Usage
- This combination is prescribed for the temporary relief of burning, irritation, and discomfort due to dryness of the eye. This dryness can be caused by various factors such as exposure to wind or sun, reduced tear production, or increased tear evaporation. It is also used as a protectant against further irritation.
- Pharmacological Classification: Ophthalmic lubricant, demulcent.
- Mechanism of Action: The combination works by mimicking natural tears and lubricating the ocular surface. Dextran 70 and Hydroxypropylmethylcellulose are demulcents, providing a soothing and protective coating over the cornea. Glycerin acts as a humectant, drawing water to the ocular surface to maintain moisture.
Alternate Names
- Hypromellose + Glycerin + Dextran, Hydroxypropyl Methylcellulose + Glycerin + Dextran 70 Ophthalmic Solution.
- Brand Names: Tears Naturale Forte, Ara Eye Drops, Gentle Tears, Celsus, and various generic formulations.
How It Works
- Pharmacodynamics: The primary effect is to lubricate and protect the ocular surface, reducing dryness, irritation, and discomfort.
- Pharmacokinetics: Primarily topical action; minimal systemic absorption.
- Mode of Action: Dextran 70 and Hydroxypropylmethylcellulose increase the viscosity of the tear film and form a protective layer on the ocular surface, preventing evaporation and providing lubrication. Glycerin attracts and retains moisture on the eye’s surface. There is no specific receptor binding, enzyme inhibition, or neurotransmitter modulation involved.
- Elimination Pathways: Due to minimal systemic absorption, elimination pathways are not clinically significant. Excess solution is typically blinked away or wiped off.
Dosage
Standard Dosage
Adults: Instill 1 or 2 drops in the affected eye(s) as needed or as directed by the physician.
Children: Similar to adult dosing, instill 1 or 2 drops as needed. Pediatric safety has been established, but always consult a doctor before administering to children.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically required.
- Patients with Renal Impairment: No dosage adjustments are needed.
- Patients with Hepatic Dysfunction: No dosage adjustments are needed.
- Patients with Comorbid Conditions: Exercise caution with glaucoma patients and those with other pre-existing eye conditions. Consult a doctor for specific advice.
Clinical Use Cases
The dosage remains consistent across these clinical settings: instill 1-2 drops in the affected eye(s) as needed or as prescribed by the physician.
- Intubation: Can be used to lubricate the eyes and prevent dryness during procedures requiring intubation.
- Surgical Procedures: May be used before, during, or after ophthalmic surgeries as needed to maintain ocular surface lubrication.
- Mechanical Ventilation: Helps to prevent corneal dryness in patients on mechanical ventilation.
- Intensive Care Unit (ICU) Use: Provides relief from dry eye in critically ill patients.
- Emergency Situations: May be used to alleviate eye irritation caused by foreign bodies or chemical exposure.
Dosage Adjustments
Generally, no specific dosage adjustments are needed. If symptoms persist or worsen after 72 hours, consult a physician.
Side Effects
Common Side Effects
- Temporary blurred vision immediately after application.
- Minor burning or stinging sensation upon instillation.
- Transient eye irritation.
Rare but Serious Side Effects
- Eye pain.
- Changes in vision.
- Continued redness or irritation that persists beyond 72 hours.
Long-Term Effects
No significant long-term adverse effects have been reported with this combination.
Adverse Drug Reactions (ADR)
Allergic reactions, though rare, can occur. These may include itching, swelling, rash, severe dizziness, and trouble breathing. Seek immediate medical attention if these occur.
Contraindications
- Known hypersensitivity to Dextran 70, Glycerin, Hydroxypropylmethylcellulose, or any other component of the formulation.
Drug Interactions
- Advise patients to wait at least 5 minutes between instilling this combination and other eye drops.
- Interactions with other medications are minimal due to low systemic absorption. Inform your doctor of all other medications being used, including other eye drops, to prevent potential interactions.
Pregnancy and Breastfeeding
- Considered safe to use during pregnancy and breastfeeding, but consult a physician before use.
- Choose preservative-free formulations when possible.
Drug Profile Summary
- Mechanism of Action: Lubricates and protects the ocular surface.
- Side Effects: Blurred vision, burning/stinging, irritation (usually transient).
- Contraindications: Hypersensitivity to any component.
- Drug Interactions: Minimal due to low systemic absorption; maintain a gap between other eye drops.
- Pregnancy & Breastfeeding: Generally safe, consult a doctor.
- Dosage: 1-2 drops as needed.
- Monitoring Parameters: Resolution of dryness, irritation, and discomfort; monitor for persistent or worsening symptoms.
Popular Combinations
This combination itself is a popular and effective formulation for dry eye.
Precautions
- Ensure proper hygiene before application to avoid contamination.
- Do not touch the tip of the bottle to any surface.
- If the solution changes color or becomes cloudy, do not use.
- Remove contact lenses before use.
- Exercise caution when driving or operating machinery immediately after use due to potential temporary blurred vision.
- Specific Populations: Consult with a physician for guidance during pregnancy, breastfeeding, and for use in children.
FAQs (Frequently Asked Questions)
A: The standard dosage is 1-2 drops in the affected eye(s) as needed or as directed by the physician. This applies to both adults and children.
A: Remove contact lenses before instilling the drops. You can reinsert your lenses 15 minutes after administration.
Q3: Are there any serious side effects I should be aware of?
A: Although rare, serious side effects can include eye pain, changes in vision, and persistent redness or irritation. Seek immediate medical attention if any of these occur.
Q4: Can I use this if I am pregnant or breastfeeding?
A: Consult your doctor before using during pregnancy or breastfeeding. Preservative-free options are generally preferred during these periods.
Q5: How long can I use this product?
A: Use as needed for symptom relief. If symptoms persist or worsen after 72 hours, consult your physician.
Q6: What should I do if I accidentally get this in my mouth or nose?
A: Rinse thoroughly with water.
Q7: Can I use this with other eye drops?
A: Yes, but wait at least 5 minutes between the application of different eye drops. Inform your doctor about all other medications you are using.
Q8: How should this product be stored?
A: Store in a cool, dark place. Do not freeze.
Q9: Does this medication have any interactions with alcohol?
A: Interaction with alcohol is unknown. However, always consult with your physician regarding alcohol consumption while using any medication.
