Usage
Boric acid + hydroxypropylmethylcellulose ophthalmic solution is primarily used as a lubricant and artificial tear for the relief of dry eyes and ocular irritation. It is also used during eye examinations and surgical procedures to maintain corneal moisture and protect the eye surface. Boric acid, in combination with other ingredients like hydroxypropyl methylcellulose, acts as a buffer and helps maintain the pH of the solution. Hydroxypropyl methylcellulose is a lubricant. Thus this drug combination is classified as an ophthalmic lubricant and demulcent.
Alternate Names
While “Boric Acid + Hydroxypropylmethylcellulose” is the generic name, this combination is often referred to as artificial tears. Various brand names exist, and some include “ART Eye Drop.”
How It Works
Pharmacodynamics: Hydroxypropylmethylcellulose (HPMC) is a viscosity-enhancing agent. It increases the thickness of the tear film, prolonging its contact time with the ocular surface and providing lubrication. Boric acid acts as a buffering agent, helping to maintain the physiological pH of the tear film. This combined effect alleviates dryness, irritation, and discomfort associated with dry eye conditions.
Pharmacokinetics: HPMC is not systemically absorbed following topical ocular administration. Boric acid, when used in ophthalmic solutions at recommended concentrations, is minimally absorbed. The small amount that might be absorbed is excreted primarily by the kidneys.
Dosage
Standard Dosage
Adults: Instill 1-2 drops into the affected eye(s) three to four times daily, or as needed.
Children: The dosage for children is generally the same as for adults, but should be administered under the supervision of a healthcare professional. Specifically, for children above two years of age, use under the supervision of a medical professional. Its use is contraindicated in children below the age of two.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically required, but monitoring for potential adverse effects is advisable.
- Patients with Renal Impairment: Dosage adjustment is usually unnecessary due to minimal systemic absorption.
- Patients with Hepatic Dysfunction: Dosage adjustment is usually unnecessary due to minimal systemic absorption.
- Patients with Comorbid Conditions: Use with caution in patients with glaucoma or other ocular conditions.
Clinical Use Cases
The standard dosage generally applies to these clinical scenarios:
- Intubation: Use as needed for ocular lubrication.
- Surgical Procedures: Use during ophthalmic procedures to maintain moisture and protect the cornea.
- Mechanical Ventilation: Apply regularly to prevent corneal drying.
- Intensive Care Unit (ICU) Use: Frequent instillation is recommended.
- Emergency Situations: Use as needed to alleviate ocular irritation or dryness.
Dosage Adjustments
While not routinely necessary, dosage adjustments may be considered in individual cases based on patient response and tolerance.
Side Effects
Common Side Effects:
- Transient blurred vision
- Mild stinging or burning upon instillation
- Sticky eyelashes
Rare but Serious Side Effects:
- Eye pain
- Vision changes
- Severe eye irritation or redness
- Allergic reactions (e.g., rash, itching, hives)
Long-Term Effects: No significant long-term adverse effects have been reported with typical use.
Adverse Drug Reactions (ADR): Clinically significant ADRs are rare but may include severe allergic reactions.
Contraindications
- Hypersensitivity to boric acid or HPMC.
- Children under 2 years of age.
Drug Interactions
No significant drug interactions have been reported with boric acid + hydroxypropylmethylcellulose ophthalmic solution. However, always inform your doctor about all other medications, including over-the-counter drugs and supplements, that you are using.
Pregnancy and Breastfeeding
Data regarding the use of boric acid + HPMC ophthalmic solution during pregnancy and breastfeeding is limited. Consult with a healthcare professional to weigh the potential benefits and risks before use in these populations. As a precaution, use of this drug combination is not recommended in pregnancy and breastfeeding.
Drug Profile Summary
- Mechanism of Action: HPMC lubricates the ocular surface. Boric acid acts as a buffer.
- Side Effects: Transient blurred vision, mild stinging, sticky eyelashes. Rarely, allergic reactions.
- Contraindications: Hypersensitivity to components, age below 2 years.
- Drug Interactions: None reported.
- Pregnancy & Breastfeeding: Consult a doctor; generally avoided.
- Dosage: 1–2 drops 3–4 times/day or as needed.
- Monitoring Parameters: Observe for eye irritation, vision changes, and allergic reactions.
Popular Combinations
Boric acid and HPMC are commonly combined in various artificial tear formulations. Sometimes, other ingredients like electrolytes might be added to mimic natural tears more closely.
Precautions
- General Precautions: Assess for hypersensitivity.
- Specific Populations: Use with caution in pregnant/breastfeeding women. Contraindicated in children under 2 years. Use with caution in the elderly or individuals with glaucoma.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Boric Acid + Hydroxypropylmethylcellulose?
A: The usual dosage is 1-2 drops in the affected eye(s) three to four times a day or as needed.
A: Some formulations may be incompatible with certain types of contact lenses, particularly soft lenses. Consult the product labeling or your doctor.
Q3: What should I do if I experience blurred vision after using the drops?
A: Blurred vision is usually temporary and resolves quickly. If blurring persists or worsens, consult your doctor.
Q4: Can I use this if I have glaucoma?
A: Use with caution in patients with glaucoma and consult with a doctor.
Q5: Are there any long-term side effects associated with the use of these eye drops?
A: No significant long-term side effects have been reported with proper use.
Q6: Can pregnant or breastfeeding women use these eye drops?
A: Consult with a healthcare professional before using these eye drops if you are pregnant or breastfeeding. Limited safety data is available, and caution is advised.
Q7: How should I store the eye drops?
A: Store as directed on the product packaging. Generally, store at room temperature, away from direct sunlight and excessive heat. Discard the bottle after the expiry date or four weeks after first opening, whichever comes first.
Q8: What should I do if I accidentally ingest the eye drops?
A: While small amounts are unlikely to cause serious harm, contact a poison control center or seek medical advice.
Q9: Is it okay to use these drops with other eye medications?
A: Inform your ophthalmologist about all other medications you are using, including other eye drops, to avoid potential drug interactions. If using other eye medications, separate administration by at least 5 minutes.
Q10: What should I do if my symptoms do not improve after using this medication?
A: Consult your ophthalmologist if your symptoms don’t improve or if they worsen after a few days of use.
