1. Clinical Overview
A sterile, topical ophthalmic solution combining a high-viscosity ocular lubricant (Carboxymethylcellulose) with a broad-spectrum, preservative-free antimicrobial agent (Oxychloro Complex). It is primarily indicated for the management of dry eye disease (DED) and for the prevention/treatment of ocular surface infections, particularly in contact lens wearers. The combination provides dual-action: lubrication and protection against microbial contamination.
| Onset | Duration | Bioavailability |
|---|---|---|
| Lubrication: Immediate upon instillation. Antimicrobial: Begins within minutes of contact. | Lubrication: 45 to 90 minutes, depending on tear film stability and environmental conditions. Antimicrobial: Persists on the ocular surface for several hours, providing a protective shield. | Topical ophthalmic. Systemic absorption is negligible (<0.01%). Action is primarily local on the ocular surface. |
2. Mechanism of Action
Carboxymethylcellulose (CMC) is an anionic, water-soluble polymer that mimics the mucin layer of the tear film. It increases the viscosity and stability of the pre-corneal tear film, prolonging the breakup time (TBUT), hydrating the ocular surface, and protecting corneal epithelial cells. Oxychloro Complex (OCC), a stabilized form of hypochlorous acid (HOCl), is a potent, naturally occurring antimicrobial oxidant produced by neutrophils. It rapidly oxidizes and denatures proteins, lipids, and nucleic acids of microorganisms (bacteria, viruses, fungi, and acanthamoeba) on contact, disrupting cell membranes and causing microbial death.
3. Indications & Uses
- Moderate to Severe Dry Eye Disease (DED) / Keratoconjunctivitis Sicca
- Prophylaxis and adjunctive treatment of ocular surface infections (bacterial, viral, fungal)
- Management of Meibomian Gland Dysfunction (MGD) and Blepharitis
4. Dosage & Administration
Adult Dosage: One to two drops in the affected eye(s), 3 to 4 times daily, or as directed by the physician. For contact lens wear: Apply 1-2 drops to lubricate and disinfect lenses while in the eye, or use to rinse lenses before insertion.
Administration: 1. Wash hands before use. 2. Tilt head back, pull down the lower eyelid to form a pouch. 3. Instill the prescribed number of drops without touching the dropper tip to the eye, eyelid, or any surface. 4. Close eyes gently for 1-2 minutes, applying gentle pressure to the nasolacrimal duct (inner corner of the eye) to minimize systemic drainage. 5. Wait at least 5-10 minutes before instilling any other topical ophthalmic medication. 6. Contact lenses can be worn during use; it is compatible.
5. Side Effects
Common side effects may include:
- Transient mild blurring of vision immediately after instillation
- Mild, temporary stinging or burning sensation upon application
- Eye redness (hyperemia)
- Watery eyes (reflex tearing)
6. Drug Interactions
| Drug | Effect | Severity |
|---|---|---|
| Topical Ophthalmic Aminoglycosides (e.g., Tobramycin, Gentamicin) | The oxidizing nature of OCC may theoretically inactivate aminoglycosides if instilled simultaneously. No clinical significance established. | Moderate |
| Topical Ophthalmic Silver Preparations | Possible chemical interaction forming silver chloride precipitate. Avoid concurrent use. | Major |
| Other Topical Eye Drops | Physical incompatibility. Instilling multiple drops in quick succession can dilute and wash away each medication. Maintain a 5-10 minute interval. | Moderate |
7. Patient Counselling
- DO wash hands before use.
- DO wait at least 5-10 minutes between different eye drops.
- DO store in a cool place, protect from direct sunlight.
- DO NOT touch the dropper tip to any surface to avoid contamination.
- DO NOT use if the solution changes color or becomes cloudy.
- DO NOT wear contact lenses if the eye is red or infected unless advised by a doctor.
8. Toxicology & Storage
Overdose: Accidental ingestion of bottle contents is unlikely to cause systemic toxicity due to low volume and concentration. Ocular overdose (excessive instillation) may lead to increased blurring, discomfort, and washout of natural tears.
Storage: Store below 25°C. Do not freeze. Keep the bottle tightly closed when not in use. Protect from direct light. Discard the bottle 30 days after opening to prevent contamination. Keep out of reach of children.