Usage
Flurbiprofen + Gatifloxacin ophthalmic solution is prescribed for the treatment of bacterial eye infections, such as bacterial conjunctivitis (pink eye). It is also used prophylactically before certain ophthalmic surgical procedures, such as cataract surgery.
Pharmacological Classification:
- Flurbiprofen: Non-Steroidal Anti-inflammatory Drug (NSAID)
- Gatifloxacin: Fluoroquinolone antibiotic
Mechanism of Action:
Flurbiprofen inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis and thus decreasing inflammation and pain. Gatifloxacin inhibits bacterial DNA gyrase and topoisomerase IV, essential enzymes for bacterial DNA replication and repair, leading to bacterial cell death.
Alternate Names
Some alternate names include Flubigat, Flugati, Gatizex-F, and Noirgat-F. Brand names vary depending on the manufacturer; examples include Bigflur G, Fiago FL, Flubgy, Flubigat, Flubip G, Flugati, Flurgat, Gatiaid-F, and Gaticel FL.
How It Works
Pharmacodynamics: Flurbiprofen reduces ocular inflammation and pain by inhibiting COX enzymes and prostaglandin synthesis. Gatifloxacin exerts bactericidal action by inhibiting bacterial DNA gyrase and topoisomerase IV, disrupting bacterial DNA replication and repair.
Pharmacokinetics: Absorption of both drugs after topical ophthalmic administration is limited, minimizing systemic exposure. Information regarding specific metabolic pathways and elimination for the combination ophthalmic product is limited in the provided sources. However, flurbiprofen is generally metabolized in the liver and excreted primarily in the urine, while gatifloxacin is also metabolized hepatically and excreted through renal and fecal pathways.
Dosage
Standard Dosage
Adults:
For bacterial conjunctivitis, instill 1-2 drops into the affected eye(s) every 2 hours for the first two days, then 1-2 drops four times a day for the next five days. For pre-operative prophylaxis, instill 1 drop every 30 minutes, beginning 2 hours before surgery (total of 4 drops). Post-operatively, instill 1 drop every 4 hours for 1-3 weeks. Another source mentions 1-2 drops 2-4 times daily as a typical dosage.
Children:
Use in children under 1 year of age is not recommended. For children older than 1 year, the dosage should be determined by a physician. One source mentions a similar dosing regimen for children 1 year and older as for adults with bacterial conjunctivitis.
Special Cases:
- Elderly Patients: Dosage adjustments are generally not necessary.
- Patients with Renal Impairment: Caution is advised, and dose adjustments may be necessary.
- Patients with Hepatic Dysfunction: Caution is advised, and dose adjustments may be necessary.
- Patients with Comorbid Conditions: Use with caution in patients with diabetes, nasal polyps, bleeding or clotting disorders, or other eye problems. Consult a physician.
Clinical Use Cases
- Intubation: Not applicable (ophthalmic use only).
- Surgical Procedures: Prophylactically before cataract and other eye surgeries (see Standard Dosage - Adults).
- Mechanical Ventilation: Not applicable (ophthalmic use only).
- Intensive Care Unit (ICU) Use: Specific dosing recommendations are not mentioned in the sources.
- Emergency Situations: Not indicated for emergency situations.
Dosage Adjustments
Dose modifications may be necessary for patients with renal or hepatic impairment. Consult a physician to determine appropriate adjustments.
Side Effects
Common Side Effects
Blurred vision, burning/stinging sensation in the eye, eye discomfort, eye irritation, temporary stinging or burning, dry eyes, eye pain, eye discharge, increased sensitivity to light.
Rare but Serious Side Effects
Severe allergic reactions (rash, itching, swelling), severe eye pain, vision changes.
Long-Term Effects
Information on chronic complications from prolonged use is not readily available in the sources.
Adverse Drug Reactions (ADR)
Severe allergic reactions require immediate medical attention.
Contraindications
Hypersensitivity to flurbiprofen, gatifloxacin, or any component of the formulation. Viral eye infections (e.g., herpes simplex keratitis, vaccinia, varicella).
Drug Interactions
Corticosteroids (e.g., prednisone), blood thinners (e.g., warfarin, dabigatran, enoxaparin), anti-platelet drugs (e.g., clopidogrel), alcohol, other NSAIDs (e.g., aspirin), antidiabetic drugs (e.g., glyburide).
Pregnancy and Breastfeeding
Consult a physician before use during pregnancy or breastfeeding. The safety of this combination during pregnancy and breastfeeding has not been definitively established. Limited information suggests potential low risk to breastfed infants, but caution is still advised.
Drug Profile Summary
- Mechanism of Action: Flurbiprofen (NSAID) reduces inflammation and pain; Gatifloxacin (fluoroquinolone antibiotic) inhibits bacterial DNA replication.
- Side Effects: Blurred vision, burning/stinging, eye discomfort, allergic reactions (rare).
- Contraindications: Hypersensitivity, viral eye infections.
- Drug Interactions: Corticosteroids, blood thinners, anti-platelets, alcohol, NSAIDs, antidiabetics.
- Pregnancy & Breastfeeding: Consult a physician before use.
- Dosage: See Dosage section.
- Monitoring Parameters: Monitor for signs of allergic reaction and improvement of infection.
Popular Combinations
This medication is itself a combination product. Combining it with other ophthalmic medications would require careful consideration and physician oversight.
Precautions
- General Precautions: Evaluate for allergies and pre-existing eye conditions.
- Specific Populations: Consult a physician before use in pregnant/breastfeeding women or children.
- Lifestyle Considerations: Avoid driving immediately after use due to potential blurred vision.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Flurbiprofen + Gatifloxacin?
A: For adults and children over 1 year with bacterial conjunctivitis, instill 1-2 drops every 2 hours for the first two days, then four times a day for five days. For surgical prophylaxis, different regimens apply (see Dosage section).
A: No, avoid wearing contact lenses during treatment.
Q3: What should I do if I miss a dose?
A: Instill the missed dose as soon as you remember. If it’s close to your next scheduled dose, skip the missed one and continue with your regular schedule.
Q4: Is this medication safe for pregnant or breastfeeding women?
A: Consult your doctor before using this solution if you are pregnant or breastfeeding.
Q5: What are the common side effects?
A: Common side effects include blurred vision, burning/stinging sensation, eye discomfort, and eye irritation.
Q6: How should I store this medication?
A: Store the eye drops in a cool, dry place, away from direct sunlight and out of reach of children.
Q7: Can I use this eye drop for other types of eye infections?
A: This medicine is specifically for bacterial eye infections. Do not use for other types without consulting your doctor.
A: Seek immediate medical attention if you experience severe eye pain, vision changes, or signs of an allergic reaction like rash, itching, or swelling.
Q9: How long does it take for this medication to work?
A: Symptom relief is often noticeable within a few days, but complete the full treatment duration as prescribed by your doctor.
