How to Use Debrox (Carbamide Peroxide) Drops for Earwax Removal
Administration Technique
For adults and children over 12 years, tilt your head sideways and place 5 to 10 drops into the ear, keeping the applicator tip outside the ear canal, then maintain this position for several minutes by keeping your head tilted or placing cotton in the ear—use twice daily for up to four days. 1
Optimal Drop Application Method
- Have someone else administer the drops whenever possible, as only 40% of patients who self-administer do so correctly during the first 3 days, and adherence increases significantly when another person applies the drops 2, 3
- Lie down with the affected ear facing upward to ensure proper penetration 3
- Fill the ear canal completely with drops and remain in this position for 3 to 5 minutes 2, 3
- Gently move the pinna in a to-and-fro motion or perform tragal pumping (pressing in and out on the tragus) to eliminate trapped air and ensure the drops reach deep into the canal 2, 3
- After placing drops, leave the canal open to dry rather than plugging it 2
Irrigation After Drop Use
The most cost-effective and evidence-based approach is to use Debrox drops for 3-5 days, followed by gentle self-irrigation at home with body-temperature water using a soft rubber bulb syringe. 4, 1
When and How to Irrigate
- After completing the 4-day course of Debrox, any remaining wax may be removed by gently flushing the ear with warm water using a soft rubber bulb ear syringe 1
- Use body-temperature water (close to 37°C/98.6°F) to avoid caloric effects that can cause dizziness 2, 4
- Plain water or saline is as effective as specially formulated irrigation products 4, 5
- Self-irrigation after cerumenolytic use is more cost-effective than professional irrigation in primary care 4, 6
Critical Safety Contraindications
Do NOT use Debrox drops if you have any of the following conditions—these are absolute contraindications: 2, 4
- Perforated eardrum or history of eardrum perforation
- History of ear surgery (unless cleared by an ENT specialist)
- Tympanostomy tubes (ear tubes) in place
- Active ear infection or otitis externa
- Ear canal stenosis or bony growths (exostoses)
Additional Caution Required For
- Patients on anticoagulant therapy 2, 4
- Immunocompromised individuals 2, 4
- Diabetic patients 2, 4
- Prior radiation therapy to the head and neck 2, 4
If you taste the eardrops after application, this may indicate a perforation in your eardrum—stop using the drops and contact your doctor immediately. 3
Special Populations
- Children under 12 years should consult a doctor before using Debrox 1
- Children under 3 years require physician consultation 4
Expected Outcomes and Follow-Up
- Most patients experience improvement within 48-72 hours of starting treatment 3
- Continue using drops for the full 4-day course even if symptoms improve earlier 3
- If symptoms persist beyond 7 days or if the impaction is not resolved after drops and irrigation, seek medical evaluation for manual removal by a healthcare provider 4, 3
What NOT to Do
Strongly avoid these practices that can worsen impaction or cause injury: 2, 4
- Never use cotton-tipped swabs, as they push wax deeper and can cause canal laceration, eardrum perforation, or damage to the hearing bones 2, 4
- Never use ear candling—it has no evidence of benefit and can cause serious burns, ear canal occlusion, and eardrum perforation 2, 4
- Avoid home oral jet irrigators, as they lack safety and efficacy research 4
Keeping the Ear Dry During Treatment
- Keep the ear dry while using Debrox to prevent infection 3, 7
- Cover the ear canal opening with an earplug or cotton with petroleum jelly before showering or washing hair 3
- Avoid scratching or touching the ear 3
Comparative Effectiveness
No evidence shows that Debrox (carbamide peroxide) is superior to plain water, saline, or other water-based cerumenolytics—all are equally effective for earwax removal. 4, 5, 8 However, water-based preparations like Debrox have the lowest risk of local skin reactions compared to oil-based products 4