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Drugs List

  • ALOMIDE 0.1% eye drops
  • lodoxamide 0.1% eye drops
  • Therapeutic Indications

    Uses

    Treatment of ocular symptoms of non-infectious allergic conjunctivitis (vernal conjunctivitis, giant papillary conjunctivitis and allergic-atopic conjunctivitis).

    Lodoxamide may be effective against other ocular diseases where type I immediate hypersensitivity (or mast cells) play a major role in the inflammatory process.

    Dosage

    To reduce systemic absorption compress the lacrimal sac during administration and for one minute afterwards.

    Patients should be advised that the effect of lodoxamide therapy is dependent upon its administration at regular intervals, as directed.

    Wash hands before use.

    Soft contact lenses should be removed before instillation of the eye drops and may be reinserted after 15 minutes.

    Avoid contact of the container with the eye or other surfaces as contamination leading to ophthalmic infection may occur.

    Leave an interval of at least 10 minutes before instilling another ophthalmic medication.

    Discard multi dose eye drops 4 weeks after first opening.

    Adults

    Instil one or two drops into each eye four times daily, at regular intervals.

    Elderly

    As for adults. No special precautions to be followed.

    Children

    Children over 4 years
    One or two drops to be instilled into each eye four times daily, at regular intervals.

    Children under 4 years
    Not recommend. The safety and efficacy of lodoxamide in children under 4 years old, have not been established.

    Additional Dosage Information

    Improvements in signs and symptoms are usually apparent within a few days, occasionally treatment for up to 4 weeks is required. Treatment should be continued for as long as necessary to sustain improvement.

    Administration

    For ocular use.

    Avoid contact of the container with the eye or other surfaces as contamination leading to ophthalmic infection may occur.

    Contraindications

    Children under 4 years.

    Precautions and Warnings

    Contains benzalkonium chloride. Soft contact lenses should be removed before instillation of the eye drops and may be reinserted after 15 minutes.

    Do not exceed the recommended frequency of administration. However, regular administration is required for effective treatment.
    In some patients improvement of symptoms may required treatment for up to 4 weeks.

    Pregnancy (see under 'Pregnancy')

    Lactation (see under 'Lactation')

    Pregnancy and Lactation

    Pregnancy

    There is inadequate experience of the use of ocular lodoxamide in pregnancy. Although animal studies do not indicate harmful effects with regard to reproductive toxicity, the manufacturer states it is preferable to avoid use.

    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 14-17 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 at ( https://www.toxbase.org/ ) or if this is unavailable at the backup site ( https://www.TOXBASEbackup.org/ ).

    Lactation

    It is not known whether lodoxamide is excreted in human milk. The manufacturer states that a risk to the nursing infant cannot be excluded.

    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

    Effects on Ability to Drive and Operate Machinery

    Instillation of eye drops may cause transient blurring of vision. Avoid driving or operating machinery until vision is clear.

    Counselling

    Advise patient to compress the lacrimal sac during administration and for one minute afterwards, to reduce systemic absorption.

    Patient should be advised that the effect of lodoxamide therapy is dependent upon its administration at regular intervals, as directed.

    Advise patient to wash their hands prior to use.

    Advise patient to avoid contact of the container with eye or other surfaces as contamination leading to ophthalmic infection may occur.

    Advise patient that instillation of eye drops in allergic conjunctivitis may cause initial discomfort, this will decline with improvement in the allergic condition, however if these symptoms persist, contact the prescriber.

    Advise patient that eye drops may cause transient blurred vision after instillation and to avoid driving or operating machinery until vision is clear.

    Advise patient to leave an interval of at least 10 minutes before instilling another ophthalmic medication.

    Advise patient to discard 4 weeks after first opening.

    Advise patient not to wear soft contact lenses during treatment. Soft contact lenses should be removed before instillation of the eye drops and may be reinserted after 15 minutes.

    Side Effects

    Ocular side effects
    Ocular burning
    Stinging
    Ocular pruritus
    Blurred vision (transient)
    Lid margin crusting
    Dry eyes
    Tearing
    Hyperemia
    Sensation of foreign body in eye
    Ocular pain
    Conjunctival discharge
    Ocular oedema
    Eye fatigue
    Ocular warming sensation
    Eyelid oedema
    Conjunctival chemosis
    Cells in anterior chamber of eye
    Epitheliopathy
    Keratopathy
    Keratitis
    Blepharitis
    Sticky sensation of the eye
    Corneal erosion
    Dim vision
    Ocular discomfort
    Corneal abrasion
    Corneal deposits
    Corneal scar
    Allergic reaction
    Lachrymation

    Non-ocular events
    Sensation of warmth
    Headache
    Nausea
    Gastric discomfort
    Dizziness
    Somnolence
    Dryness of nose
    Sneezing
    Rash
    Flushing
    Palpitations
    Dysgeusia

    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 ).

    Shelf Life and Storage

    Do not store above 25 degrees C.

    Reference Sources

    Summary of Product Characteristics Alomide Allergy Eye Drops, Alcon Laboratories, Revised 8.11.2010

    Summary of Product Characteristics Alomide Eye Drops Solution, Alcon Laboratories (UK) Ltd, Revised 8.11.2010

    British National Formulary, 62nd Edition (2011) Pharmaceutical Press, London.

    BNF for Children (2011-2012) Pharmaceutical Press, London

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

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.