Carbamide Peroxide Toxicity (2024)

The Full Story

Carbamide peroxide is a combination of hydrogen peroxide and urea. Depending on the concentration, it is commonly used for ear wax removal (6.5%), as an oral rinse (10%), and in home teeth-whitening products (16–44%). Carbamide peroxide releases hydrogen peroxide when it comes into contact with water or the surfaces of the ear or tooth.

Hydrogen peroxide released from carbamide peroxide can be toxic if swallowed. Swallowing small amounts of low-concentration (up to 14%) carbamide peroxide can cause stomach upset, an episode of vomiting, or throat irritation, but it would not expected to cause any more serious symptoms. However, swallowing a large amount of a low-concentration or a higher concentration product (greater than 15%) can result in more serious symptoms such as burns to the mouth, esophagus, or stomach. A gas embolism might form, leading to stroke or a heart attack. A gas embolism occurs when bubbles of air or another gas travel to the circulatory system and obstruct blood flow. Some symptoms of a gas embolism include difficulty breathing, chest pain, and confusion. Although a gas embolism is rare, it can be life threatening and emergency medical attention is required.

Carbamide peroxide is commonly used in teeth-whitening kits. These kits are sold for home use or used in dental offices. Home users should follow product directions closely to avoid any irritation of tissues that carbamide peroxide might cause. Tooth sensitivity and gum irritation are both common side effects. Anyone who chooses to use a home teeth-whitening kit should first consult with a dental healthcare provider.

A common call Poison Control receives is when ear wax remover is mistaken for eye drops and accidentally instilled in the eye(s). If this happens, immediately rinse with plenty of running water for 15–20 minutes. Then, use the webPOISONCONTROL® online tool for guidance or call Poison Control at 1-800-222-1222.

Diana N. Pei, PharmD
Certified Specialist in Poison Information

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Because these medications are often sold without child-resistant packaging, it is very important to keep them far away from the reach of young children.
  • Always use carbamide peroxide products according to the package label.

This Really Happened

Case 1. A 54-year-old-woman unintentionally put ear wax solution containing carbamide peroxide into her eye about 15 minutes prior to calling the local Emergency Medical Services (EMS) to her home. Her eye was swollen, red, and irritated. She irrigated her eye with water for about 7 minutes before EMS called Poison Control. Poison Control instructed them to continue irrigating her eyes with water for a total of 15 minutes. When Poison Control followed up with her an hour later, she still had eye irritation, redness, and a foreign body sensation. She was referred to either an emergency room or urgent care clinic for medical evaluation. Poison Control followed up the following day after she was seen at an urgent care clinic. She did not have a corneal abrasion, and her symptoms had resolved on their own without further treatment.

Case 2. A mother called after accidentally putting carbamide peroxide ear drops instead of a prescription eye drop medication into her 2-year-old daughter’s eyes. She immediately irrigated the girl’s eyes with water, and the girl had no symptoms. Poison Control instructed the mother to let the girl rest her eyes and to take her to an emergency room or urgent care clinic if any new symptoms developed. Poison Control followed up the next day and the girl did well with no symptoms.

Share this:

For More Information

Carbamide peroxide drops. New York: WebMD; [cited 2021 Aug 30].

Oral health topics: whitening. Chicago: American Dental Association; [updated 2020 Oct 30; cited 2021 Aug 30].

References

PubChem compound summary for CID 31294, carbamide peroxide. Bethesda (MD): National Library of Medicine; [cited 2021 Sep 3].

Soloway RAG. Hydrogen peroxide. The Poison Post. 2012 Jun.

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Because these medications are often sold without child-resistant packaging, it is very important to keep them far away from the reach of young children.
  • Always use carbamide peroxide products according to the package label.

This Really Happened

Case 1. A 54-year-old-woman unintentionally put ear wax solution containing carbamide peroxide into her eye about 15 minutes prior to calling the local Emergency Medical Services (EMS) to her home. Her eye was swollen, red, and irritated. She irrigated her eye with water for about 7 minutes before EMS called Poison Control. Poison Control instructed them to continue irrigating her eyes with water for a total of 15 minutes. When Poison Control followed up with her an hour later, she still had eye irritation, redness, and a foreign body sensation. She was referred to either an emergency room or urgent care clinic for medical evaluation. Poison Control followed up the following day after she was seen at an urgent care clinic. She did not have a corneal abrasion, and her symptoms had resolved on their own without further treatment.

Case 2. A mother called after accidentally putting carbamide peroxide ear drops instead of a prescription eye drop medication into her 2-year-old daughter’s eyes. She immediately irrigated the girl’s eyes with water, and the girl had no symptoms. Poison Control instructed the mother to let the girl rest her eyes and to take her to an emergency room or urgent care clinic if any new symptoms developed. Poison Control followed up the next day and the girl did well with no symptoms.

Carbamide Peroxide Toxicity (2024)

FAQs

Carbamide Peroxide Toxicity? ›

Hydrogen peroxide released from carbamide peroxide can be toxic if swallowed. Swallowing small amounts of low-concentration (up to 14%) carbamide peroxide can cause stomach upset, an episode of vomiting, or throat irritation, but it would not expected to cause any more serious symptoms.

