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Acetic acid is a weak acid with antibacterial and antifungal activity that compounding pharmacies prepare by prescription.
Acetic acid is the acid found in vinegar. In medicine it is used as a mild anti-infective: the acetic acid otic solution label describes it as antibacterial and antifungal. FDA-approved manufactured products include acetic acid otic solution, a nonaqueous ear drop in a propylene glycol vehicle approved for superficial infections of the outer ear canal, and sterile acetic acid irrigation for the urinary bladder, approved as a rinse for people with long-term indwelling urinary catheters to help limit ammonia-forming bacteria and calcium buildup on the catheter. MedlinePlus lists vinegar (acetic acid) ear drops among treatments for swimmer's ear, and clinicians apply acetic acid to the cervix during colposcopy. A prescriber might order acetic acid compounded in a strength, vehicle or combination that is not manufactured. Compounded preparations are not FDA-approved and require a prescription.
Acetic acid products have no boxed warning. Ear drops can sting or burn, especially when first placed in an inflamed ear, and local irritation has been reported very rarely; stop using them and call your prescriber if irritation or a sensitivity reaction develops. Do not use acetic acid ear drops if you are allergic to any ingredient or if your eardrum has a hole (perforation). Safety of the ear solution in children under 3 has not been established. Bladder irrigation is not for injection; with sores in the bladder lining it can irritate them and cause acidosis, and pain and blood in the urine have been reported. The labels list no drug interactions. The irrigation label says it should be used in pregnancy only if clearly needed, and LactMed has no acetic acid entry. Talk to your prescriber or pharmacist about breastfeeding or any side effects.
Acetic acid is a weak organic acid. The otic solution is a nonaqueous preparation buffered to an acidic pH in propylene glycol, which lowers surface tension, with benzethonium chloride, a surfactant that promotes tissue contact; the label attributes antibacterial and antifungal activity to acetic acid. Per the irrigation label, the minimal amount that may reach the systemic circulation is readily metabolized. Labeled indications: acetic acid otic solution for superficial infections of the external auditory canal caused by susceptible organisms, contraindicated with tympanic membrane perforation; acetic acid irrigation as a constant or intermittent bladder rinse in patients with prolonged indwelling urethral catheters, and for periodic catheter irrigation to reduce calcium encrustation. StatPearls describes acetic acid applied to the cervix during colposcopy, where dysplastic cells turn acetowhite to guide biopsy. Other uses are not FDA-approved indications. The irrigation solution contains no antimicrobial preservative, so unused portions are discarded. Monitor for local irritation and, with bladder irrigation, for acidosis, pain and hematuria, particularly with mucosal lesions. Dosing is per prescriber. Acetic acid is not a controlled substance.
Compounded at Bayview
Patient guides for the preparations we make most often. Each one is compounded to order and requires a prescription.
We do not have a patient page for this ingredient yet. That does not mean we cannot make it. Bayview compounds this ingredient to a prescriber's order, and our full compounding formulary lists every preparation we make. Viewing the formulary requires a prescriber account.
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Every preparation in our formulary that contains this ingredient. Strength, base and dose form are set by the prescription.
Other salt forms of this molecule, and ingredients commonly compounded alongside it.
This page describes an active pharmaceutical ingredient, not a finished drug product. Bayview Pharmacy compounds preparations containing it only on a prescriber's order for an individual patient.
Compounded preparations are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. Nothing on this page is a claim that any preparation is effective for any condition.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Our pharmacists work with prescribers to build preparations around a patient's dose, form and tolerances. Ask us what is possible with this ingredient.
