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Acetic acid

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Acetic acid
Copyright 1978-2011 Lexicomp, Inc. All rights reserved.

(For additional information see “Acetic acid: Patient drug information”)

Brand Names: U.S.

  • VoSoL®
Pharmacologic Category

  • Otic Agent, Anti-infective;
  • Topical Skin Product
Dosing: AdultIrrigation (Note: Dosage of an irrigating solution depends on the capacity or surface area of the structure being irrigated):

For continuous irrigation of the urinary bladder with 0.25% acetic acid irrigation, the rate of administration will approximate the rate of urine flow; usually 500-1500 mL/24 hours

For periodic irrigation of an indwelling urinary catheter to maintain patency, about 50 mL of 0.25% acetic acid irrigation is required

Otitis externa: Otic: Insert saturated wick; keep moist 24 hours; remove wick and instill 5 drops 3-4 times/day

Dosing: PediatricOtitis externa: Otic: Children ≥3 years: Insert saturated wick; keep moist 24 hours; remove wick and instill 5 drops 3-4 times/day. Note: 3-4 drops may be sufficient in children due to the smaller capacity of the ear canal.

Dosing: GeriatricRefer to adult dosing.

Dosage Forms: U.S.Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, for irrigation: 0.25% (1000 mL)

Solution, for irrigation [preservative free]: 0.25% (250 mL, 500 mL, 1000 mL)

Solution, otic [drops]: 2% (15 mL, 60 mL)

VoSoL®: 2% (15 mL) [contains benzethonium chloride]

Generic Equivalent Available: U.S.Yes

AdministrationNot for internal intake or I.V. infusion; topical use or irrigation use only.

Medication Safety Issues

Sound-alike/look-alike issues:

Acetic acid for irrigation may be confused with glacial acetic acid

VoSol® may be confused with Vexol®,VoSol® HC

Adverse Reactions SignificantFrequency not defined.

Irrigation solution:

Endocrine & Metabolic: Systemic acidosis

Genitourinary: Urologic pain

Local: Irritation

Renal: Hematuria

Otic solution: Otic: Irritation, burning, stinging

ContraindicationsHypersensitivity to acetic acid or any component of the formulation; during transurethral procedures (irrigation); perforated tympanic membrane (otic solution)

Warnings/Precautions Concerns related to adverse effects:

• Bladder irritation: Use of irrigation in patients with mucosal lesions of urinary bladder may cause irritation. Open lesions of the bladder mucosa may result in systemic acidosis from absorption.

Other warnings/precautions:

• Administration: Not for internal intake or I.V. infusion; topical use or irrigation use only.

Drug Interactions

(For additional information: Launch Lexi-Interact™ Drug Interactions Program )

BCG: Antibiotics may diminish the therapeutic effect of BCG. Risk X: Avoid combination

Pregnancy Risk FactorC (show table)

International Brand Names

  • Aquaear (AU);
  • Earcalm (GB, IE);
  • Suym Otico (PE);
  • Vosol (NZ)
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REFERENCES

  1. Kawamata M, Fujita S, and Mayumi T, “Acetic Acid Intoxication by Rectal Administration,” J Toxicol Clin Toxicol, 1994, 32(3):333-6. [PubMed 8007044]
  2. Penner GE, “Acid Ingestion: Toxicology and Treatment,” Ann Emerg Med, 1980, 9(7):374-9. [PubMed 7396252]
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