Page 87 - Community pharmcy practice E-book 2025

02/11/2025, 00:10 Otic & Ophthalmic Disorders | Dermatological Disorders

As carbamide peroxide is exposed to moisture, it breaks down to release hydrogen peroxide and urea.

Hydrogen peroxide and oxygen release slowly, resulting in weak antibacterial effect and mechanical
loosening of cerumen.

Anhydrous glycerine along with urea acts to soften and penetrate cerumen to help loosen excessive earwax.
Anhydrous glycerine is widely used as a solvent and vehicle that has both emollient and humectant
properties.

Any cerumen remaining after treatment may be removed with gentle, warm-water irrigation administered
with the otic syringe.

Patient counselling & Administration instructions of carbamide peroxide 6.5% in anhydrous glycerin:
Carbamide peroxide is given by instilling 5–10 drops into the ear that has excessive or impacted earwax
twice daily up to 4 days.

The patient's head should be tilted and drops placed into the ear canal.

The patient should remain in position for 5 minutes. (WHY !?)

Caution is essential during use of ear syringe tip to be correctly placed and not over-inserted into the EAC.

This product can be used in children 12 years of age and older and adults.

No special consideration for use is necessary in pregnant or lactating women or in older adults.

DO NOT
Do not let the medication come into contact with the eyes.

Do not use this medication if you have a fever, ear drainage, pain more severe than a dull pain,
dizziness, or a ruptured eardrum, or have had ear surgery within the past 6 weeks.

Do not use this medication to treat inflamed ear tissue, swimmer's ear, or itching of the ear canal.

Prolonged contact between carbamide peroxide solution and the skin of the ear canal can cause
dermatitis.

Discontinue treatment if irritation or a rash appears.

Other OTC cerumenolytics (Off-labeled use)
Hydrogen peroxide 3%
Hydrogen peroxide can be a source of nascent oxygen (O2).

when exposed to moisture and function as a weak antibacterial agent. Hydrogen peroxide 3% has been
used to flush the ear canal during procedures for softening or removing earwax.

Because hydrogen peroxide solutions contain water, overuse may predispose the ear to infection from
tissue maceration caused by excessive water left in the EAC.

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