Carbamide peroxide is also called urea-hydrogen peroxide, which is a water-soluble compound used as a disinfectant and dental bleaching agent for teeth whitening. It is used orally for the treatment of canker sores, minor wounds, and gum inflammation due to minor dental procedures, dentures, orthodontic appliances, accidental injury, or other irritations of mouth and gums. It also helps in the removal of phlegm, mucus, or other secretions associated with an occasional sore mouth. When used topically in the ear, it softens and loosens the mucus that helps in the removal of ear wax.

Carbamide peroxide dose in Adults

Carbamide peroxide dose in the treatment of Ear wax removal:

• Instill 5 - 10 drops in the ear twice a day for up to 4 days.

Carbamide peroxide dose in the treatment of Mouth, gum, or dental irritation:

• Use up to 4 times a day after meals and at bedtime by directly applying to the affected area or as an oral rinse for up to seven days.
  • Place several undiluted drops on the affected area then expectorate after 2 - 3 minutes when used for direct application.
  • Place 10 - 20 drops onto the tongue, mix with saliva, swish for 1 minute or more, and then expectorate when using it as an oral rinse.

    ---

Carbamide peroxide Use for teeth whitening:

• Off-label over the counter uses include teeth whitening.
• Teeth-whitening pens are available that are applied over the teeth.

Carbamide peroxide dose in Childrens

Carbamide Peroxide dose in the treatment of Ear wax removal:

• Children less than 12 years of age:

  • 6.5% solution 1 - 5 drops in the ear twice a day for up to 4 days.

• Children older than 12 years and Adolescents:

  • 6.5% solution 5 - 10 drops in the ear twice a day for up to 4 days.

Carbamide Peroxide dose in the treatment of Mouth, gum, or dental irritation:

• Children older than 2 years and Adolescents:
  • 10% solution:
    • Use up to 4 times a day after meals and at bedtime by directly applying to the affected area or as an oral rinse for up to seven days.
      • Place several undiluted drops on the affected area then expectorate after 2 - 3 minutes when used for direct application.
      • Place 10 - 20 drops onto the tongue, mix with saliva, swish for 1 minute or more, and then expectorate when using it as an oral rinse.

Use in Pregnancy and breastfeeding:

It can be used during pregnancy and lactation.

Dose in Kidney disease:

No dose adjustment is required in patients with renal disease.

Dose in Liver disease:

No dose adjustment is required in patients with liver disease.

Common Side Effects Of Carbamide peroxide Include:

• Dermatologic:

  • Localized erythema, skin rash

• Infection:

  • Superinfection

• Local:

  • Local irritation
  • Redness

Precautions to take while using Carbamide peroxide:

• If there is swelling, rash or fever, the patient should stop using carbamide peroxide.
• If the redness, irritation, or pain persists for longer than seven days, you should seek medical attention.
  • If you have eardrum perforation, pain, irritation, rash or eardrum discharge, consult your healthcare provider immediately.
  • Patients with persistent symptoms for more than 4 days after ear surgery should consult a doctor before using the device.

Monitoring parameters:

None required

How to use Carbamide peroxide?

• It should not be ingested or use for an ophthalmic purpose. It is used as ear drops.
• The patient should be instructed to tilt the head sideways and apply drops into the ear.
• On contact with earwax, the solution will foam that may produce a crackling sound.
• The head should be kept in the tilted position for several minutes or cotton may be placed in the ear.
• The earwax may be then removed by gently flushing the ear with warm water by using a soft rubber bulb ear syringe.

Mechanism of action of Carbamide peroxide:

• It reacts with enzyme catalase to release hydrogen peroxide.
• This deodorant action is believed to be caused by the inhibition of odor-causing bacteria.It takes approximately 24 hours for it to start working.  
  • Carbamide peroxide foams and softens impacted earswax.

Carbamide Peroxide Brand Names (International):

• Earclear
• Exterol
• Hyperol
• Perroxy
• Remowax

Carbamide Peroxide brands in Pakistan: