A sterile, multi-ingredient ophthalmic solution indicated for the treatment of superficial bacterial infections of the eye and its adnexa. It combines antibacterial, astringent, and osmotic actions to combat infection, reduce inflammation, and cleanse the eye. This combination is a mainstay in Indian ophthalmology for managing common bacterial conjunctivitis and blepharitis.
Adult: 1-2 drops into the affected eye(s) every 3-4 hours during the day. In severe infections, may be used hourly for the first 24-48 hours as directed by a physician.
Note: 1. Wash hands thoroughly. 2. Tilt head back. 3. Gently pull lower eyelid down to form a pouch. 4. Instill the prescribed number of drops without touching the dropper tip to the eye, eyelid, or any surface. 5. Close eyes gently for 1-2 minutes, applying gentle pressure to the inner corner of the eye (nasolacrimal occlusion) to minimize systemic absorption. 6. Wait at least 10-15 minutes before instilling any other ophthalmic medication.
The combination exerts a synergistic multi-target effect. Sulphacetamide sodium is a competitive antagonist of para-aminobenzoic acid (PABA), inhibiting bacterial dihydropteroate synthase, thus preventing folic acid synthesis and arresting bacterial growth. Boric acid provides a mild antiseptic and buffering action, maintaining the pH of the solution and soothing the eye. Sodium chloride acts as an isotonic agent, matching the osmotic pressure of tears to prevent stinging and as a cleansing irrigant. Zinc sulfate acts as a mild astringent and antiseptic, precipitating proteins to reduce exudation and inflammation, and providing a protective coat over the mucous membrane.
Pregnancy: Category C (US FDA). Sulphacetamide crosses the placenta. Use only if clearly needed and potential benefit justifies potential risk to the fetus, especially in the first trimester. Avoid prolonged use.
Driving: May cause temporary blurred vision after instillation. Patients should not drive or operate machinery until vision clears (typically 5-10 minutes).
| Silver-containing preparations (e.g., Silver Nitrate) | Incompatible; may form insoluble silver sulphacetamide precipitate. | Major |
| Local Anesthetics (e.g., Procaine, Tetracaine) | Antagonism of sulphacetamide's antibacterial effect as these are esters of PABA. | Moderate |
| Oral Sulfonamides or Methotrexate | Potential additive systemic toxicity if significant topical absorption occurs. | Moderate |
| Topical Corticosteroids (e.g., Dexamethasone eye drops) | May mask signs of infection or enhance spread of infection. Use combination only under strict supervision. | Major |
Same composition (Boric Acid (1.9% w/v) + Sodium Chloride (1% w/v) + Sulphacetamide (12% w/v) + Zinc Sulfate (0.1% w/v)), different brands: