Usage
This ophthalmic solution is primarily prescribed for bacterial eye infections (e.g., conjunctivitis, blepharitis) and ocular allergies.
Pharmacological Classification:
- Antibiotic (Sulphacetamide)
- Antihistamine (Chlorpheniramine Maleate)
- Antiseptic (Boric Acid, Zinc Sulfate)
- Lubricant (Hydroxypropylmethylcellulose)
- Isotonic Agent (Sodium Chloride)
Mechanism of Action:
This combination medication works through the synergistic action of its components: Sulphacetamide inhibits bacterial growth, Chlorpheniramine Maleate reduces allergic reactions, Boric Acid and Zinc Sulfate provide antiseptic action, Hydroxypropylmethylcellulose lubricates the eye, and Sodium Chloride maintains isotonicity.
Alternate Names
This combination does not have a widely recognized single alternate name. It is often referred to by its component names or by brand names like Tekmide. Regional variations may also exist.
How It Works
Pharmacodynamics:
- Sulphacetamide: Inhibits bacterial dihydropteroate synthase, disrupting folic acid synthesis and impeding bacterial growth (bacteriostatic effect).
- Chlorpheniramine Maleate: Antagonizes histamine H1 receptors, reducing ocular allergic manifestations (itching, redness, watering).
- Boric Acid/Zinc Sulfate: Exert antiseptic and astringent effects, soothing eye irritation.
- Hydroxypropylmethylcellulose: Enhances tear film viscosity, prolonging drug contact time with the ocular surface.
- Sodium Chloride: Maintains physiological osmotic balance.
Pharmacokinetics: Primarily topical action; limited systemic absorption. Sulphacetamide and Boric Acid can be absorbed systemically. Elimination pathways are primarily renal.
Mode of Action: See pharmacodynamics above.
Dosage
Standard Dosage
Adults:
Instill 1–2 drops in the affected eye(s) every 4–6 hours, or as directed by a physician.
Children:
Use with caution in children. Consult a pediatrician or ophthalmologist for appropriate dosing based on the child’s age and weight.
Special Cases:
- Elderly Patients: No specific adjustments are typically necessary, but close monitoring for adverse effects is advised.
- Patients with Renal Impairment: Use cautiously. Dosage adjustment might be required due to systemic absorption potential of boric acid and sulfacetamide.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are typically recommended, but monitor for adverse reactions.
- Patients with Comorbid Conditions: Evaluate on a case-by-case basis, considering potential drug interactions and disease-specific factors.
Clinical Use Cases
Dosage in specialized clinical settings should be guided by individual patient needs and clinical judgment. The standard dosage recommendations generally apply.
Dosage Adjustments
Adjustments may be necessary for patients with renal/hepatic impairment and other relevant medical conditions. Consider patient-specific factors like age, weight, and concurrent medications.
Side Effects
Common Side Effects:
Transient local irritation, burning, stinging, or blurred vision.
Rare but Serious Side Effects:
Severe allergic reactions (e.g., angioedema, anaphylaxis), Stevens-Johnson syndrome (rare).
Long-Term Effects:
With prolonged use, potential for secondary infections or development of resistant bacterial strains.
Adverse Drug Reactions (ADR):
Any sign of hypersensitivity or severe local reaction necessitates immediate discontinuation and medical evaluation.
Contraindications
Hypersensitivity to sulfonamides or any component of the formulation.
Drug Interactions
Sulphacetamide can potentiate the effects of anticoagulants (e.g., warfarin). Silver preparations are incompatible with sulphacetamide.
Pregnancy and Breastfeeding
Use with caution during pregnancy and breastfeeding. Safety during these periods has not been fully established. Consider the potential benefits versus risks.
Drug Profile Summary
- Mechanism of Action: Combined antibiotic, antihistamine, antiseptic, lubricant, and isotonic action.
- Side Effects: Local irritation, rare serious allergic reactions.
- Contraindications: Sulfonamide hypersensitivity.
- Drug Interactions: Anticoagulants, silver preparations.
- Pregnancy & Breastfeeding: Use cautiously.
- Dosage: Adults: 1–2 drops in the affected eye(s) every 4–6 hours. Pediatric dosing requires specialist consultation.
- Monitoring Parameters: Observe for local reactions and signs of hypersensitivity.
Popular Combinations
This combination itself represents a frequently used formulation in ophthalmology. No specific additional combinations are commonly recommended.
Precautions
Evaluate patient history for allergies, relevant comorbidities (renal/hepatic impairment), and concurrent medications. Exercise caution in pregnant/breastfeeding patients, children, and the elderly. Advise patients about potential temporary blurred vision and its impact on activities requiring visual acuity.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Boric Acid + Chlorpheniramine Maleate + Hydroxypropylmethylcellulose + Sodium Chloride + Sulphacetamide + Zinc Sulfate?
A: The standard dosage is 1-2 drops in the affected eye(s) every 4-6 hours. Consult a specialist for pediatric or special population dosing.
A: It’s generally advisable to remove contact lenses before instilling the drops and wait for 15-20 minutes before reinserting. Certain preservatives in some formulations can be absorbed by contact lenses.
Q3: What are the common side effects?
A: Common side effects include transient burning, stinging, or blurred vision upon instillation.
Q4: What should I do if I experience severe or persistent side effects?
A: Discontinue use immediately and consult an ophthalmologist.
Q5: Can this medicine be used during pregnancy or breastfeeding?
A: Use with caution. Discuss potential risks and benefits with your doctor.
Q6: How long should I use this medication?
A: Follow the prescribed duration. Do not discontinue prematurely, even if symptoms improve. Consult your doctor if symptoms persist or worsen.
Q7: Is it safe to drive or operate machinery after using this medication?
A: The drops might cause temporary blurring of vision. Avoid driving or operating machinery until your vision clears.
Q8: Are there any dietary restrictions while using this medication?
A: No specific dietary restrictions are typically associated with this ophthalmic solution.
Q9: What should I do if I miss a dose?
A: Instill the missed dose as soon as you remember, unless it’s almost time for the next dose. Do not double the dose.
