Drugs List

Therapeutic Indications

Uses

Dry eye syndrome
Lubrication of eye
Tear deficiency

Contraindications

Wearing of contact lenses

Precautions and Warnings

Hereditary fructose intolerance

Advise patient blurred vision may affect ability to drive/operate machinery
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Some brands contain benzalkonium chloride
Discard any remaining solution 28 days after opening
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Contains phosphate: Risk of calcification in existing notable cornea damage
Discontinue if irritation persists/worsens or continued redness occurs
Advise patient to avoid touching the eye/other surfaces with container tip
Advise patient to consult a doctor if symptoms persist despite treatment
If soft contact lenses worn,insert them 15 minutes after using eye drops

Preserved formulations contain benzalkonium chloride.

Pregnancy and Lactation

Pregnancy

Hypromellose is considered safe for use in pregnancy.

There is no, or a limited amount of, data from the use of ophthalmic hypromellose in pregnant women. Systemic exposure to hypromellose following topical ocular administration is negligible and the product has no pharmacological properties.

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

Hypromellose is considered safe for use in breastfeeding.

It is unknown whether topical hypromellose/metabolites are excreted in human milk. No effects on the breastfed newborn/infant are anticipated since the systemic exposure of the breastfeeding woman to hypromellose is negligible. In addition to this, hypromellose is pharmacologically inert.

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)
Ocular hyperaemia
Ocular irritation
Ocular pain
Sensation of foreign body in eye
Stinging

Presentation

Eye drops containing hypromellose (preservative containing and preservative-free)

Drugs List

Therapeutic Indications

Uses

Dry eye syndrome
Lubrication of eye
Tear deficiency

Dosage

Adults

Elderly

Children

Contraindications

Wearing of contact lenses

Precautions and Warnings

Hereditary fructose intolerance

Advise patient blurred vision may affect ability to drive/operate machinery
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Some brands contain benzalkonium chloride
Discard any remaining solution 28 days after opening
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Contains phosphate: Risk of calcification in existing notable cornea damage
Discontinue if irritation persists/worsens or continued redness occurs
Advise patient to avoid touching the eye/other surfaces with container tip
Advise patient to consult a doctor if symptoms persist despite treatment
If soft contact lenses worn,insert them 15 minutes after using eye drops

Preserved formulations contain benzalkonium chloride.

Pregnancy and Lactation

Pregnancy

Hypromellose is considered safe for use in pregnancy.

There is no, or a limited amount of, data from the use of ophthalmic hypromellose in pregnant women. Systemic exposure to hypromellose following topical ocular administration is negligible and the product has no pharmacological properties.

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

Hypromellose is considered safe for use in breastfeeding.

It is unknown whether topical hypromellose/metabolites are excreted in human milk. No effects on the breastfed newborn/infant are anticipated since the systemic exposure of the breastfeeding woman to hypromellose is negligible. In addition to this, hypromellose is pharmacologically inert.

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)
Ocular hyperaemia
Ocular irritation
Ocular pain
Sensation of foreign body in eye
Stinging

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: April 2016

Reference Sources

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

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

Summary of Product Characteristics: Artelac 3.2 mg/ml Eye Drops Solution. Bausch & Lomb (UK) Ltd. Revised May 2015.

Summary of Product Characteristics: Isopto Alkaline. Alcon Laboratories (U.K.) Limited. Revised December 2014.

Summary of Product Characteristics: Isopto Plain. Alcon Laboratories (U.K.) Limited. Revised December 2014.