What is the recommended regimen for using Debrox (carbamide peroxide) ear drops?

Debrox (Carbamide Peroxide) Ear Drops Regimen

For adults and children over 12 years, instill 5-10 drops into the affected ear twice daily for up to 4 days, keeping the head tilted or placing cotton in the ear for several minutes to allow penetration. 1

Dosing and Duration

• Adults and children ≥12 years: Apply 5-10 drops into the ear canal twice daily for up to 4 days 1
• Children <12 years: Consult a physician before use 1
• After the 4-day treatment course, any remaining wax may be removed by gently flushing the ear with warm water using a soft rubber bulb ear syringe 1

Proper Administration Technique

Having someone else administer the drops significantly improves effectiveness, as only 40% of patients who self-administer do so correctly. 2, 3

Step-by-Step Application:

• Position: Lie down with the affected ear facing upward 2, 3
• Instillation: Place enough drops to fill the ear canal completely (5-10 drops) 1
• Dwell time: Remain in this position for 3-5 minutes to allow adequate penetration—use a timer 4, 2, 3
• Enhance penetration: Gently move the ear in a to-and-fro motion OR press the tragus (small cartilage in front of the ear) with an in/out pumping movement 4, 2, 3
• After application: Wipe off excess drops and resume normal activities 4

Important Precautions

• Keep the ear dry during treatment by covering the ear canal with an earplug or cotton with petroleum jelly before showering 3
• Do not clean the ear yourself during treatment, as the ear canal is tender and you could damage it or the eardrum 4, 2
• The tip of the applicator should not enter the ear canal 1
• If you taste the drops, this indicates a possible perforation of the eardrum—contact your physician immediately 4, 3

When Professional Intervention Is Needed

• If drops do not easily run into the ear canal, professional aural toilet (cleaning) may be necessary to remove obstructing debris 4, 2
• A wick may need to be placed by a clinician to facilitate drop penetration into an obstructed canal 4, 2
• Do not remove a wick yourself unless specifically instructed—if it falls out on its own, this indicates improving inflammation 4, 3

Expected Outcomes and Follow-Up

• Most patients experience improvement within 48-72 hours of starting treatment 3
• If symptoms persist beyond 7 days or worsen, notify your doctor 2, 3
• Continue treatment for the full prescribed duration even if symptoms improve to prevent relapse 3

Safety Profile

• Carbamide peroxide is generally safe and well-tolerated with no serious adverse effects reported in clinical studies 5, 6
• Minor adverse effects may include local irritation, itching, or discomfort in fewer than 3% of patients 3, 5
• Never use ear candles, as they cause harm including ear canal obstruction, hearing loss, and tympanic membrane perforation 4, 2

Evidence Quality Note

While carbamide peroxide shows instant cerumen degradation in laboratory studies 6, clinical trials have shown mixed results, with one study finding no superiority over saline placebo 7. However, the FDA-approved regimen remains the standard recommendation for over-the-counter cerumen management 1.