Drugs List

Therapeutic Indications

Uses

Lubrication of eye

Contraindications

None known

Precautions and Warnings

Wearing of contact lenses

Advise patient blurred vision may affect ability to drive/operate machinery
Some brands contain benzalkonium chloride
Some brands contain cetrimide
Administer other ophthalmic products at least 15 minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Advise patient to avoid touching the eye/other surfaces with container tip
Advise patient to consult physician if condition worsens / does not improve
If soft contact lenses worn,insert them 15 minutes after using eye drops

Preserved formulations may contain benzalkonium chloride or cetrimide.

Pregnancy and Lactation

Pregnancy

Use carbomer 980 with caution during pregnancy.

Carbomers of various grades are high molecular weight polymers used as bio-adhesives, emulsifying agents, suspending agents, gel agents and tablet binders.

At the time of writing there is limited published experience regarding the safety of carbomer 980 in human pregnancy, therefore the manufacturers advise that administration is not recommended except for compelling reasons. Schaefer advises that artificial tears may be used for all appropriate indications during pregnancy (Schaefer 2008).

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use carbomer 980 with caution during breast feeding.

Carbomers of various grades are high molecular weight polymers used as bio-adhesives, emulsifying agents, suspending agents, gel agents and tablet binders.

At the time of writing there is limited published experience regarding the safety of carbomer 980 in human lactation. They have a high molecular weight and and are considered unlikely to be present in breast milk. The manufacturers advise that administration is not recommended whilst breast feeding, except for compelling reasons. Schaefer, however, considers that most eye drops are compatible with breastfeeding and that artificial tears are not amongst those ophthalmic preparations likely to raise concern.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Blurred vision (transient)
Conjunctival oedema
Contact dermatitis
Corneal irritation
Increased lacrimation
Lid margin crusting
Ocular discomfort
Ocular hyperaemia
Ocular irritation
Ocular pain
Ocular pruritus
Periorbital oedema

Presentation

Carbomer 980 (polyacrylic acid) eye drops preserved and preservative-free

Drugs List

Therapeutic Indications

Uses

Lubrication of eye

Dosage

Adults

Elderly

Children

Contraindications

None known

Precautions and Warnings

Wearing of contact lenses

Advise patient blurred vision may affect ability to drive/operate machinery
Some brands contain benzalkonium chloride
Some brands contain cetrimide
Administer other ophthalmic products at least 15 minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Advise patient to avoid touching the eye/other surfaces with container tip
Advise patient to consult physician if condition worsens / does not improve
If soft contact lenses worn,insert them 15 minutes after using eye drops

Preserved formulations may contain benzalkonium chloride or cetrimide.

Pregnancy and Lactation

Pregnancy

Use carbomer 980 with caution during pregnancy.

Carbomers of various grades are high molecular weight polymers used as bio-adhesives, emulsifying agents, suspending agents, gel agents and tablet binders.

At the time of writing there is limited published experience regarding the safety of carbomer 980 in human pregnancy, therefore the manufacturers advise that administration is not recommended except for compelling reasons. Schaefer advises that artificial tears may be used for all appropriate indications during pregnancy (Schaefer 2008).

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use carbomer 980 with caution during breast feeding.

Carbomers of various grades are high molecular weight polymers used as bio-adhesives, emulsifying agents, suspending agents, gel agents and tablet binders.

At the time of writing there is limited published experience regarding the safety of carbomer 980 in human lactation. They have a high molecular weight and and are considered unlikely to be present in breast milk. The manufacturers advise that administration is not recommended whilst breast feeding, except for compelling reasons. Schaefer, however, considers that most eye drops are compatible with breastfeeding and that artificial tears are not amongst those ophthalmic preparations likely to raise concern.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Blurred vision (transient)
Conjunctival oedema
Contact dermatitis
Corneal irritation
Increased lacrimation
Lid margin crusting
Ocular discomfort
Ocular hyperaemia
Ocular irritation
Ocular pain
Ocular pruritus
Periorbital oedema

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: June 2016

Reference Sources

Joint Formulary Committee. British National Formulary. 71st ed. London: BMJ Group and Pharmaceutical Press; 2016.

Medications and Mothers' Milk, Sixteenth Edition (2014) Hale, T and Rowe, H, Hale Publishing, Plano, Texas.

Paediatric Formulary Committee. BNF for Children 2015-2016. London: BMJ Group, Pharmaceutical Press, and RCPCH Publications; 2015.

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Summary of Product Characteristics: GelTears. Bausch & Lomb UK Limited. Revised June 2015.

Summary of Product Characteristics: Viscotears Liquid Gel. Novartis Pharmaceuticals UK Ltd. Revised May 2015.

Summary of Product Characteristics: Viscotears Single Dose Unit 2.0mg/g Eye Gel. Novartis Pharmaceuticals UK Ltd. Revised May 2015.