Docusate sodium 20-Apr-2016
(Dioctyl sodium sulphosuccinate)
lINDICATIONS AND DOSE
Removal of ear wax
▶TO THE EAR
▶Child 1–17 years:(consult product literature)lLESS SUITABLE FOR PRESCRIBINGEar drops less suitable
for prescribing.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Ear drops
EXCIPIENTS:May contain Propylene glycol
▶Molcer(Wallace Manufacturing Chemists Ltd)
Docusate sodium 50 mg per 1 mlMolcer ear drops| 15 mlp
£ 5. 60
▶Waxsol(Meda Pharmaceuticals Ltd)
Docusate sodium 5 mg per 1 mlWaxsol ear drops| 10 mlp£ 1. 95
DT = £ 1. 95Olive oil
lINDICATIONS AND DOSE
Removal of earwax
▶TO THE EAR
▶Child:Apply twice daily for several days (if wax is hard
and impacted)lDIRECTIONS FOR ADMINISTRATIONThe patient should lie
with the affected ear uppermost for 5 to 10 minutes after a
generous amount of the softening remedy has been
introduced into the ear. Allow ear drops to warm to room
temperature before use.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Spray
▶Earol(HL Healthcare Ltd)
Earol olive oil ear spray| 10 mls
Ear drops
▶Olive oil (Non-proprietary)
Olive oil ear drops| 10 ml £ 1. 35 – £ 1. 42
▶Arjun(Arjun Products Ltd)
Arjun ear drops| 10 ml £ 1. 26
▶Cerumol (olive oil)(Thornton & Ross Ltd)
Cerumol olive oil ear drops| 10 mls
▶KliarVax(Essential-Healthcare Ltd)
KliarVax ear drops| 10 ml £ 0. 97
▶Oleax(JR Biomedical Ltd)
Oleax ear drops| 15 ml £ 1. 40
▶Olive oil(Thornton & Ross Ltd)
Care olive oil ear drops| 10 ml £ 1. 42
▶St George’s(St Georges Medical Ltd)
Olive oil ear drops| 10 ml £ 1. 40 | 20 ml £ 2. 70Urea hydrogen peroxide
lINDICATIONS AND DOSE
Softening and removal of earwax
▶TO THE EAR
▶Child:(consult product literature)lPATIENT AND CARER ADVICEThe patient should lie with
the affected ear uppermost for 5 to 10 minutes after a
generous amount of the softening remedy has been
introduced into the ear.
lLESS SUITABLE FOR PRESCRIBINGUrea-hydrogen peroxide
ear drops are less suitable for prescribing.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Ear drops
▶Exterol(Dermal Laboratories Ltd)
Urea hydrogen peroxide 50 mg per 1 gramExterol 5 % ear drops|
8 mlp£ 1. 75 DT = £ 2. 89
▶Otex(Dendron Ltd)
Urea hydrogen peroxide 50 mg per 1 gramOtex 5 % ear drops|
8 mlp£ 2. 89 DT = £ 2. 89Nose
Nose 31-Oct-2017
Rhinitis
Rhinitis is often self-limiting. Many nasal preparations
contain sympathomimetic drugs which can give rise to
rebound congestion (rhinitis medicamentosa) and may
damage the nasal cilia. Sodium chloride 0. 9 % solution p. 589
may be used as a douche or‘sniff’following endonasal
surgery.
Administration
To administer nasal drops, lay the child face-upward with
the neck extended, instil the drops, then sit the child up and
tilt the head forward.Drugs used in nasal allergy
Mild allergic rhinitis is controlled byantihistamines(see
under Antihistamines, allergen immunotherapy and allergic
emergencies p. 171 ) or topicalnasal corticosteroids;
systemic nasal decongestants are not recommended for use
in children. Topical nasal decongestants can be used for a
short period to relieve congestion and allow penetration of a
topical nasal corticosteroid.
More persistent symptoms can be relieved by topical nasal
corticosteroids; sodium cromoglicate p. 701 is an
alternative, but may be less effective. The topical
antihistamine, azelastine hydrochloride p. 698 , is useful for
controlling breakthrough symptoms in allergic rhinitis.
Azelastine hydrochloride is less effective than nasal
corticosteroids, but probably more effective than sodium
cromoglicate. In seasonal allergic rhinitis (e.g. hay fever),
treatment should begin 2 to 3 weeks before the season
commences and may have to be continued for several
months; continuous long-term treatment may be required in
perennial rhinitis.
Montelukast p. 165 is less effective than topical nasal
corticosteroids; it can be used in children with seasonal
allergic rhinitis (unresponsive to other treatments) and
concomitant asthma.
Children with disabling symptoms of seasonal rhinitis (e.g.
students taking important examinations), may be treated
with oralcorticosteroidsfor short periods. Oral
corticosteroids may also be used at the beginning of a course
of treatment with a corticosteroid spray to relieve severe
mucosal oedema and allow the spray to penetrate the nasal
mucosa.
Sometimes allergic rhinitis is accompanied by vasomotor
rhinitis. In this situation, the addition of topical nasal
ipratropium bromide p. 698 can reduce watery rhinorrhoea.Corticosteroids
Corticosteroid nasal preparations should be avoided in the
presence of untreated nasal infections, after nasal surgery
(until healing has occurred), and in pulmonary tuberculosis.
Systemic absorption may follow nasal administration
particularly if high doses are used or if treatment is
prolonged; for cautions and side-effects of systemic
corticosteroids. The risk of systemic effects may be greater
with nasal drops than with nasal sprays; drops are694 Nose BNFC 2018 – 2019
Ear, nose and oropharynx12