A sterile, multi-ingredient ophthalmic solution indicated for the treatment of bacterial conjunctivitis and other superficial eye infections. It combines a sulfonamide antibiotic (Sulphacetamide) with an antiseptic (Boric Acid), a preservative/anaesthetic (Chlorbutol), an antihistamine (Chlorpheniramine), and an isotonic agent (Sodium Chloride). This combination provides antibacterial, anti-inflammatory, and soothing effects, making it a common choice for managing infective and allergic conjunctival conditions in the Indian outpatient setting.
Adult: One to two drops into the affected eye(s) every 4 to 6 hours. In severe infections, may be used hourly for the first 1-2 days, then reduce frequency.
Note: 1. Wash hands. 2. Tilt head back. 3. Gently pull lower eyelid to form a pouch. 4. Instill prescribed drops without touching the dropper tip to eye or any surface. 5. Close eyes gently for 1-2 minutes, applying light pressure to the inner corner (nasolacrimal duct) to minimize systemic absorption. 6. Wait at least 5-10 minutes before instilling any other eye medication.
Sulphacetamide is a competitive antagonist of para-aminobenzoic acid (PABA), inhibiting bacterial dihydropteroate synthase, thereby preventing folic acid synthesis and inhibiting bacterial growth (bacteriostatic). Boric Acid provides a mild antiseptic and buffering action, maintaining an acidic pH unfavorable for some pathogens. Chlorbutol acts as a preservative and has mild local anaesthetic and antibacterial properties. Chlorpheniramine Maleate is a propylamine-type H1-receptor antagonist, blocking histamine-mediated allergic responses (itching, redness). Sodium Chloride maintains isotonicity with tear fluid to prevent stinging and corneal damage.
Pregnancy: Category C (US FDA). Sulphacetamide and Chlorpheniramine cross the placenta. Use only if potential benefit justifies potential risk to the fetus. Avoid in late pregnancy near term (risk of kernicterus from sulphonamides).
Driving: May cause transient blurred vision, dizziness, or drowsiness (due to Chlorpheniramine). Patients should not drive or operate machinery until their vision is clear and they know how the medication affects them.
| Silver Preparations (e.g., Silver Nitrate) | Incompatible; forms precipitate. | Major |
| Local Anaesthetics (e.g., Procaine, Tetracaine) | Antagonizes antibacterial effect of sulphacetamide (both are PABA derivatives). | Major |
| Oral Sulfonamides | Increased risk of systemic sulphonamide toxicity and hypersensitivity. | Moderate |
| Monoamine Oxidase Inhibitors (MAOIs) e.g., Phenelzine | Potentiation of anticholinergic and CNS depressant effects of Chlorpheniramine. | Moderate |
| Alcohol, CNS Depressants (Benzodiazepines, Opioids) | Enhanced sedation if Chlorpheniramine is absorbed systemically. | Moderate |
Same composition (Boric Acid (1.9% w/v) + Chlorbutol (0.5% w/v) + Chlorpheniramine Maleate (0.01% w/v) + Sodium Chloride (0.1% w/v) + Sulphacetamide (15% w/v)), different brands: