- Dry Eye/OSD
Prescribing Acetylcysteine
Indication
Unlabeled use for vernal and giant papillary conjunctivitis, filamentary keratitis, aqueous-deficient dry eye, corneal melt
Mechanism of Action
Intracellular effect on goblet cells during mucin formation softens mucuous, anti-collagenase effect may promote reepitheliazation
Available Quantities
Varies
Dosage/Instructions
Dilute to 2% to 5% with artificial tears or saline for use as in aqueous deficient dry eye. Dilute to 10% to 20% and use 4-6x.day for use as an anti-mucolytic or collagenase-inhibiting agent for treatment of ocular burns, filamentary keratopathy, corneal melt, etc.
Safety Info for Acetylcysteine
Pregnancy & Nursing
Limited data; potential risks to the fetus not well established
Pediatric Use
No studies
Contraindications, side effects, etc.
Contraindications: Allergy to acetylcysteine.
Warnings/Precautions: Inform medical caregivers if you have a stomach ulcer, stomach bleeding, high blood pressure, congestive heart failure, or kidney disease. Caution advised if you are pregnant or breastfeeding.
Common Side Effects: Mild nausea, stomach upset, vomiting, rash, fever. In rare cases, severe or ongoing vomiting, coughing up blood, and signs of liver damage (such as upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice) may occur.Acetylcysteine 5%, 10%, 20%ophthalmic solution - NSAID
Prescribing Acular LS®
Indication
Reduction of ocular pain and burning/stinging following corneal refractive surgery, relief of itch of seasonal allergic conjunctivitisMechanism of Action
Inhibits cycloxygenase and therefore prostaglandin synthesis, reducing pain and inflammation. This action helps in managing post-surgical symptoms such as pain and swelling in the eye.Available Quantities
5 mlDosage/Instructions
One drop four times a day in the operated eye as needed for up to 4 days following surgerySafety Info for Acular LS®
Pregnancy & Nursing
Should be used only when prescribed during the first 6 months of pregnancy. Avoid use during the last 3 months of pregnancy. Unknown if excreted in breast milk.Pediatric Use
>3 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to ketorolac or related NSAIDs (nonsteroidal anti-inflammatory drugs). It is also contraindicated in patients with a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Warnings: Ketorolac may cause stinging or burning upon instillation and may temporarily blur vision. Systemic absorption can occur, potentially leading to systemic side effects. Prolonged use should be avoided. Common Side Effects: Common side effects include stinging or burning sensation, transient blurred vision, and increased redness in the eye.Ketorolac Tromethamine (0.4%)ophthalmic solution - NSAID
Prescribing Acular®
Indication
Relief of ocular itching due to seasonal allergic conjunctivitis, postoperative inflammation in cataract surgery patientsMechanism of Action
Inhibits prostaglandin synthesis, reducing pain and vasopermeability. This action helps in reducing inflammation and associated symptoms in the eye.Available Quantities
5 mlDosage/Instructions
1 drop four times a day to the affected eye(s)Safety Info for Acular®
Pregnancy & Nursing
Should be used only when prescribed during the first 6 months of pregnancy. Avoid use during the last 3 months of pregnancy. Unknown if excreted in breast milk.Pediatric Use
>2 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to ketorolac or related NSAIDs (nonsteroidal anti-inflammatory drugs). It is also contraindicated in patients with a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Warnings: Ketorolac may cause stinging or burning upon instillation and may temporarily blur vision. Systemic absorption can occur, potentially leading to systemic side effects. Prolonged use should be avoided. Common Side Effects: Common side effects include stinging or burning sensation, transient blurred vision, and increased redness in the eye.Ketorolac Tromethamine (0.5%)ophthalmic solution - NSAID
Prescribing Acuvail®
Indication
Treatment of pain and inflammation following cataract surgeryMechanism of Action
Inhibits cycloxygenase and therefore prostaglandin synthesis, reducing pain and inflammation. This action helps in managing post-surgical symptoms such as pain and swelling in the eye.Available Quantities
30 ct 0.4 ml vialsDosage/Instructions
1 drop to the affected eye twice daily beginning 1 day prior to cataract surgery, continued on the day of surgery, and through the first 2 weeks of the postoperative periodSafety Info for Acuvail®
Pregnancy & Nursing
Because of the known effects of prostaglandin-inhibiting drugs on the fetal cardiovascular system (closure of the ductus arteriosus), the use of ACUVAIL solution during late pregnancy should be avoided. Unknown if excreted in breast milk.Pediatric Use
≥2 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to ketorolac or related NSAIDs (nonsteroidal anti-inflammatory drugs). It is also contraindicated in patients with a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Warnings: Ketorolac may cause stinging or burning upon instillation and may temporarily blur vision. Systemic absorption can occur, potentially leading to systemic side effects. Prolonged use should be avoided. Common Side Effects: Common side effects include stinging or burning sensation, transient blurred vision, and increased redness in the eye.Ketorolac Tromethamine (0.45%)ophthalmic solution - Local Anesthetic
Prescribing Akten®
Indication
Ocular surface anesthesia during ophthalmologic proceduresMechanism of Action
Blocks sodium ion channels required for initiation and conduction of neuronal impulsesAvailable Quantities
Single-patient useDosage/Instructions
Apply as directed by a healthcare professionalSafety Info for Akten®
Pregnancy & Nursing
Limited data; potential risks to the fetus not well establishedPediatric Use
All agesContraindications, side effects, etc.
