Usage
Hydroxypropylmethylcellulose + sodium perborate monohydrate is prescribed for the temporary relief of burning, irritation, and discomfort associated with dry eye syndrome. This can be caused by decreased tear production or increased tear evaporation due to environmental factors like wind and sun exposure. It is also used to alleviate similar symptoms caused by eye irritation. This combination medication falls under the pharmacological classification of ocular lubricants and artificial tears.
The mechanism of action involves two components:
- Hydroxypropyl methylcellulose (HPMC): This acts as a lubricant, mimicking natural tears. It forms a protective film over the cornea, helping to retain moisture and reduce friction.
- Sodium perborate monohydrate: This component acts as an antiseptic and also releases oxygen upon contact with the eye. This contributes to cleansing, reducing irritation, and providing antimicrobial action.
Alternate Names
- Hydroxypropyl methylcellulose (HPMC) + Sodium perborate monohydrate
- Sodium perborate + Hypromellose
- Hypromellose + sodium perborate
Some brand names include:
- Ducira Gel
- Moisol-Z Eye Drops
- ACRYTEAR
- Retentio Eye Drops
- Extralube Eye Gel (contains HPMC but as a single ingredient preparation)
- Teargrip (contains HPMC and sodium perborate)
How It Works
Pharmacodynamics: HPMC increases tear film viscosity, reduces tear evaporation, and lubricates the ocular surface. Sodium perborate provides a mild antiseptic action by releasing oxygen, which helps cleanse the eye and may exert anti-inflammatory effects.
Pharmacokinetics:
- Absorption: Primarily local to the ocular surface with minimal systemic absorption.
- Metabolism: Sodium perborate decomposes into oxygen and water upon contact with the eye. HPMC is not significantly metabolized in the eye.
- Elimination: Excess medication is eliminated through blinking and tear drainage.
Dosage
Standard Dosage
Adults: Instill 1-2 drops in the affected eye(s) as needed, or as directed by an ophthalmologist.
Children: Use in children should be under the guidance of a healthcare provider, who will determine the appropriate dosage based on the child’s age and the severity of the dry eye condition.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically necessary. However, close monitoring for potential side effects is recommended.
- Patients with Renal Impairment: No specific dosage adjustments are typically necessary.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are typically necessary.
- Patients with Comorbid Conditions: Patients with glaucoma, high blood pressure, diabetes, existing eye infections or injuries, hyperthyroidism, or heart, kidney, or liver problems should use this medication with caution and under close medical supervision.
Clinical Use Cases
This medication is primarily used for managing dry eye symptoms. It is not typically used for intubation, surgical procedures, mechanical ventilation, ICU care, or emergency situations.
Dosage Adjustments
Dose modifications are not typically necessary for renal or hepatic impairment. However, individual patient factors and comorbid conditions may necessitate adjustments as directed by a physician.
Side Effects
Common Side Effects:
- Blurred vision (temporary)
- Eye irritation or redness
- Stinging or burning sensation upon instillation
- Sticky eyelashes
- Watery eyes
Rare but Serious Side Effects:
- Allergic reactions (e.g., itching, rash, swelling around the eyes)
Long-Term Effects: No specific long-term adverse effects have been reported.
Adverse Drug Reactions (ADR): Severe allergic reactions should be treated as a medical emergency.
Contraindications
- Known hypersensitivity to any of the components.
- Severe eye infections or injuries.
Drug Interactions
It is recommended to wait 10–15 minutes between applications of different eye medications. Consult a doctor if using other ophthalmic medications concurrently. While no significant drug-drug interactions are known, inform your doctor of all medications being used.
Pregnancy and Breastfeeding
Consult a physician before using during pregnancy or breastfeeding. Safety in these populations has not been definitively established.
Drug Profile Summary
- Mechanism of Action: HPMC lubricates, and sodium perborate acts as a mild antiseptic and cleansing agent.
- Side Effects: Blurred vision (transient), eye irritation, stinging.
- Contraindications: Hypersensitivity, severe eye infections.
- Drug Interactions: Other ophthalmic medications.
- Pregnancy & Breastfeeding: Consult a physician.
- Dosage: 1-2 drops as needed.
- Monitoring Parameters: Monitor for allergic reactions or worsening symptoms.
Popular Combinations
Hydroxypropylmethylcellulose + sodium perborate monohydrate is not typically used in combination with other drugs for dry eye treatment.
Precautions
- General Precautions: Pre-screening for allergies to the components is important.
- Specific Populations: As mentioned above, exercise caution in pregnant/breastfeeding women, children, and those with specific comorbid conditions.
- Lifestyle Considerations: Transient blurred vision may temporarily impair driving ability.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Hydroxypropylmethylcellulose + sodium perborate monohydrate?
A: The typical adult dosage is 1–2 drops in the affected eye(s) as needed. For children, consult a pediatrician for appropriate dosing.
A: It’s generally recommended to remove contact lenses before using this medication and wait 15 minutes after instillation before reinserting them.
Q3: What should I do if I experience blurred vision after using the drops?
A: Blurred vision is usually temporary. Avoid activities requiring clear vision until it resolves. If it persists, consult your doctor.
Q4: Can I use other eye drops with this medication?
A: You can, but it’s advised to wait 10–15 minutes between applying different eye drops. Inform your doctor of all other ophthalmic medications you are using.
Q5: Is this medication safe during pregnancy or breastfeeding?
A: Consult your physician before using Hydroxypropylmethylcellulose + sodium perborate monohydrate if you are pregnant or breastfeeding.
Q6: What are the signs of an allergic reaction to this medication?
A: Allergic reactions can manifest as itching, rash, or swelling around the eyes. Seek immediate medical attention if you experience these symptoms.
Q7: How long can I use this medication?
A: You should use this medication as directed by your doctor. For persistent dry eye symptoms, consult your ophthalmologist. Do not use for longer than a week without consulting a doctor.
A: Eye gels tend to have a thicker consistency and may provide longer-lasting lubrication compared to eye drops, but they can also cause more blurring of vision immediately after application. The choice between the two depends on individual patient needs and preferences.
Q9: Can I use this medication if I have glaucoma?
A: You should use this medication with caution and under the close supervision of your doctor if you have glaucoma.
