Tears Naturale (Dextran,Hypromellose)

Uses

As a lubricant and artificial tear in dry eye and other ocular irritation syndromes associated with deficient tear or mucous secretion. This combination also prevents cornea to damage in patients with keratoconjunctivitis and for ocular lubrication. It is also used for the temporary relief of burning and irritation due to dryness of the eye and for use as the protectant against further irritation.

Tears Naturale (Dextran,Hypromellose) is also used to associated treatment for these conditions: Blood Circulation Disorder, Capillary disorder, Dry Eyes, Ocular Irritation, Pulmonary Embolism, Pulmonary Embolism caused by procedures associated with a high incidence of thromboembolic complications, Shock, Thrombosis, Venous, Venous Thrombosis caused by procedures associated with a high incidence of thromboembolic complications, Thrombotic events, Plasma Volume Replacement, Priming fluid in pump oxygenators therapyDry Eyes, Ocular Discomfort, Ocular Irritation

How Tears Naturale (Dextran,Hypromellose) works

In preclinical studies, the mechanism of action is thought to be related to the blockage of the uptake of tissue plasminogen activator by mannose-binding receptors. This process has a direct effect by enhancing endogenous fibrinolysis.

Promotes corneal wetting by the stabilization and thickening the precorneal tear film and prolonging the tear film breakdown time, which is usually shortened in dry eye conditions. Hypromellose also acts to lubricate and protect the eye .

The surface active properties of the vehicles found in artificial tears solutions act to stabilize the tear film and increase tear viscosity to prevent delay tear evaporation and delay tear drainage .

In the intact eye, the corneal surface is moistened primarily by the mucin that is produced in the conjunctiva. Mucin is adsorbed on the corneal surface and forms a hydrophilic surface. This creates a moisture barrier. In the typical dry eye, and particularly in case of mucin deficiency, the application of artificial tear fluid is highly recommended. Both its surface activity and its adsorptive capacity make hypromellose optimal for this use. Hypromellose has a physical-chemical action and leads to, in an aqueous solution, a reduced surface tension as well as an increased level of viscosity. Hypromellose adheres well to the cornea and conjunctiva and provides ample moisture. Irritation symptoms caused by blinking, which occur in the case of tear fluid deficiency, are therefore decreased and symptoms of epithelial desiccation are also alleviated .

Dosage

Tears Naturale (Dextran,Hypromellose) dosage

Adults and children: One or two drops three times daily or as directed by the physician.

Side Effects

There are no known side effects with the use of it, however, if the patient experiences any reaction in eye or other part of the body after using this medication then consult with doctor.

Toxicity

Some reports have shown adverse effects when used in therapeutical doses and some teratogenic effects have been demonstrated when used in large doses. The current LD50 reported in rats is 10700 mg/kg.

LD 50 (Rat): > 5 g/kg .

Hypromellose is considered low toxicity to non-toxic .

Adverse events may include blurred vision and contact dermatitis . Hypersensitivity and intolerance reactions may occur (for example, eye burning, pain, increased lacrimation, a sensation of foreign body, conjunctival hyperemia, eyelid swelling, pruritus). The stickiness sensation of the eyelids, the decreased sense of smell, photosensitivity .

Precaution

If irritation persists or if the condition does not improve, patient should seek further advice from doctor.

Interaction

Interacts with enzyme inducer (phenytoin) & enzyme inhibitor (cimetidine).

Volume of Distribution

The reported volume of distribution of dextran suggested a distribution throughout the blood volume. This volume of distribution is reported to be of around 120 ml. The organ that presented a higher accumulation of dextran was the liver.

Elimination Route

Dextran presents a very low oral bioavailability that is reduced as the chain gets longer. Thus, the bioavailability of dextran is inversely proportional to the length of the carbohydrate chain.

Not systemically absorbed .

Half Life

The elimination half-life will depend on the length of the carbohydrate chain. The higher the molecular weight of the dextran the longer it will be the elimination half-life. The half-life will go from 1.9 hours from dextran 1 to 42 hours in the case of dextran 60.

Elimination Route

The elimination of dextran will depend on the length of the carbohydrate chain, the administration route, and the molecular weight. For dextran 1, it is reported to be mainly secreted unchanged in the urine in a ratio of 80% of the administered dose when administered parentally. It is registered that the weight threshold for unrestricted glomerular filtration is about 15 kDa and if the dextran overpasses 50 kDa it will not be renally eliminated in any significant amount.

Pregnancy & Breastfeeding use

There is insufficient evidence as to the safety in pregnancy and lactation. Therefore, this product should only be used in pregnancy and lactation if it is considered essential by the physician.

Contraindication

Tears Naturale (Dextran,Hypromellose) contains Benzalkonium Chloride BP and should not be used when soft contact lenses are being worn.

Acute Overdose

No case of overdose has been reported.

Storage Condition

Store below 25°C and do not freeze. Do not use after 30 days of first opening. Keep the container closed tightly after each opening.

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