Dawaa Reference

Clinical reference

Cerumen impaction (impacted earwax)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources6 sources

AAO-HNS Cerumen Impaction Guideline 2017 · DailyMed Carbamide Peroxide 6.5% Otic Solution Package Insert (SetID 8295b9d2-3b17-48f8-b3d4-4bd8288cf69a) · NICE CKS Earwax · No labelled dose - plain oil, instilled to effect · Egyptian National Drug Formulary - git.pdf, Docusate sodium monograph (chapter PDF p135) · Sevy JO, Hohman MH, Singh A. Cerumen Impaction Removal. [Updated 2023 Mar 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK448155. PMID: 28846265.

Verified against4 documents
  • DailyMed Carbamide Peroxide 6.5% Otic Solution Package Insert (SetID 8295b9d2-3b17-48f8-b3d4-4bd8288cf69a)
  • No labelled dose - plain oil, instilled to effect
  • Egyptian National Drug Formulary - git.pdf, Docusate sodium monograph (chapter PDF p135)
  • Sevy JO, Hohman MH, Singh A. Cerumen Impaction Removal. [Updated 2023 Mar 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK448155. PMID: 28846265.

Verified date2026-08

1

OLIVE OIL

1st line

Formear

Adult dose and duration

Instill 3-5 drops into affected ear 2-3 times daily for 3-5 days prior to ear syringing/irrigation x 3-5 days

Paediatric dose

Child: 2-3 drops into ear twice daily for 3-5 days

Choice

Alternatives. Olive oil is the gentle first-line cerumenolytic named in the entry, and softening the wax before irrigation is what the appointment is for.

Dose source

No labelled dose - plain oil, instilled to effect

Why

Gentle first-line cerumenolytic to soften hard wax prior to mechanical irrigation

Cautions
  • Warm drops to room temperature before instillation (cold drops induce caloric vertigo and nystagmus).
  • Avoid if tympanic membrane perforation, previous ear surgery, or active ear infection is suspected.
  • Plain olive oil carries no licensed dose. Warm it to body temperature first - cold oil in the ear canal sets off vertigo and nausea.
Egyptian brands
Egyptian brandManufacturerIndicative price
AURIS EAR DROPS 15 ML! also contains almond oil, bht, calendula oil, chlorobutanol, paraffin oil, tea tree oil, vitamin eHEALTHY GROUP FOR COSMETICS > LANDMARK PHARMA10.50 EGP
OLIVRUM 15 ML EAR DROPS! also contains almond oil, chamomile oil, climbazole, coconut oil, lavender oil, lidocaine, paraffin oil, tea tree oilNILE COSMOTICS FACRORY > NUTRISYNTH FOR TRADE AND DISTRIBUTION49.00 EGP
ALEAVIA EAR DROPS 15 ML! also contains almond oil, coconut, garlic oil, paraffin, tea tree oilEL NILE > OPTIMASA60.00 EGP
2

CARBAMIDE PEROXIDE

1st line

Formear

Adult dose and duration

Instill 5-10 drops of 6.5% solution into affected ear canal twice daily for up to 4 days, then flush gently with warm water x 4 days

Paediatric dose

(Child >=12 years: instill 5-10 drops into affected ear canal twice daily for up to 4 days)

Dose by age
12 years and over:Instill 5 to 10 drops into affected ear canal twice daily for up to 4 days.
Dose source

DailyMed Carbamide Peroxide 6.5% Otic Solution Package Insert (SetID 8295b9d2-3b17-48f8-b3d4-4bd8288cf69a)

Why

Effervescent cerumenolytic agent releasing oxygen to break up impacted earwax

Cautions
  • Transient foaming, bubbling, or tingling sensation in ear is expected.
  • Do not use if tympanic membrane is perforated or ear tubes are present.
  • Discontinue if severe ear pain or discharge develops.
Egyptian brands
Egyptian brandManufacturerIndicative price
PERROXY 6.5% EAR DROPS 15 MLPHAROPHARMA6.75 EGP
EAR WAX 6.5MG/100ML DROPSUNIPHARMA CO. > UNIPHARMA6.75 EGP
REMOWAX 5 % EAR DROPS 15 MLHI-PHARM24.00 EGP
3

DOCUSATE SODIUM

1st line

Formear

Adult dose and duration

4 drops instilled into the affected ear(s) twice daily x 2 to 3 days

Paediatric dose

Children: reduce the number of drops to the amount needed to fill the ear canal with solution (per ENDF).

Dose source

Egyptian National Drug Formulary - git.pdf, Docusate sodium monograph (chapter PDF p135)

Why

Direct match - the formulary explicitly lists an otic indication 'for the softening of earwax to facilitate its removal' with a specific dosing line.

Cautions
  • Instilled into the ear canal as drops, not taken by mouth.
  • Avoid irrigation if there is a known or suspected perforated eardrum, prior ear surgery, or active outer-ear infection; refer to ENT if pain, discharge, or a foreign body is present.
  • Avoid if a perforated eardrum, prior ear surgery, or active outer-ear infection is known or suspected.
  • Refer to ENT if pain, discharge, or a suspected foreign body is present rather than irrigating.
  • Softening drops are usually followed by irrigation or micro-suction to complete wax removal - drops alone may not fully clear the impaction.
Egyptian brands
Egyptian brandManufacturerIndicative price
WAX OUT 5GM/100ML EAR DROPS 15 MLHI-PHARM10.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.