Usage
- This combination medication, classified as an ophthalmologic agent, is primarily prescribed for the treatment of dry eye syndrome (DES) or keratoconjunctivitis sicca. This condition involves insufficient tear production or excessive tear evaporation, resulting in dryness, irritation, and discomfort. It is also beneficial in managing post-operative dry eyes, corneal burns, and promoting corneal wound healing after procedures like LASIK or cataract surgery. Dexpanthenol (also known as D-Panthenol or Panthenol) and sodium hyaluronate are frequently included as ingredients in various moisturizing and lubricating eye drops, nasal sprays, and skin care products. Dexpanthenol promotes corneal wound healing and demonstrates anti-inflammatory properties, hence its application in treating eye dryness, minor injuries, and irritations, as well as burns and other skin conditions. Sodium hyaluronate functions by attracting and holding water molecules, thereby providing moisture and lubrication to the eyes and other body tissues. It is used to address dry eye, osteoarthritis of the knee, skin ulcers, wounds, incisions, and burns.
- Pharmacological Classification: Ophthalmic lubricant, artificial tears, wound healing agent.
- Mechanism of Action: Sodium hyaluronate is a glycosaminoglycan that lubricates and hydrates the ocular surface. D-Panthenol, a provitamin of B5, promotes corneal wound healing and has anti-inflammatory effects.
Alternate Names
- Dexpanthenol + Sodium Hyaluronate
- Panthenol + Sodium Hyaluronate
- Brand Names: Hylo-Care, Hyacarenol, Bepanthen, Optidew, Nah-D, Aquaeye, HealTears, others (brand names may vary regionally).
How It Works
- Pharmacodynamics: Sodium hyaluronate increases tear film viscosity and stability, reducing tear evaporation and improving ocular surface lubrication. D-Panthenol enhances corneal epithelial cell migration and proliferation, facilitating wound healing and reducing inflammation.
- Pharmacokinetics: Topically applied sodium hyaluronate has limited systemic absorption. D-Panthenol, when applied to the eye, is converted to pantothenic acid and absorbed into ocular tissues, with minimal systemic absorption. The primary elimination pathways of pantothenic acid from the body are renal excretion with approximately 70% being removed in the urine, while the remainder can be found in the faeces.
- Mode of Action: Sodium hyaluronate mimics the natural hyaluronic acid found in the tear film, binding water molecules to enhance hydration and lubrication. D-Panthenol, after conversion to pantothenic acid, plays a role in cellular metabolism, supporting epithelial cell regeneration and modulating inflammatory processes.
- Receptor Binding/Enzyme Inhibition: The primary mechanism of action for sodium hyaluronate is related to its unique viscoelastic properties that form a protective, moisturizing barrier over the ocular surface and stimulate epithelial regeneration. There does not appear to be a direct interaction of the substance with specific cell receptors or enzymes. As D-panthenol functions as a provitamin of pantothenic acid (vitamin B5), it transforms into pantothenic acid in the body and contributes to a range of metabolic processes within cells, such as the production of coenzyme A and fatty acids. This, in turn, impacts cell development, functioning, and renewal. Similar to sodium hyaluronate, it does not exhibit direct engagement with particular receptors or enzymes.
- Elimination Pathways: Sodium hyaluronate is primarily eliminated through local drainage from the ocular surface. Pantothenic acid (converted from D-Panthenol) is eliminated primarily via renal excretion.
Dosage
Standard Dosage
Adults:
- 1-2 drops instilled into the affected eye(s) 4-6 times per day.
- Frequency can be adjusted based on the severity of symptoms and clinical response, up to a maximum of 8 times a day.
Children:
- 1 drop instilled into the affected eye(s) 4 times per day.
- Pediatric use should be under the supervision of a healthcare provider.
Special Cases:
- Elderly Patients: Dosage adjustment is generally not required.
- Patients with Renal Impairment: Dosage adjustment is not necessary, as the drug can be safely used in individuals with kidney disease.
- Patients with Hepatic Dysfunction: Dosage adjustment is not necessary, as the drug can be safely used in individuals with liver disease.
- Patients with Comorbid Conditions: No specific dosage adjustments mentioned for common comorbidities like diabetes or cardiovascular disease. However, individualized adjustments might be required based on specific conditions and concurrent medications.
Clinical Use Cases
- Intubation, Surgical Procedures, Mechanical Ventilation, ICU Use, Emergency Situations: While the drug is primarily used for dry eye, it can be utilized in these settings to maintain ocular surface lubrication and protect against corneal damage. Dosage adjustments should be made based on the patient’s specific needs and clinical context.
Dosage Adjustments
- Dose modifications may be needed in specific scenarios such as persistent ocular irritation, co-administration of other ophthalmic medications (maintain a 5-minute interval), or individual patient responses.