Contraindications: There are no specific contraindications listed. Warnings/Precautions: Akten® is only for topical ophthalmic use and should not be injected. Prolonged use can lead to permanent corneal opacification and ulceration with accompanying visual loss. It should be administered by a healthcare provider and is not intended for patient self-administration. Common Side Effects: The most common adverse reactions include conjunctival hyperemia, corneal epithelial changes, headache, and burning upon instillation.Lidocaine Hydrochloride 3.5%ophthalmic gel - Allergy
Prescribing Alaway®, Zaditor®
Indication
allergic conjunctivitisMechanism of Action
Ketotifen antagonizes H1 histamine receptors, stabilizes mast cells, inhibits the release of pro-inflammatorymediators.Available Quantities
5ml, 10mlDosage/Instructions
Adults and children 3 years and older: put 1 drop in the affected eye(s) twice daily, every 8-12 hours, no more than twice per daySafety Info for Alaway®, Zaditor®
Pregnancy & Nursing
Animal studies of toxic doses did not reveal evidence of teratogenecity. No human data is available.Pediatric Use
≥3 yearsContraindications, side effects, etc.
Contraindications: Avoid if allergic to ketotifen or have eye irritation from contact lenses. Side Effects: More common side effects include eye redness and swelling, headaches, stuffy or runny nose, burning or stinging of eyes, dry eyes, eyelid disorder, eye sensitivity to light, fever, tiredness, achiness, sore throat, pupil enlargement, tearing. Serious side effects can include severe burning, stinging, or irritation after use.ketotifen 0.025%, 0.035%ophthalmic solution - Local Anesthetic
Prescribing Alcaine®
Indication
Short-duration corneal anesthesia for procedures like tonometry, gonioscopy, foreign body removalMechanism of Action
Blocks sodium ion channels required for initiation and conduction of neuronal impulsesAvailable Quantities
15 ml bottleDosage/Instructions
1 to 2 drops in each eye before operating; 1 drop every 5 to 10 minutes for 5 to 7 doses for short proceduresSafety Info for Alcaine®
Pregnancy & Nursing
Limited data; potential risks to the fetus not well establishedPediatric Use
All agesContraindications, side effects, etc.
Contraindications: Hypersensitivity to any ingredients of the preparation. Warnings/Precautions: Not for injection, for topical ophthalmic use only. Prolonged use is not recommended as it may produce permanent corneal opacification with visual loss. Common Side Effects: Temporary stinging, burning, conjunctival redness, rare severe allergic corneal reaction, allergic contact dermatitis.Proparacaine Hydrochloride 0.5%ophthalmic solution - Allergy
Prescribing Alocril®
Indication
allergic conjunctivitisMechanism of Action
Nedocromil inhibits the activation and release of inflammatory mediators such as histamine, prostaglandin D2, and leukotrienes c4 from different types of cellsAvailable Quantities
5mlDosage/Instructions
1 or 2 drops in each eye twice a day at regular intervalsSafety Info for Alocril®
Pregnancy & Nursing
Use during pregnancy only if clearly needed. Unknown if excreted into human milkPediatric Use
≥3 yearsContraindications, side effects, etc.
Warnings: Avoid contact with soft contact lenses. Not approved for use in children younger than 3 years old. Side Effects: Common side effects include headache, runny or stuffy nose, eye redness, increased sensitivity to light, and mild eye irritation. Serious effects may include severe burning, stinging, or irritation after use. For more details, visit Alocril® on Drugs.com.nedocromil sodium 2.0%ophthalmic solution - Allergy
Prescribing Alomide®
Indication
vernal keratoconjunctivitis, vernal conjunctivitis, vernal keratitis.Mechanism of Action
Lodoxamide tromethamine 0.1% (Alomide) stabilizes mast cells by preventing calcium influx upon antigen stimulation and decreasing vascular permeability. It inhibits theType 1 immediate hypersensitivity reaction.Available Quantities
10mlDosage/Instructions
1-2 drops in affected eye four times daily for up to 3 monthsSafety Info for Alomide®
Pregnancy & Nursing
Reproduction studies with lodoxamide tromethamine administered orally to rats and rabbits have not shown any effects of the product on fertility or reproductive performance, or any evidence of embryotoxicity or pre – and post -natal toxicity. However, there are no adequate and well controlled studies in pregnant women. Since animal reproductive studies are not always predictive of human response, ALOMIDE should be used during pregnancy only if clearly neededPediatric Use
>2 yearsContraindications, side effects, etc.
