Usage
This combination medication is primarily prescribed for impacted earwax (cerumen) removal and associated symptoms like ear pain and itching. It can also be used for external otitis (swimmer’s ear) to soften and remove debris.
Pharmacological Classification: This is a combination product with cerumenolytic, local anesthetic, antiseptic, analgesic, and soothing properties.
Mechanism of Action: The combined action of these ingredients softens and breaks down earwax, numbs the ear canal to reduce pain, and may offer mild anti-inflammatory and antiseptic effects.
Alternate Names
This combination is often found in ear drops under various brand names such as Waxactin, Waxolve, Edvaar W, and Dewax. It may also be referred to as Auralgan Otic Solution.
How It Works
Pharmacodynamics: Paradichlorobenzene softens and dissolves earwax. Lidocaine provides local anesthesia, blocking nerve signals and reducing pain. Chlorbutol acts as a mild local anesthetic and antiseptic. Turpentine oil acts as a solvent for earwax and may have mild anti-inflammatory effects.
Pharmacokinetics: This medication is for topical application in the ear canal. Systemic absorption is minimal, resulting in primarily localized effects. Specific information on metabolism and elimination pathways for this combination is limited.
Dosage
Standard Dosage
Adults:
Instill 2-3 drops into the affected ear 2-3 times a day. Avoid touching the dropper to the ear.
Children:
Consult a healthcare professional before using this medication in children under 12 years old.
Special Cases:
- Elderly Patients: Use cautiously and monitor for adverse effects. Dosage adjustments may be required.
- Patients with Renal Impairment: No specific dosage adjustments are typically needed, but monitor for adverse reactions.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are typically needed, but monitor for adverse reactions.
- Patients with Comorbid Conditions: Evaluate for potential drug interactions.
Clinical Use Cases
Primarily indicated for impacted earwax removal. This medication is not typically used for intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Side Effects
Common Side Effects:
Temporary stinging, burning, or discomfort in the ear; itching or redness in or around the ear; unpleasant taste in the mouth; skin rash or irritation; temporary hearing loss.
Rare but Serious Side Effects:
Allergic reactions (rash, itching, swelling, dizziness, trouble breathing); methemoglobinemia; angioedema.
Long-Term Effects:
Limited data available.
Adverse Drug Reactions (ADR):
Severe allergic reactions require immediate medical attention.
Contraindications
Known allergy to any of the components (Chlorbutol, Lidocaine, Paradichlorobenzene, Turpentine Oil); injured or perforated eardrum; inflamed ear canal; eczema on the outer ear.
Drug Interactions
Limited data available for specific drug interactions with this combination product. Inform your doctor about all medications you are currently taking, including prescription, over-the-counter, and herbal remedies. Potential interactions may exist with antibiotic or antifungal ear drops (e.g., ciprofloxacin, clotrimazole) and decongestants (e.g., pseudoephedrine). Systemic analgesics like acetaminophen or ibuprofen may also affect efficacy.
Pregnancy and Breastfeeding
Consult your doctor before using this medication if you are pregnant, planning to become pregnant, or are breastfeeding. This medication may be unsafe during pregnancy and data on its safety during breastfeeding is limited.
Drug Profile Summary
- Mechanism of Action: Softens earwax, provides local anesthesia, and has mild antiseptic properties.
- Side Effects: Stinging, burning, itching, redness, temporary hearing loss, allergic reactions.
- Contraindications: Perforated eardrum, hypersensitivity.
- Drug Interactions: Limited data available. Consult your physician.
- Pregnancy & Breastfeeding: Consult your physician. Use with caution.
- Dosage: 2–3 drops in affected ear 2–3 times/day (adults).
- Monitoring Parameters: Observe for adverse effects.
Popular Combinations
Not typically used in combination with other ear drops.
Precautions
Screen patients for allergies and ear conditions before use. Advise pregnant/breastfeeding women, children, and the elderly to use with caution under medical supervision. Avoid prolonged use without consulting a physician.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Chlorbutol + Lidocaine + Paradichlorobenzene + Turpentine Oil?
A: Adults: 2-3 drops in the affected ear 2-3 times per day. Pediatric use should be under the guidance of a healthcare professional.
Q2: Can this be used if the eardrum is perforated?
A: No, this medication is contraindicated in patients with a perforated eardrum.
Q3: What are the common side effects?
A: Common side effects may include temporary stinging, burning, itching, and redness in the ear.
Q4: How long can I use this medication?
A: Do not use for more than 3 days without consulting a doctor.
Q5: Can I use this if I am allergic to any of the ingredients?
A: No, it is contraindicated if you have a known allergy to any of the components.
Q6: Can pregnant or breastfeeding women use this?
A: Consult a physician before use during pregnancy or breastfeeding.
Q7: What should I do if I accidentally get the drops in my eyes?
A: Rinse thoroughly with water and consult a doctor if irritation persists.
Q8: How does this medication work to remove earwax?
A: Paradichlorobenzene softens the wax, while turpentine oil and chlorbutol help dissolve and loosen it. Lidocaine numbs the area to reduce discomfort.
Q9: What should I do if I experience severe ear pain after using the drops?
A: Stop using the drops immediately and consult a doctor.
