorption
Highly lipophilic; penetrates the epidermis well but systemic absorption is minimal, reducing systemic side effects.
Distribution
Primarily localized to the epidermal and dermal layers of the skin at the site of application.
Metabolism
Biotransformed locally in the epidermis to its active form, hydrocortisone 17-propionate.
Elimination
Cleared locally with minimal systemic circulation.
Overdose
Massive over-application or protracted use can result in epidermal atrophy (thinning of the skin). While systemic effects (such as increases in liver enzyme activities or depression of cortisol response to ACTH stimulation) are minimized by the pro-drug formulation, they may theoretically occur with significant overdosage or ingestion.
Available products
Formulations
- Topical spray: 0.584 mg/ml
- Otic suspension: 1.11 mg/ml (combined with miconazole 15.1 mg/ml and gentamicin 1505 IU/ml)
- Topical spray (0.0584%)
- Otic suspension (in combination with miconazole and gentamicin)
Veterinary
- Cortavance 76 ml spray (0.584 mg/ml)
- Easotic suspension for ears (1.11 mg/ml hydrocortisone aceponate, 15.1 mg/ml miconazole, 1505 IU/ml gentamicin)
- Cortavance 0.0584% cutaneous spray, solution for dogs
- Easotic ear drops, suspension for dogs (combination with gentamicin and miconazole)
Regulatory status
Approved for veterinary use in dogs.
POM-V classification.
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Normal precautions should be observed. Store at room temperature and keep out of reach of children.
Client information
Apply this medication exactly as directed by your veterinarian.
- Do not apply to open sores or ulcerated skin.
- If using the ear drops, your vet must confirm the ear drum is intact before starting treatment.
- Avoid spraying near the eyes or mouth.
- Wash your hands after applying the medication, or wear gloves.
- Contact your vet if you notice redness in the ear, if the skin appears unusually thin, or if your older dog seems to have trouble hearing.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.