Monday Pharmaceutical Mystery: January 3

A patient comes into your pharmacy holding a piece of paper for liquid docusate. What should you do?

While working at the pharmacy, a patient asks you to help him find liquid docusate (Colace) for earwax. You notice he is holding a piece of paper. Certain that he must be confused, you ask him if the paper is from the doctor. Sure enough, the directions on the paper—from an ENT!—state that the patient should use docusate in the ear to soften the ear wax.

Mystery: Why is docusate being used for earwax?

Solution: In a study of 50 patients, the researchers found docusate sodium solution to be a more effective ceruminolytic, when compared to triethanolamine polypeptide (Cerumenex). One treatment with docusate, followed by irrigation, resulted in complete/partial visualization of the tympanic membrane in most patients. 1

Published in the Annals of Emergency Medicine, the authors of the study recommended the use of docusate sodium as a ceruminolytic, especially in children.1

Interestingly, in Australia, docusate is available commercially in ear drop form as Waxsol.2

Patients with a perforated eardrum, due to a tympanostomy tube or a previous tube that left an open hole, should not use docusate in the ears, or if the ear is sore or inflamed. The patient should consult an ENT for advice.

REFERENCES

  • Singer AJ, Sauris E, Viccellio AW. Ceruminolytic effects of docusate sodium: a randomized, controlled trial. Ann Emerg Med. 2000 Sep;36(3):228-32. Accessed 2, 2020.
  • Virtual Medical Centre. Waxsol Ear Drops. https://www.myvmc.com/drugs/waxsol/ Accessed February 2, 2020. While working at the pharmacy, a patient asks you to help him find liquid docusate (Colace) for earwax. You notice he is holding a piece of paper. Certain that he must be confused, you ask him if the paper is from the doctor. Sure enough, the directions on the paper—from an ENT!—state that the patient should use docusate in the ear to soften the ear wax.