Contraindicated in patients with hypersensitivity to lodoxamide or any other ingredient in the product. Potential side effects include eye irritation, discomfort, or blurred vision.lodoxamide tromethamine 0.1%ophthalmic solution - Antiglaucoma
Prescribing Alphagan-P®
Indication
Lowering of intraocular pressure in open-angle glaucoma or ocular hypertensionMechanism of Action
Brimonidine is a clonidine derivative and a relatively selective α2 adrenergic receptor agonist. It reduces intraocular pressure by decreasing aqueous humor production and increasing uveoscleral outflow. The inhibition of adenylate cyclase leads to reduced cAMP, which modulates aqueous humor dynamics.Available Quantities
5 ml, 10 ml, 15 mlDosage/Instructions
0.1% or 0.15% 3 times daily, 8 hours apart (monotherapy); twice daily (as adjunctive therapy)Safety Info for Alphagan-P®
Pregnancy & Nursing
No teratogenicity in rats at 360 times the normal human dosagePediatric Use
≥2 yearsContraindications, side effects, etc.
Contraindicated in patients on monoamine oxidase inhibitors (MAOIs). Warnings include potential for allergic reactions, ocular hyperemia, pruritus, systemic effects due to absorption (e.g., decrease in blood pressure and heart rate), and caution in pediatric patients and those with cardiovascular diseases. Adverse reactions include allergic conjunctivitis, conjunctival hyperemia, eye pruritus, burning sensation, conjunctival folliculosis, hypertension, ocular allergic reaction, oral dryness, visual disturbance, abnormal taste, allergic reaction, asthenia, blepharitis, blurred vision, bronchitis, cataract, conjunctival edema, cough, dizziness, dyspepsia, dyspnea, epiphora, eye discharge, eye dryness, eye irritation, eye pain, eyelid edema, fatigue, flu syndrome, follicular conjunctivitis, foreign body sensation, gastrointestinal disorder, headache, hypercholesterolemia, hypotension, infection, insomnia, keratitis, lid disorder, pharyngitis, photophobia, rash, rhinitis, sinus infection, sinusitis, somnolence, stinging, superficial punctate keratopathy, tearing, visual field defect, vitreous detachment, worsened visual acuity, corneal erosion, hordeolum, nasal dryness, and taste perversion.Brimonidine (0.1%, 0.15%, 0.2% B&L)ophthalmic solution - Allergy, Steroid
Prescribing Alrex®
Indication
Seasonal allergic conjunctivitisMechanism of Action
Inhibits leukocyte migration, capillary dilation, fibroblast proliferationAvailable Quantities
5ml, 10mlDosage/Instructions
1 drop 4 times/daySafety Info for Alrex®
Pregnancy & Nursing
Embryotoxic in rabbits at high doses; no human dataPediatric Use
≥18 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to loteprednol etabonate or related corticosteroids. Contraindicated in patients with fungal or viral eye infections. Warnings: Loteprednol etabonate is a corticosteroid and may increase the risk of elevated intraocular pressure, cataracts, and secondary eye infections. It should be used cautiously and under supervision. Common Side Effects: Common side effects include eye irritation, burning, and stinging.Loteprednol Etabonate 0.2%ophthalmic suspension - Diagnostic Dye, Local Anesthetic
Prescribing Altafluor®
Indication
Ophthalmic procedures requiring a disclosing agent and topical anestheticMechanism of Action
Fluorescein for staining and Benoxinate for local anesthesiaAvailable Quantities
5 mL bottleDosage/Instructions
Instill 1 to 2 drops topically in the eye as neededSafety Info for Altafluor®
Pregnancy & Nursing
Limited data; potential risks to the fetus not well establishedPediatric Use
All agesContraindications, side effects, etc.
