Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Gel, Mouth/Throat:
Peroxyl Spot Treatment: 1.5% (15 g) [mint flavor]
Solution, External:
Eskata: 40% (1 ea) [contains isopropyl alcohol]
GoodSense Hydrogen Peroxide: 3% (236 mL, 473 mL, 946 mL)
Generic: 3% (30 mL, 120 mL [DSC], 237 mL [DSC], 473 mL, 480 mL [DSC], 946 mL, 3840 mL)
Solution, Mouth/Throat:
Perox-A-Mint: 1.5% (44 mL, 237 mL [DSC]) [alcohol free; contains brilliant blue fcf (fd&c blue #1), fd&c yellow #6 (sunset yellow), polysorbate 80, saccharin sodium]
Pharmacology
Mechanism of Action
Antiseptic oxidant that slowly releases oxygen and water upon contact with serum or tissue catalase
The mechanism of action for the treatment of seborrheic keratosis is unknown.
Pharmacokinetics/Pharmacodynamics
Absorption
None
Duration of Action
Only while bubbling action occurs.
Use: Labeled Indications
Antiseptic; minor dermal abrasion: Cleanse wounds, suppurating ulcers, and local infections; used in the treatment of inflammatory conditions of the external auditory canal
Mouth, gum, or dental irritation; Removal of oral secretions: Used as a mouthwash or gargle
Seborrheic keratosis (topical solution 40% only): Treatment of seborrheic keratoses
Contraindications
Should not be used in abscesses.
Topical solution 40%: There are no contraindications listed in the manufacturer's labeling
Dosage and Administration
Dosing: Adult
Antiseptic; minor dermal abrasion: Topical solution (3%), spray (3%): Apply a small amount to affected area(s) 1 to 3 times daily
Removal of oral secretions: Topical solution (3%): After dilution, swish solution around mouth over affected area for at least 1 minute, then spit out; may use up to 4 times daily after meals and bedtime
Mouth, gum, or dental irritation:
Oral rinse (1.4%): Topical: 10 mL swished around mouth over affected area for at least 1 minute, then spit out; may use up to 4 times daily after meals and at bedtime
Oral gel (1.7%): Topical: Apply several drops to affected area, allow medication to remain on site for at least 1 minute, then spit out; may use up to 4 times daily after meals and at bedtime
Seborrheic keratoses (raised): Topical solution (40%): Apply to lesions 4 times, ~1 minute apart, during a single in-office treatment session. If the treated lesions have not completely cleared ~3 weeks after treatment, may repeat
Dosing: Pediatric
Antiseptic; minor dermal abrasion: Children ≥2 years and Adolescents: Topical solution (3%), spray (3%): Apply a small amount to affected area(s) 1 to 3 times daily
Removal of oral secretions: Children ≥2 years and Adolescents: Topical solution (3%): After dilution, swish solution around mouth over affected area for at least 1 minute, then spit out; may use up to 4 times daily after meals and bedtime
Mouth, gum, or dental irritation: Children ≥2 years and Adolescents:
Oral rinse (1.4%): Topical: 10 mL swished around mouth over affected area for at least 1 minute, then spit out; may use up to 4 times daily after meals and at bedtime
Oral gel (1.7%): Topical: Apply several drops to affected area, allow medication to remain on site for at least 1 minute, then spit out; may use up to 4 times daily after meals and at bedtime
Administration
Topical: Dermal application:
Solution/spray (3%): Do not shake. Hold container away from face when opening. Clean the affected area prior to application. May cover with a sterile bandage after solution has dried. Solutions with a concentration >3% are irritants and must be diluted prior to use.
Solution (40%): For topical use only; not for oral, ophthalmic, or intravaginal use. Prior to application, clean lesions with alcohol wipe. Refer to manufacturer's labeling for preparation instructions. Apply solution directly to the lesion in a circular motion, uniformly wetting the lesion surface, including the edges without excess running or dripping. Do not apply to open or infected lesions. During the application, remove any excess solution from the surrounding skin using a clean absorbent wipe (do not use paper towels or tissue). Apply again in the same manner, 3 additional applications 1 minute apart.
Topical: Oral application: For topical use only; do not swallow.
Removal of oral secretions: Solution (3%): Mix with equal amounts of water; swish around mouth over affected area for at least 1 minute, then spit out.
Mouth, gum, or dental irritation:
Oral rinse (1.4%): Swish around the mouth over affected area for at least one minute, then spit out.
Gel (1.7%): Apply to affected area(s) of mouth. Allow to remain in place for at least 1 minute, then spit out.
Storage
Store at room temperature.
Drug Interactions
Taurolidine: May enhance the adverse/toxic effect of Hydrogen Peroxide. Specifically, concomitant use of taurolidine and hydrogen peroxide may increase the risk of metabolic acidosis. Avoid combination
Adverse Reactions
>10%:
Dermatologic: Erythema (99%), stinging of the skin (97%), desquamation (90%), crusted skin (81%), pruritus (58%), hyperpigmentation (39%), skin vesicle (24%), hypopigmentation (19%), severe erythema (19%), skin erosion (15%)
Local: Skin edema (91%)
1% to 10%: Dermatologic: Dermal ulcer (9%), skin atrophy (4%), cicatrix of skin (3%)
<1%, postmarketing, and/or case reports: Arthropathy (crepitus), eyelid edema, herpes zoster infection
Warnings/Precautions
Concerns related to adverse effects:
- Dermatologic reactions: Have occurred in the treatment area after application for seborrheic keratoses; severe reactions included erosion, ulceration, vesiculation, and scarring. Do not initiate a second treatment course for seborrheic keratoses until the skin has recovered from any reaction caused by the previous treatment.
Dosage forms specific issues:
- Topical solution 40%: Do not apply to the eyes or mucous membranes. Avoid treating seborrheic keratoses within the orbital rim. Direct contact with the eye can cause corneal injury (erosion, ulceration, perforation, and scarring), chemical conjunctivitis, eyelid edema, severe eye pain, or permanent eye injury, including blindness. If accidental exposure occurs, flush with water for 15 to 30 minutes and further evaluate as appropriate.
Other warnings/precautions:
- Appropriate use: Repeat use as a mouthwash or gargle may produce irritation of the buccal mucous membrane or "hairy tongue"; bandages should not be applied too quickly after its use; 10% and 30% solutions must be diluted prior to use.
Patient Education
What is this drug used for?
- It is used to prevent skin infections.
- It is used to help get rid of phlegm or mucus or help with a sore mouth.
- It is used to prevent mouth infections
- It is used to treat a type of skin growth called seborrheic keratoses.
Frequently reported side effects of this drug
- Stinging
- Itching
- Blisters
- Swelling
- Redness
- Crusting
- Scaling
- Skin discoloration
Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:
- Severe application site irritation
- Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.
Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.
Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.