Is carbamide peroxide carcinogenic? ›

Even though carbamide peroxide and the hydrogen peroxide generated in the whitening process are not proven carcinogens in the oral cavity, they cause local inflammation and mucosal trauma at high concentrations.

How safe is carbamide peroxide? ›

Carbamide peroxide is generally considered safe. Since this compound breaks down into hydrogen peroxide and urea, it is safe to swallow and usually does not cause harm. However, it is crucial always to use the correct dosage and application of carbamide peroxide to prevent side effects.

Can you overdose on carbamide peroxide? ›

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222.

When should you not use carbamide peroxide? ›

They need to know if you have any of these conditions:
  1. dizziness.
  2. ear discharge.
  3. ear pain, irritation or rash.
  4. infection.
  5. perforated eardrum (hole in eardrum)
  6. an unusual or allergic reaction to carbamide peroxide, glycerin, hydrogen peroxide, other medicines, foods, dyes, or preservatives.
  7. pregnant or trying to get pregnant.

Is carbamide toxic to humans? ›

Carbamide peroxide releases hydrogen peroxide when it comes into contact with water or the surfaces of the ear or tooth. Hydrogen peroxide released from carbamide peroxide can be toxic if swallowed.

What is safer hydrogen peroxide or carbamide peroxide? ›

“Carbamide peroxide is commonly used in tooth whitening products because it is more stable than hydrogen peroxide and has a longer shelf life. It also breaks down more slowly, which means that it can be used for longer periods of time without causing irritation to the gums or teeth.”

Is carbamide peroxide FDA approved? ›

The FDA considers carbamide peroxide to be safe in oral mucosal injury drug products as an oral wound healing agent, although there is insufficient data to establish general recognition of the effectiveness of this ingredient as an oral wound healing agent.

Can you sleep with carbamide peroxide? ›

You may wear your trays overnight if you have no sensitivities with 4 hours. General manufacturers recommended wearing times are: For Carbamide Peroxide Bleaching Gels (Pola Night): 10% Carbamide Peroxide (3.6% Hydrogen Peroxide) = use 1 x 2hours/day to overnight, while sleeping, if no sensitivity arises.

How long can I leave carbamide peroxide on my teeth? ›

Recommended wear time is 2 hours-10 hours (overnight). If you have tooth sensitivity*, reduce to 1 hour twice per day or 1 hour once every 3 days.

What happens if you get carbamide peroxide on your gums? ›

When used incorrectly or in excessive amounts, carbamide peroxide can cause harm to the teeth and gums. It may lead to tooth sensitivity, gum irritation, and even chemical burns.

What happens if you get carbamide peroxide in your eyes? ›

If Exposed to Eyes

If someone gets a carbamide peroxide product in the eye there can be immediate burning and stinging, which requires prompt first aid to avoid an eye injury. Immediately rinse with plenty of lukewarm water. Call the Missouri Poison Center at 1-800-222-1222 for further recommendations.

Is carbamide peroxide legal? ›

It is generally accepted that 10% carbamide peroxide content would yield a maximum of 3.6% hydrogen peroxide. Thus, the commonly used products containing 16% carbamide peroxide are allowed as they would normally release less than 6% hydrogen peroxide.

What are the disadvantages of carbamide peroxide? ›

Carbamide peroxide breaks down into hydrogen peroxide, a bleaching agent. Bleaching the teeth consistently strips away enamel, leading to unpleasant and blotchy appearance via exposing the darker dentin. It is worth noting that affected enamel makes the teeth brittle and vulnerable to chipping or cracking.

What are safe levels of carbamide peroxide? ›

The 10±1% carbamide peroxide dosage was the only level to date to acquire the American Dental Association's stamp of approval, ensuring its safety and effectiveness for at-home tooth whitening with customized trays.

What are contraindications for carbamide peroxide? ›

You should not use carbamide peroxide if you have a hole in your ear drum (ruptured ear drum), or if you have any signs of ear infection or injury, such as pain, warmth, swelling, drainage, or bleeding.

Is peroxide carcinogenic? ›

How likely is hydrogen peroxide to cause cancer? The International Agency for Research on Cancer (IARC) has determined that hydrogen peroxide is not classifiable as to its carcinogenicity to humans.

Are teeth whitening strips carcinogenic? ›

What They Found. In summary, the researchers found no definitive link between teeth whiteners and oral cancer. The free radicals generated during the whitening process are stilled believed to have carcinogenic potential, but so far the data is inconclusive.

Is carbamide peroxide bad for ears? ›

Pharmacist tips for Carbamide peroxide (Debrox)

This could cause damage to your inner ear. In addition, this could raise the risk of introducing bacteria inside the ear and causing an ear infection.

References

Top Articles
Latest Posts
Article information

Author: Sen. Emmett Berge

Last Updated:

Views: 6242

Rating: 5 / 5 (60 voted)

Reviews: 83% of readers found this page helpful

Author information

Name: Sen. Emmett Berge

Birthday: 1993-06-17

Address: 787 Elvis Divide, Port Brice, OH 24507-6802

Phone: +9779049645255

Job: Senior Healthcare Specialist

Hobby: Cycling, Model building, Kitesurfing, Origami, Lapidary, Dance, Basketball

Introduction: My name is Sen. Emmett Berge, I am a funny, vast, charming, courageous, enthusiastic, jolly, famous person who loves writing and wants to share my knowledge and understanding with you.