Contraindications: Hypersensitivity to any component of this product. Warnings/Precautions: Corneal toxicity: Prolonged use or abuse may lead to corneal epithelial toxicity, potentially causing epithelial defects and permanent corneal damage. Corneal injury: Patients should avoid touching their eye for approximately 20 minutes after using the anesthetic as accidental injuries can occur due to the insensitivity of the eye. Common Side Effects: The most common ocular adverse events include stinging, burning, conjunctival redness, ocular hyperemia, eye irritation, blurred vision, and punctate keratitis.Fluorescein Sodium 0.25% and Benoxinate Hydrochloride 0.4%ophthalmic solution - Antibiotic
Prescribing Amoxil®
Indication
Treatment of ocular infections like preseptal cellulitis, dacryocystitis, and other bacterial infectionsMechanism of Action
Amoxicillin acts through the inhibition of biosynthesis of cell wall mucopeptide. It is bactericidal against susceptible organisms during the stage of active multiplication4Available Quantities
125 mg, 200 mg, 250 mg, 400 mg, 500 mg, 875 mg tabletsDosage/Instructions
Adults: 750 to 1750 mg/day in divided doses every 8 to 12 hours. Pediatric Patients over 3 Months of Age: 20 to 45 mg/kg/day in divided doses every 8 to 12 hoursSafety Info for Amoxil®
Pregnancy & Nursing
Caution should be exercised when amoxicillin is administered to a nursing woman8Pediatric Use
All agesContraindications, side effects, etc.
Contraindications: Hypersensitivity to amoxicillin, penicillins, or any component of the formulation. Warnings/Precautions: Use with caution in patients with a history of allergic reactions to other beta-lactams. Potential for cross-reactivity with cephalosporins in penicillin-allergic patients. Caution in patients with renal impairment. Common Side Effects: Nausea, vomiting, diarrhea, rash, and allergic reactions including anaphylaxis. Rarely, Clostridium difficile-associated diarrhea and Stevens-Johnson syndrome.Amoxicillinoral suspension, oral tablet - Mydriatics/Cycloplegics
Prescribing Atropine
Indication
Cycloplegia, Mydriasis, pupil dilation in acute iritis and uveitis, penalization of the healthy eye in amblyopiaMechanism of Action
Atropine sulfate is a competitive muscarinic acetylcholine receptor antagonist. It blocks the action of acetylcholine, leading to pupil dilation (mydriasis) and paralysis of the ciliary muscle (cycloplegia). This action is utilized in cycloplegic refraction and reducing inflammation in uveitis/iritis.Available Quantities
2 ml, 5 ml, 15 mlDosage/Instructions
For cycloplegia: 1 drop 0.5% to 1% bid for 1 or 2 days before examination. For uveitis/iritis: 1 or 2 drops up to 4 times daily (1% bid typically)Safety Info for Atropine
Pregnancy & Nursing
It is not known whether topically administered atropine sulfate can cause fetal harmPediatric Use
≥3 monthsContraindications, side effects, etc.
Contraindications: Allergic reaction to atropine or related compounds. Warnings: Caution in patients with narrow-angle glaucoma. Common Side Effects: Blurred vision, light sensitivity, stinging or burning sensation.Atropine sulfate 0.5%, 1%, 2%ophthalmic solution - Mydriatics/Cycloplegics
Prescribing Atropine Ointment
Indication
Cycloplegic refraction, pupil dilation in acute inflammatory conditions of the iris and uveal tractMechanism of Action
Atropine sulfate is a competitive muscarinic acetylcholine receptor antagonist. It blocks the action of acetylcholine, leading to pupil dilation (mydriasis) and paralysis of the ciliary muscle (cycloplegia). This action is utilized in cycloplegic refraction and reducing inflammation in uveitis/iritis.Available Quantities
3.5 gmDosage/Instructions
For uveitis/iritis: Apply a half-inch strip twice daily. For cycloplegia: Apply a half-inch strip twice daily for 1 to 3 days before examinationSafety Info for Atropine Ointment
Pregnancy & Nursing
Use with caution during pregnancy and nursing; safety profile unknownPediatric Use
≥3 monthsContraindications, side effects, etc.
Contraindications: Allergic reaction to atropine or related compounds. Warnings: Caution in patients with narrow-angle glaucoma. Common Side Effects: Blurred vision, light sensitivity, stinging or burning sensation.Atropine sulfate 1%ophthalmic ointment - Antibiotic
Prescribing Augmentin®
Indication
Treatment of ocular infections like preseptal cellulitis, dacryocystitisMechanism of Action
Inhibits bacterial cell wall synthesis and is effective against beta-lactamase-producing organismsAvailable Quantities
250 mg/125 mg, 500 mg/125 mg, 875 mg/125 mg tablets; 125 mg/31.25 mg, 200 mg/28.5 mg, 250 mg/62.5 mg, 400 mg/57 mg per 5 mL suspensionDosage/Instructions
875 mg twice daily or 500 mg three times dailySafety Info for Augmentin®
Pregnancy & Nursing
Generally considered safe in pregnancy. Caution should be exercised when administered to a nursing womanPediatric Use
All agesContraindications, side effects, etc.
