# Cerumen impaction (impacted earwax) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## 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. ## Treatment metadata - Olive oil — ear - Carbamide peroxide — ear - Docusate sodium — ear ## Complete treatment card ```text CERUMEN IMPACTION (IMPACTED EARWAX) 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 against 4 sources listed above (2026-08) 1. OLIVE OIL [1st line] Adult Instill 3-5 drops into affected ear 2-3 times daily for 3-5 days prior to ear syringing/irrigation x 3-5 days Peds 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. Source No labelled dose - plain oil, instilled to effect Why Gentle first-line cerumenolytic to soften hard wax prior to mechanical irrigation Caution 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. Egypt AURIS EAR DROPS 15 ML HEALTHY GROUP... 10.50 EGP -> ! also contains almond oil, bht, calendula oil, chlorobutanol, paraffin oil, tea tree oil, vitamin e OLIVRUM 15 ML EAR DROPS NILE COSMOTIC... 49.00 EGP -> ! also contains almond oil, chamomile oil, climbazole, coconut oil, lavender oil, lidocaine, paraffin oil, tea tree oil ALEAVIA EAR DROPS 15 ML EL NILE > OPT... 60.00 EGP -> ! also contains almond oil, coconut, garlic oil, paraffin, tea tree oil 2. CARBAMIDE PEROXIDE [1st line] Adult 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 Peds 12 years and over: Instill 5 to 10 drops into affected ear canal twice daily for up to 4 days. (Child >=12 years: instill 5-10 drops into affected ear canal twice daily for up to 4 days) 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 Caution 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. Egypt PERROXY 6.5% EAR DROPS 15 ML PHAROPHARMA 6.75 EGP EAR WAX 6.5MG/100ML DROPS UNIPHARMA CO.... 6.75 EGP REMOWAX 5 % EAR DROPS 15 ML HI-PHARM 24.00 EGP 3. DOCUSATE SODIUM [1st line] Adult 4 drops instilled into the affected ear(s) twice daily x 2 to 3 days Peds Children: reduce the number of drops to the amount needed to fill the ear canal with solution (per ENDF). 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. Caution 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. Egypt WAX OUT 5GM/100ML EAR DROPS 15 ML HI-PHARM 10.50 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)