Indications
Acetic acid is the acid found in vinegar. In medicine it is used in dilute form in ear sprays and drops to treat and prevent mild infection and inflammation of the outer ear canal (otitis externa, often called swimmer’s ear). It is also an ingredient of the acid concentrate used to make dialysis fluid for people having haemodialysis because of kidney failure.
How It Works
In the ear, dilute acetic acid makes the ear canal slightly more acidic. Most bacteria and fungi that cause outer ear infections cannot grow well in an acidic environment, so the infection settles and the skin can heal. In dialysis fluid, a small amount of acetic acid (or acetate) helps keep the fluid at the correct acidity and stops minerals from settling out.
Dosage and Administration
Ear spray or drops: use as directed on the label or by your doctor. A typical ear spray is used as one spray into the affected ear three times a day, for up to 7 days, in adults and children aged 12 years and over. Tilt the head so the affected ear faces up, apply the dose, and keep the head tilted for a short time. Do not use for longer than advised.
Dialysis use: the acid concentrate is mixed and given only by trained dialysis staff, following the prescription set by the kidney doctor.
Interactions
No important interactions are expected with dilute acetic acid ear products. Do not use other ear drops at the same time unless your doctor advises it. For dialysis, the dialysis team adjusts the fluid to fit your other treatments.
Contraindications
- Known allergy or sensitivity to acetic acid or any ingredient of the product.
- A perforated (burst) eardrum or grommets (ear tubes) for ear products, unless a doctor advises otherwise.
Side Effects
Ear products may cause a short-lived stinging or burning feeling, mild irritation or redness. Allergic reactions are rare.
Get urgent medical help if you have severe ear pain, swelling spreading to the face or neck, high fever, discharge with blood, sudden hearing loss, dizziness, or signs of allergy such as swelling of the face or difficulty breathing. If ear symptoms do not improve within a few days, see a doctor.
Pregnancy and Lactation
Very little acetic acid from ear products enters the body, so they are generally considered acceptable during pregnancy and breastfeeding. Still, ask your doctor or pharmacist before use. Dialysis fluids are prescribed by the kidney doctor, who considers pregnancy.
Precautions and Warnings
- For use in the ear only; do not swallow and avoid contact with the eyes.
- See a doctor if there is ear discharge, severe pain, hearing loss or fever before using, as a more serious infection may need other treatment.
- Not usually recommended for children under 12 years without medical advice.
- Concentrated acetic acid is corrosive; only diluted medical products should be used.
Overdose
Using the ear product too often may increase irritation. If a large amount is swallowed, rinse the mouth, drink some water and seek medical advice. Concentrated acetic acid is dangerous if swallowed and needs emergency care.
Therapeutic Class
Topical ear antiseptic (acidifying agent); component of haemodialysis concentrate.
Storage
Store ear products below 30°C in a dry place, away from light and out of the reach of children. Dialysis concentrates should be stored as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.