Contraindications: Hypersensitivity to amoxicillin, clavulanate, or any other component of the formulation, history of amoxicillin-clavulanate-associated cholestatic jaundice/hepatic dysfunction. Warnings/Precautions: Use caution in patients with hepatic dysfunction, renal impairment, or a history of gastrointestinal disease (especially colitis). Monitor liver function tests periodically. Common Side Effects: Diarrhea, nausea, vomiting, rash, and allergic reactions. Less common but more severe side effects include liver dysfunction, anaphylaxis, Stevens-Johnson syndrome, and Clostridium difficile-associated diarrhea.Amoxicillin/Clavulanateoral suspension, oral tablet - Antibiotic
Prescribing AzaSite®
Indication
bacterial conjunctivitis, blepharitis*Mechanism of Action
Azithromycin is a macrolide antibiotic that works by binding to the 23S rRNA of the 50S ribosomal subunit of the bacteria, inhibiting protein synthesis and therefore bacterial growth. Macrolides, including azithromycin, have a broad-spectrum antibacterial activity due to their strong affinity for bacterial ribosomes. Effective against the following organisms: CDC coryneform group G, Haemophilus influenzae, Staphylococcus aureus, Streptococcus mitis group, Streptococcus pneumoniaeAvailable Quantities
2.5 mlDosage/Instructions
Day 1-2: Instill 1 drop in the affected eye(s) 2x/day Days 3-7: Instill 1 drop in the affected eye(s)1x/daySafety Info for AzaSite®
Pregnancy & Nursing
Animal studies with doses up to 200 mg/kg/day, approximately 5,000 times the maximum human ocular daily dose of 2 mg, showed no harm to the fetus but caused moderate maternal toxicity. However, there are no adequate and well-controlled studies in pregnant women. It is not known whether azithromycin is excreted in human milk.Pediatric Use
≥1 yearContraindications, side effects, etc.
Contraindications: Allergy to azithromycin. Warnings: Not for injection, only for topical ophthalmic use. Common Side Effects: Eye irritation, blurred vision, nasal congestion, periocular swelling, rash, sinusitis, urticaria.azithromycin 1%ophthalmic solution - Antiglaucoma
Prescribing Azopt®
Indication
Lowering intraocular pressure in ocular hypertension or open-angle glaucomaMechanism of Action
Brinzolamide inhibits carbonic anhydrase II in the ciliary processes, which is believed to slow the formation of bicarbonate ions. This reduction leads to decreased sodium and fluid transport, subsequently lowering aqueous humor secretion and reducing intraocular pressure.Available Quantities
10 ml, 15 mlDosage/Instructions
1 drop 3 times dailySafety Info for Azopt®
Pregnancy & Nursing
There are no adequate and well-controlled studies in pregnant women. Use cautiously during pregnancy.Pediatric Use
No studiesContraindications, side effects, etc.
Contraindicated in patients with hypersensitivity to brinzolamide or any other component. Warnings include sulfonamide hypersensitivity reactions, temporary blurred vision, avoiding contamination of the product, caution in patients with intercurrent ocular conditions, and concomitant topical ocular therapy. The preservative in Azopt, benzalkonium chloride, may be absorbed by soft contact lenses, so lenses should be removed during instillation and reinserted after 15 minutes.Brinzolamide 1%ophthalmic suspension - Antibiotic
Prescribing Bacitracin Ointment
Indication
bacterial conjunctivitis, bacterial keratitis, bacterial keratoconjunctivitisMechanism of Action
Bacitracin forms complexes with divalent metal ions (Mn, Co, Ni, Cu, Zn) that bind to C55-isoprenyl pyrophosphate. This binding inhibits the hydrolysis of lipid dolichol pyrophosphate, ultimately disrupting cell wall synthesis. Additionally, these bacitracin-metal complexes can bind to DNA and induce oxidative cleavage (Susceptible organisms include: Many gram-positive bacteria, including Staphylococcus spp., Streptococcus spp., Corynebacterium spp., Clostridium spp., and Actinomyces spp., and few gram-negative organisms, such as Neisseria spp.— most gram-negative organisms are resistant)Available Quantities
3.5 gDosage/Instructions
Apply directly into the conjunctival sac 1 to 3 times daily. In blepharitis all scales and crusts should be carefully removed and the ointment then spread uniformly over the lid margins.Safety Info for Bacitracin Ointment
Pregnancy & Nursing
Poorly absorbed after topical application and oral ingestion—considered a low risk to nursing infants and pregnant mothers.Pediatric Use
All agesContraindications, side effects, etc.