Side Effects
Common Side Effects
- Blurred vision (transient)
- Eye redness, discomfort, or irritation
- Increased sensitivity to light
- Stickiness of eyelashes
- Swelling of eyelids
- Watery eyes
- Itching or burning sensation in the eye
Rare but Serious Side Effects
- Severe allergic reactions (e.g., anaphylaxis) – requires urgent medical attention.
Long-Term Effects
- No specific long-term effects have been reported, but prolonged use warrants monitoring for any adverse reactions.
Adverse Drug Reactions (ADR)
- Clinically significant ADRs are rare but may include severe hypersensitivity reactions, requiring immediate intervention.
Contraindications
- Known hypersensitivity to D-Panthenol, sodium hyaluronate, or any components of the formulation.
Drug Interactions
- Limited data on drug interactions, maintain a 5-minute interval between ophthalmic medications.
- No significant drug interactions are usually encountered, except those arising from allergies to any component of the formulation.
- No known interactions with commonly prescribed medications, OTC drugs, supplements, or lifestyle factors.
Pregnancy and Breastfeeding
- Pregnancy Safety Category: Insufficient data available for D-panthenol use during pregnancy. Topical application of D-Panthenol is generally considered safe during pregnancy for treating minor burns, sunburns, diaper rash, and other skin irritations, but it is essential to seek advice from a medical practitioner before applying it to sensitive areas or extensive open wounds. No clinical data on Dexpanthenol during pregnancy, while studies for Sodium Hyaluronate reproduction showed no specific risk.
- Breastfeeding: D-Panthenol should be used with caution during breastfeeding. Seek medical advice before using. Sodium Hyaluronate has no relevant data regarding breast milk secretion.
Drug Profile Summary
- Mechanism of Action: Sodium hyaluronate lubricates and hydrates, while D-Panthenol promotes healing and reduces inflammation.
- Side Effects: Blurred vision, eye irritation, redness, sensitivity to light, stickiness of eyelashes, eyelid swelling.
- Contraindications: Hypersensitivity to any component.
- Drug Interactions: Limited data, maintain a 5-minute interval between ophthalmic medications.
- Pregnancy & Breastfeeding: Use with caution if clearly needed. Consult a physician.
- Dosage: 1-2 drops 4-6 times/day (adults), 1 drop 4 times/day (children). Adjustments may be needed.
- Monitoring Parameters: Resolution of dry eye symptoms, any adverse reactions.
Popular Combinations
- D-Panthenol + Sodium Hyaluronate is often used as a standalone treatment.
- There are no established clinically beneficial combined uses for D-Panthenol + Sodium Hyaluronate, but it is sometimes used alongside antibiotic eye drops for wound healing and lubricating eye drops for managing dry eye.
Precautions
- Ensure proper hygiene when instilling drops to avoid contamination.
- Avoid touching the tip of the container to the eye or any other surface.
- If symptoms persist or worsen, consult a doctor.
- Specific Populations: Consult a physician if pregnant, breastfeeding, or using in children and elderly.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for D-Panthenol + Sodium Hyaluronate?
A: The typical dosage for adults is 1-2 drops in the affected eye(s) 4-6 times daily. For children, it’s usually 1 drop 4 times a day. Adjustments may be needed based on severity and individual response.
A: Consult your doctor for advice, although removing contact lenses before application and waiting 15 minutes before reinsertion is generally recommended.
Q3: What are the common side effects of D-Panthenol + Sodium Hyaluronate?
A: Common side effects include temporary blurred vision, eye redness, irritation, increased light sensitivity, stickiness of eyelashes, and mild eyelid swelling.
Q4: Is it safe to use this medication during pregnancy or breastfeeding?
A: Consult your doctor before use during pregnancy or breastfeeding. Safety data is limited. Caution is advised, especially during pregnancy.
Q5: How does D-Panthenol + Sodium Hyaluronate work to relieve dry eye?
A: Sodium hyaluronate enhances tear film stability and reduces evaporation, while D-Panthenol aids corneal healing and reduces inflammation, thereby addressing the underlying causes and symptoms of dry eye.
Q6: Are there any drug interactions I should be aware of?
A: Limited interaction data exists. Maintain a 5-minute interval between different ophthalmic medications.
Q7: Can this medication be used for other eye conditions besides dry eye?
A: Yes, it can be beneficial for managing post-operative dry eyes, corneal burns, and supporting corneal healing after eye surgeries like LASIK or cataract removal.
Q8: How long can I use D-Panthenol + Sodium Hyaluronate eye drops?
A: The duration of use depends on the individual’s condition and response. Consult your doctor for guidance on how long to use the medication.
Q9: What should I do if my symptoms don’t improve or worsen after using this medication?
A: Discontinue use and promptly consult your ophthalmologist if your dry eye symptoms don’t improve or if they worsen.
