Chlorbutol + Polyvinyl Alcohol + Povidone Iodine

Usage

• This combination medication is primarily prescribed for the treatment of dry eyes and minor eye irritation. Dry eyes occur when the eyes do not produce enough tears or when the tears evaporate too quickly.
• Pharmacological classification: This combination includes a lubricant (polyvinyl alcohol), an antiseptic (povidone iodine), and a preservative (chlorbutol). It can be categorized as an ophthalmic demulcent and antiseptic.
• Mechanism of Action: Polyvinyl alcohol lubricates the eye surface, mimicking natural tears. Povidone iodine acts as a broad-spectrum antiseptic, eliminating bacteria and preventing infection. Chlorbutol preserves the solution and also acts as a mild local anesthetic.

Alternate Names

• This specific combination does not have a universally recognized international nonproprietary name (INN). It’s often referred to by the names of its components.
• Brand names: Examples of brand names include Ocu Tear, Tears Plus, Irisol Plus, Tearflo, Stemoist, PVL Lubricating Eye Drops, Moss, Visio Tears. Brand names can vary regionally.

How It Works

• Pharmacodynamics: Polyvinyl alcohol increases tear film stability, reducing evaporation and providing relief from dryness and discomfort. Povidone iodine exerts its antiseptic effect by releasing free iodine, which disrupts microbial cell walls and inhibits protein synthesis. Chlorbutol provides a mild anesthetic effect, further alleviating discomfort.
• Pharmacokinetics: Absorption is minimal with topical application. Metabolism and elimination pathways for this combination have not been extensively studied. Small amounts of iodine could be absorbed, and Chlorbutol is absorbed systemically when used as an ear drop.
• Mode of action: Polyvinyl alcohol acts through physical lubrication, while povidone iodine acts at the cellular level by directly affecting microbial integrity. Chlorbutol exerts its anesthetic effect likely through membrane stabilization.
• Receptor binding, enzyme inhibition, or neurotransmitter modulation: Not applicable for this combination in its topical ophthalmic form. Chlorbutol, at high concentrations, may show GABAergic activity.
• Elimination pathways: Minimally absorbed, so elimination is not a significant concern. If absorbed, components are likely metabolized and excreted by the liver and kidneys.

Dosage

Standard Dosage

Adults: 1-2 drops instilled into the affected eye(s) every 4 hours, or as needed, or as directed by the physician.

Children: Use only under strict medical supervision and as per the physician’s advice. Dosage adjustments are usually made based on the child’s age and weight.

Special Cases:

• Elderly Patients: No specific dosage adjustments are typically required, but monitoring for any adverse effects is advised.
• Patients with Renal Impairment: Dose modifications might be considered by the physician if systemic absorption is a concern.
• Patients with Hepatic Dysfunction: Similar to renal impairment, dose modifications may be considered in case of potential systemic absorption.
• Patients with Comorbid Conditions: Patients with thyroid disorders should use povidone iodine cautiously and under medical supervision.

Clinical Use Cases

Dosage in specific medical settings is determined by physician based on patient specific factors. There is no specific information available about this combination in different clinical use cases.

Dosage Adjustments

Dose modifications are based on individual patient response and tolerability. Patients with a history of sensitivity to any of the components should use cautiously.

Side Effects

Common Side Effects

• Eye discomfort
• Eye irritation
• Blurred vision (temporary)
• Stinging or burning sensation (temporary)

Rare but Serious Side Effects

• Severe allergic reactions (e.g., rash, itching, swelling, severe dizziness, trouble breathing)
• Eye pain
• Changes in vision
• Persistent redness or irritation

Long-Term Effects

Prolonged use of povidone-iodine can potentially cause thyroid dysfunction in susceptible individuals.

Adverse Drug Reactions (ADR)

ADRs for topical use are usually limited to local effects, such as eye irritation and allergic reactions.

Contraindications

• Known hypersensitivity to any of the components.
• Pre-existing thyroid conditions (use povidone-iodine with caution).

Drug Interactions

• No significant drug interactions have been reported for topical ophthalmic use. It’s always advisable to inform your physician about all other medications being used, including other eye drops.

Pregnancy and Breastfeeding

• Consult a physician before use during pregnancy or breastfeeding. While systemic absorption is minimal, caution is advised.

Drug Profile Summary

Refer to sections above for detailed explanations.

Popular Combinations

This particular combination is itself considered a common formulation. There is no information about combining it with other drugs.

Precautions

• Wash hands thoroughly before and after application.
• Avoid touching the tip of the container to the eye or any other surface.
• Discontinue use if irritation persists or worsens and consult a physician.
• Do not use if the solution changes color or becomes cloudy.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Chlorbutol + Polyvinyl Alcohol + Povidone Iodine?

A: The usual recommendation is 1-2 drops in the affected eye(s) every 4 hours or as needed. However, always follow the physician’s prescribed dosage.

Q2: Can I use this combination while wearing contact lenses?

A: It’s generally recommended to remove contact lenses before using these eye drops and wait for 10-15 minutes before reinserting. Consult with your doctor or check the specific product instructions.

Q3: What should I do if I miss a dose?

A: If you miss a dose, instill it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not instill double doses.

Q4: Can I drive after using these eye drops?

A: These eye drops may cause temporary blurred vision. Avoid driving or operating machinery until your vision clears.

Q5: How long can I use this combination?

A: Use only as directed by your physician. If your symptoms do not improve within a few days, or if they worsen, consult your physician.

Q6: Can pregnant or breastfeeding women use this combination?

A: Consult a physician before using this combination during pregnancy or while breastfeeding.

Q7: Are there any specific storage instructions for these eye drops?

A: Store at room temperature, away from direct sunlight and heat. Keep out of reach of children.

Q8: What are the potential interactions with other eye medications?

A: Inform your physician about all other eye medications you are using. Maintain a gap of 10-15 minutes between instillations of different eye drops.

Q9: Can this combination be used in children?

A: Use in children should be only under strict medical supervision and as per the physician’s recommendation.

Q10: What should I do if my eye condition worsens despite using this medication?

A: Discontinue use and consult your physician immediately.