Contraindications: Allergy to bacitracin, zinc, mineral oil, or petroleum jelly. Warnings: Not for use on animal bites, puncture wounds, deep skin wounds, or severe burns. Common Side Effects: Usually has no side effects, but unusual effects should be reported to a doctor.500 units bacitracin per gramophthalmic ointment - Antibiotic
Prescribing Bactrim®
Indication
Treatment of preseptal cellulitisMechanism of Action
Inhibits bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid, blocking the production of tetrahydrofolic acidAvailable Quantities
250mg, 500mg tablets; 100, 200ml Bottles (250mg per 5ml)Dosage/Instructions
Children: 8 to 12 mg/kg/day trimethoprim with 40 to 60 mg/kg/day sulfamethoxazole p.o. in two divided doses. Adults: 160 to 320 mg trimethoprim with 800 to 1,600 mg sulfamethoxazole p.o. b.i.d.Safety Info for Bactrim®
Pregnancy & Nursing
No evidence of teratogenicity in rat studies at normal human dosePediatric Use
≥2 monthsContraindications, side effects, etc.
Contraindications: Known hypersensitivity to trimethoprim or sulfonamides, severe renal or liver disease, megaloblastic anemia due to folate deficiency. Warnings/Precautions: Caution in patients with G6PD deficiency, severe allergies, asthma, or thyroid dysfunction. Avoid in late pregnancy and breastfeeding. Common Side Effects: Nausea, vomiting, rash, hyperkalemia, and less commonly, severe skin reactions (e.g., Stevens-Johnson syndrome), hematological abnormalities, and renal impairment.Trimethoprim/sulfamethoxazoleoral suspension, oral tablet - Allergy
Prescribing Bepreve®
Indication
allergic conjunctivitisMechanism of Action
Bepotastine is a non-sedating, selective antagonist of the histamine 1 (H1) receptor. It belongs to the second-generation piperidine chemical class. It stabilizes mast cells and suppresses the migration of eosinophils into inflamed tissues.Available Quantities
5, 10mlDosage/Instructions
Instill 1 drop into the affected eye(s) twice a daySafety Info for Bepreve®
Pregnancy & Nursing
No controlled data in human pregnancy. The effects in nursing infants are unknownPediatric Use
≥2 yearsContraindications, side effects, etc.
Warnings: Caution advised for patients with known hypersensitivity to bepotastine. Side Effects: Common side effects include mild taste in mouth, headaches, and temporary eye burning or stinging. Less common side effects are red, sore eyes, body rash, itching, and swelling of the lips, tongue, or throat.bepotastine besilate 1.5%ophthalmic solution - Antibiotic
Prescribing Besivance®
Indication
bacterial conjunctivitisMechanism of Action
Inhibits bacterial enzymes for DNA processes, effective against aerobic and anaerobic Gram-positive and Gram-negative bacteria, including multi-drug resistant strains.Available Quantities
5 mlDosage/Instructions
1 drop in affected eye(s) 3 times/day for 7 daysSafety Info for Besivance®
Pregnancy & Nursing
No adequate studies in pregnant women; unknown if excreted in milkPediatric Use
≥1 yearContraindications, side effects, etc.
Contraindications: Allergy to besifloxacin or other quinolone antibiotics. Warnings: Not for injection into the eye. Common Side Effects: Conjunctival redness, blurred vision, eye pain, eye irritation, eye pruritus, headache.Besifloxacin Ophthalmic Suspension 0.6%ophthalmic suspension - Misc.
Prescribing Betadine® 5%
Indication
Preparation of the periocular region and irrigation of the ocular surface. Used off-label to decrease viral load in EKC (epidemic keratoconjunctivitis)Mechanism of Action
Iodine disinfectant which directly cause in vivo protein denaturation, precipitation of bacteria, and further resulting in the death of pathogenic microorganismsAvailable Quantities
30 mlDosage/Instructions
Saturate a sterile material and prep the lids, brow, and cheek in a circular motion three times. Irrigate the cornea, conjunctiva, and palpebral fornices with the solution. After two minutes, flush the area with sterile saline solution. For EKC: Anesthetize the cornea. Apply an NSAID drop to prevent Betadine-induced corneal stippling. Instill 2-3 Betadine drops, close and roll eyes for full coverage. Swab closed lids with Betadine. After 60-90 seconds, rinse with saline. Apply another NSAID drop. Prescribe steroids 4x/day for 4-5 days post-procedure inflammation and comfort.Safety Info for Betadine® 5%
Pregnancy & Nursing
Limited data; potential risks to the fetus not well establishedPediatric Use
All agesContraindications, side effects, etc.
