{ "schema_version": 1, "kind": "condition", "id": "cerumen-impaction", "name": "Cerumen impaction (impacted earwax)", "category": "chronic", "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.", "review_status": "reviewed", "verified_against": "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_date": "2026-08", "treatments": [ { "id": 391, "generic": "Olive oil", "line": 1, "is_adjunct": false, "form": "ear", "strength_mg": null, "adult_dose": "Instill 3-5 drops into affected ear 2-3 times daily for 3-5 days prior to ear syringing/irrigation", "adult_duration": "3-5 days", "dose_source": "No labelled dose - plain oil, instilled to effect", "rationale": "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Child: 2-3 drops into ear twice daily for 3-5 days", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "AURIS EAR DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HEALTHY GROUP FOR COSMETICS > LANDMARK PHARMA", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "almond oil, bht, calendula oil, chlorobutanol, paraffin oil, tea tree oil, vitamin e" }, { "trade_name": "OLIVRUM 15 ML EAR DROPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NILE COSMOTICS FACRORY > NUTRISYNTH FOR TRADE AND DISTRIBUTION", "price_egp": 49.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "almond oil, chamomile oil, climbazole, coconut oil, lavender oil, lidocaine, paraffin oil, tea tree oil" }, { "trade_name": "ALEAVIA EAR DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE > OPTIMASA", "price_egp": 60.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "almond oil, coconut, garlic oil, paraffin, tea tree oil" } ], "condition_id": "cerumen-impaction" }, { "id": 392, "generic": "Carbamide peroxide", "line": 1, "is_adjunct": false, "form": "ear", "strength_mg": null, "adult_dose": "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", "adult_duration": "4 days", "dose_source": "DailyMed Carbamide Peroxide 6.5% Otic Solution Package Insert (SetID 8295b9d2-3b17-48f8-b3d4-4bd8288cf69a)", "rationale": "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Child >=12 years: instill 5-10 drops into affected ear canal twice daily for up to 4 days", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "Instill 5 to 10 drops into affected ear canal twice daily for up to 4 days." } ], "peds_doses": null, "brands": [ { "trade_name": "PERROXY 6.5% EAR DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 6.75, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EAR WAX 6.5MG/100ML DROPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 6.75, "pack_count": null, "unit_price": null, "strength_mg": 6.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "REMOWAX 5 % EAR DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 24.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "cerumen-impaction" }, { "id": 393, "generic": "Docusate sodium", "line": 1, "is_adjunct": false, "form": "ear", "strength_mg": null, "adult_dose": "4 drops instilled into the affected ear(s) twice daily", "adult_duration": "2 to 3 days", "dose_source": "Egyptian National Drug Formulary - git.pdf, Docusate sodium monograph (chapter PDF p135)", "rationale": "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children: reduce the number of drops to the amount needed to fill the ear canal with solution (per ENDF).", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "WAX OUT 5GM/100ML EAR DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": 5000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "cerumen-impaction" } ] }