| Water-based |
| Acetic acid, 2.5% | Home treatment of impacted cerumen | Fill affected ear with 2 to 3 mL twice daily for up to 14 days | More effective in children than in adults |
| Docusate sodium | Soften cerumen before irrigation | Fill affected ear canal with 1 mL 15 to 30 minutes before irrigation | In one study, one-fifth of tympanic membranes were visualized without irrigation |
| Hydrogen peroxide, 3% | Soften cerumen before irrigation | Fill affected ear canal 15 to 30 minutes before irrigation | If not completely removed, bubbling may interfere with ability to visualize tympanic membrane |
| Sodium bicarbonate, 10% | Soften cerumen before irrigation or as an alternative to irrigation | Fill affected ear with 2 to 3 mL 15 to 30 minutes before irrigation, or alternatively for three to 14 days at home with or without irrigation | More effective in children than in adults |
| Triethanolamine polypeptide oleate condensate, 10% | Soften cerumen before irrigation | Fill affected ear canal 15 to 30 minutes before irrigation | Can be irritating to the ear canal and should not be used for a prolonged period |
| Water or saline | Soften cerumen before irrigation | If irrigation is attempted without softening and is ineffective after the first attempt, instill water and wait 15 minutes before repeating irrigation | — |
| Non–water- or oil-based |
| Carbamide peroxide (Debrox) | Soften cerumen before irrigation or as an alternative to irrigation | Put five to 10 drops into the affected ear twice daily for up to seven days | — |
| Choline salicylate plus glycerol (e.g., Earex Advance); ethylene oxide polyoxypropylene glycol (Addax); propylene glycol; chlorbutol, 0.5% | Soften cerumen before irrigation or as an alternative to irrigation | Put three drops into the affected ear twice daily for four days | Not all brands and formulations are available in the United States |
| Oil-based |
| Almond, arachis, or rectified camphor oil (e.g., Otocerol, Earex) | Soften cerumen before irrigation or as an alternative to irrigation | Put four drops into the affected ear twice daily for up to four days | Not all brands and formulations are available in the United States |
| Almond or mineral oil | Soften cerumen before irrigation | Put three drops into the affected ear at bedtime for three or four days | — |
| Arachis oil, 57%; chlorbutol, 5%; paradichlorobenzene, 2%, and turpentine oil, 10% (e.g., Cerumol) | Soften cerumen before irrigation or as an alternative to irrigation | Fill affected ear with 5 mL twice daily for two or three days | Not all brands and formulations are available in the United States |