Contraindications: Known sensitivity to iodine or other components of this product. Warnings/Precautions: Intended for external use only. Not for intraocular injection or irrigation. Caution is advised in patients with thyroid disorders due to the potential for iodine absorption. Common Side Effects: Local sensitivity reactions.Povidone-Iodine 5%ophthalmic solution - Antiglaucoma
Prescribing Betagan®
Indication
Lowering IOP in chronic open-angle glaucoma or ocular hypertensionMechanism of Action
Levobunolol is a noncardioselective beta-blocker. It lowers intraocular pressure (IOP) by decreasing aqueous humor production. This is achieved through the inhibition of beta-adrenergic receptors in the ciliary body, reducing cAMP levels and subsequently decreasing aqueous humor formation.Available Quantities
5 ml, 10 ml, 15 mlDosage/Instructions
0.5%: 1 or 2 drops in the morning to start, twice daily maximum. 0.25%: 1 or 2 drops twice daily.Safety Info for Betagan®
Pregnancy & Nursing
Use cautiously during pregnancy. No adequate and well-controlled studies in pregnant women.Pediatric Use
No studiesContraindications, side effects, etc.
Contraindicated in asthma, severe COPD, sinus bradycardia, AV block, cardiac failure, cardiogenic shock, hypersensitivity. Warnings include systemic absorption risks, cardiac failure, vascular insufficiency, obstructive pulmonary disease, diabetes mellitus, thyrotoxicosis, choroidal detachment. Adverse reactions: ocular burning, stinging, blepharoconjunctivitis, heart rate and blood pressure decrease, iridocyclitis, headache, ataxia, dizziness, lethargy, urticaria, pruritus.Levobunolol HCL (0.25%, 0.5%)ophthalmic solution - Antiglaucoma
Prescribing Betoptic-S®
Indication
Lowering IOP in chronic open-angle glaucoma or ocular hypertensionMechanism of Action
Betaxolol is a beta-1 cardioselective beta-blocker that reduces intraocular pressure by decreasing aqueous humor production. This reduction is thought to be achieved through the inhibition of beta-adrenergic receptors in the eye, leading to decreased formation and secretion of aqueous humor.Available Quantities
2.5 ml, 5 ml, 10 ml, 15 mlDosage/Instructions
0.25%: 1 or 2 drops twice daily (bid)Safety Info for Betoptic-S®
Pregnancy & Nursing
Use cautiously during pregnancy. No adequate and well-controlled studies in pregnant women.Pediatric Use
≥1 weekContraindications, side effects, etc.
Contraindicated in hypersensitivity, sinus bradycardia, AV block, cardiac failure, cardiogenic shock. Warnings include systemic absorption, cardiac failure, diabetes mellitus, thyrotoxicosis, muscle weakness, surgical anesthesia, bronchospasm, obstructive pulmonary disease, atopy/anaphylaxis, angle-closure glaucoma, vascular insufficiency, bacterial keratitis, choroidal detachment, contact lens wear. Adverse reactions: ocular discomfort, blurred vision, corneal punctate keratitis, foreign body sensation, photophobia, tearing, itching, dry eyes, erythema, inflammation, discharge, ocular pain, decreased visual acuity, crusty lashes, systemic reactions like bradycardia, heart block, congestive failure, pulmonary distress, insomnia, dizziness, vertigo, headaches, depression, lethargy, myasthenia gravis symptoms, hives, toxic epidermal necrolysis, hair loss, glossitis, taste and smell perversions.Betaxolol HCL (0.25%)ophthalmic solution - Diagnostic Dye
Prescribing Bio-Glo®
Indication
Detection of corneal and conjunctival lesions, aiding in contact lens fitting, evaluating tear film stability and lacrimal system patencyMechanism of Action
Stains diseased corneal cells, aids in visualizing tear film in contact lens fitting, evaluates tear film stability and lacrimal system patencyAvailable Quantities
Sterile impregnated paper stripsDosage/Instructions
To insure full fluorescence and patient comfort, the BioGlo impregnated tip should be moistened before application. 1 or 2 drops of sterile irrigating or saline solution should be used for this purpose. Touch conjunctiva or fornix as required with moistened tip. It is recommended that the patient blink several times after application.Safety Info for Bio-Glo®
Pregnancy & Nursing
Limited data; potential risks to the fetus not well establishedPediatric Use
All agesContraindications, side effects, etc.
Contraindications: Allergy to fluorescein or any part of Bio-Glo. Warnings/Precautions: It is important to use Bio-Glo as directed by a healthcare provider. The patient should be informed about potential allergy risks. Common Side Effects: Some side effects include upset stomach, vomiting, stomach pain, change in taste, and headache. The medication may temporarily change the color of the skin and urine to a yellow color, which usually normalizes within 6 to 12 hours for skin and 24 to 36 hours for urine.Fluorescein Sodiumophthalmic strip - Antibiotic/Steroid
Prescribing Blephamide®
Indication
ocular surface inflammation with superficial bacterial infection or risk of infectionMechanism of Action
Sulfacetamide sodium inhibits bacterial folic acid synthesis, crucial for bacterial growth. Prednisolone acetate is a corticosteroid, reducing inflammation by suppressing leukocyte migration and capillary permeability.Available Quantities
5 ml, 10mlDosage/Instructions
Instill 1 drop in affected eye(s) every 4 hours.Safety Info for Blephamide®
Pregnancy & Nursing
Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels. The more potent corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Pediatric Use
≥6 yearsContraindications, side effects, etc.
