Usage
- Dextran 70 + Hydroxypropylmethylcellulose is prescribed for the temporary relief of burning, irritation, and discomfort due to dryness of the eye. It can also be used as a protectant against further irritation and for the temporary relief of discomfort due to minor irritations of the eye or exposure to wind or sun. It is also used for rewetting all types of contact lenses (rigid gas permeable, soft, daily, extended wear, and disposable) to relieve discomfort, minor irritation, or blurring.
- Pharmacological classification: Ophthalmic lubricant, demulcent, artificial tears.
- Mechanism of action: This combination acts as a tear substitute. Dextran 70 and Hypromellose are both lubricants that increase the viscosity of the tear film, providing a soothing and protective coating on the ocular surface, thus relieving dryness and irritation.
Alternate Names
- Dextran 70 and Hypromellose, DUASORB™
- Brand names: Tears Naturale, Poly-Tears, Bion Tears, CVS Gentle Tears, Duratears.
How It Works
- Pharmacodynamics: Dextran 70 and Hypromellose are pharmacologically inert, meaning they do not have a direct pharmacological effect on the body. They act physically by lubricating and moisturizing the ocular surface. They increase tear film viscosity, prolong tear film break-up time, and provide a smooth, wettable surface for the cornea.
- Pharmacokinetics: Topical ocular administration results in negligible systemic absorption. Both components primarily exert their effects locally on the ocular surface. Elimination pathways are not clinically significant due to the minimal absorption. There is no information available regarding metabolism by CYP enzymes.
- Mode of action: Dextran 70 and Hypromellose physically form a lubricating, transparent, and moistening film over the cornea. This artificial tear film supplements the natural tear film, reducing surface tension and providing temporary relief from dryness and irritation. There is no receptor binding, enzyme inhibition, or neurotransmitter modulation involved.
Dosage
Standard Dosage
Adults:
Instill 1 or 2 drops in the affected eye(s) as needed, up to once every 1-2 hours, or as directed by a physician.
Children:
The same dosage as adults applies to children. No dosage adjustments are necessary.
Special Cases:
- Elderly Patients: No dosage adjustments are needed.
- Patients with Renal Impairment: No dosage adjustments are needed.
- Patients with Hepatic Dysfunction: No dosage adjustments are needed.
- Patients with Comorbid Conditions: No specific dosage adjustments are generally required, but consider individual patient needs.
Clinical Use Cases
The dosage for all listed clinical use cases is the standard dosage: instill 1 or 2 drops in the affected eye(s) as needed or as directed.
- Intubation
- Surgical Procedures
- Mechanical Ventilation
- Intensive Care Unit (ICU) Use
- Emergency Situations
Dosage Adjustments
Generally, no dosage adjustments are necessary based on renal/hepatic dysfunction, metabolic disorders, or genetic polymorphisms.
Side Effects
Common Side Effects
- Temporary blurred vision
- Minor burning or stinging upon instillation
Rare but Serious Side Effects
- Eye pain
- Changes in vision
- Continued eye redness/irritation lasting more than 72 hours
Long-Term Effects
No long-term adverse effects have been reported.
Adverse Drug Reactions (ADR)
- Allergic reactions (rare): rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing
Contraindications
- Hypersensitivity to Dextran 70, Hypromellose, or any of the excipients (e.g., benzalkonium chloride).
Drug Interactions
- If using more than one topical ophthalmic product, wait at least 5 minutes between administrations.
- Eye ointments should be administered last.
- Benzalkonium chloride can be absorbed by soft contact lenses and discolor them. Remove contact lenses before application and wait at least 15 minutes before reinsertion.
- Clinically relevant drug interactions are not expected due to the minimal systemic absorption of Dextran 70 and Hypromellose.
Pregnancy and Breastfeeding
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Pregnancy Safety Category: No specific FDA pregnancy risk category rating assigned. No adverse effects during pregnancy are anticipated due to negligible systemic absorption. Safe for use during pregnancy.
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Breastfeeding: Safe for use during breastfeeding. No adverse effects on the breastfed newborn/infant are anticipated. Excretion in breast milk is unknown but not considered clinically significant.
Drug Profile Summary
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Mechanism of Action: Lubricates and moisturizes the ocular surface, supplementing the natural tear film.
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Side Effects: Temporary blurred vision, minor burning or stinging. Rarely, eye pain, vision changes, continued redness/irritation, or allergic reactions.
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Contraindications: Hypersensitivity to any component.
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Drug Interactions: Administer other ophthalmic medications 5 minutes apart; remove contact lenses before use; ointments last.
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Pregnancy & Breastfeeding: Safe for use during pregnancy and breastfeeding.
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Dosage: 1-2 drops in the affected eye(s) as needed, up to once every 1-2 hours, or as directed.
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Monitoring Parameters: Monitor for persistent eye irritation, pain, vision changes, or signs of allergic reaction.
Popular Combinations
Often used alone. No common drug combinations are specifically recommended.
Precautions
- General Precautions: Do not use if the solution changes color or becomes cloudy. Do not touch the dropper tip to any surface. Discard single-use vials after opening.
- Specific Populations: No specific precautions for pregnant women, breastfeeding mothers, children, or the elderly.
- Lifestyle Considerations: Temporary blurred vision may affect driving or operating machinery immediately after use.
FAQs (Frequently Asked Questions)
A: The recommended dosage is 1 or 2 drops in the affected eye(s) as needed, up to every 1-2 hours, or as directed by a physician. This applies to adults and children.
A: Remove contact lenses before instilling the drops. Wait at least 15 minutes after use before reinserting lenses. Benzalkonium chloride, a common preservative, can be absorbed by and discolor soft lenses.
Q3: Is it safe to use during pregnancy or while breastfeeding?
A: Yes, it is considered safe for use during both pregnancy and breastfeeding due to its negligible systemic absorption.
Q4: What are the common side effects?
A: Common side effects include temporary blurred vision and mild burning or stinging upon instillation. These are usually transient.
Q5: What should I do if my symptoms worsen or persist?
A: Discontinue use and consult a physician if your symptoms worsen, persist for more than 72 hours, or if you experience eye pain or changes in vision.
Q6: How should I store this medication?
A: Store at room temperature (15°-25°C or 59°-77°F) and protect from excessive heat and light.
Q7: Can I use other eye drops at the same time?
A: If using other ophthalmic medications, wait at least 5 minutes between applications. Eye ointments should be applied last.
Q8: What is the mechanism of action?
A: Dextran 70 and Hypromellose work by lubricating and moisturizing the ocular surface. They create an artificial tear film, supplementing and stabilizing the natural tear film and reducing dryness and irritation.
Q9: Is this medication absorbed into the body?
A: Systemic absorption is negligible after topical ocular administration, meaning very little of the medication enters the bloodstream. It primarily acts locally on the surface of the eye.