Contraindications: Allergy to sulfacetamide sodium, prednisolone, or any part of Blephamide; fungal, TB, or viral infection of the eye. Warnings: Caution if breastfeeding; long-term use may increase risk of cataracts or glaucoma. Side Effects: Common side effects include eye irritation, dizziness. Serious side effects include allergic reactions, changes in eyesight, severe eye irritation, sensitivity to light, rare severe reactions to sulfa drugsulfacetamide 10%, prednisolone acetate 0.2%ophthalmic suspension - Antibiotic/Steroid
Prescribing Blephamide® Ointment
Indication
ocular surface inflammation with superficial bacterial infection or risk of infectionMechanism of Action
Sulfacetamide sodium inhibits bacterial folic acid synthesis, crucial for bacterial growth. Prednisolone acetate is a corticosteroid, reducing inflammation by suppressing leukocyte migration and capillary permeability.Available Quantities
3.5 gm tubeDosage/Instructions
Apply 1/2 inch ribbon to affected eye(s) every 3-4 times per day.Safety Info for Blephamide® Ointment
Pregnancy & Nursing
Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels. The more potent corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Pediatric Use
≥6 yearsContraindications, side effects, etc.
Contraindications: Allergy to sulfacetamide sodium, prednisolone, or any part of Blephamide; fungal, TB, or viral infection of the eye. Warnings: Caution if breastfeeding; long-term use may increase risk of cataracts or glaucoma. Side Effects: Common side effects include eye irritation, dizziness. Serious side effects include allergic reactions, changes in eyesight, severe eye irritation, sensitivity to light, rare severe reactions to sulfa drugsulfacetamide 10%, prednisolone acetate 0.2%ophthalmic ointment - NSAID
Prescribing Bromday®
Indication
Treatment of postoperative inflammation and reduction of ocular pain in cataract surgery patientsMechanism of Action
Bromfenac inhibits cyclooxygenase 1 and 2, blocking prostaglandin synthesis. This reduces inflammation and pain in the eye, particularly after surgery.Available Quantities
1.7 mlDosage/Instructions
One drop to the affected eye(s) once daily beginning 1 day prior to cataract surgery, continued on the day of surgery, and through the first 14 days of the postoperative periodSafety Info for Bromday®
Pregnancy & Nursing
Use during pregnancy only if the potential benefit justifies the potential risk. Unknown if excreted in breast milk.Pediatric Use
No studiesContraindications, side effects, etc.
Contraindications: Hypersensitivity to bromfenac or related NSAIDs. It is also contraindicated in patients with a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Warnings: Bromfenac may cause stinging or burning upon instillation and may temporarily blur vision. Systemic absorption can occur, potentially leading to systemic side effects. Prolonged use should be avoided. Common Side Effects: Common side effects include stinging or burning sensation, transient blurred vision, and increased redness in the eye.Bromfenac (0.09%)ophthalmic solution - NSAID
Prescribing Bromsite®
Indication
Treatment and prevention of postoperative inflammation and pain in cataract surgery patientsMechanism of Action
Bromfenac inhibits cyclooxygenase 1 and 2, reducing prostaglandin synthesis, which decreases inflammation and pain in the eye.Available Quantities
5 mLDosage/Instructions
One drop to the affected eye(s) twice daily beginning 1 day prior to surgery, continued on the day of surgery, and for 2 weeks post-surgerySafety Info for Bromsite®
Pregnancy & Nursing
No adequate studies for use during pregnancy. Avoid in late pregnancy. Unknown if excreted in breast milk.Pediatric Use
No studiesContraindications, side effects, etc.
Contraindications: Hypersensitivity to bromfenac or related NSAIDs. It is also contraindicated in patients with a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Warnings: Bromfenac may cause stinging or burning upon instillation and may temporarily blur vision. Systemic absorption can occur, potentially leading to systemic side effects. Prolonged use should be avoided. Common Side Effects: Common side effects include stinging or burning sensation, transient blurred vision, and increased redness in the eye.Bromfenac (0.075%)ophthalmic solution - Steroid
Prescribing Byqlovi®
Indication
The treatment of post-operative inflammation and pain following ocular surgery.
Mechanism of Action
Clobetasol propionate is a synthetic corticosteroid that acts as an anti-inflammatory, antipruritic, and vasoconstrictive agent. While the exact mechanism is not fully understood, corticosteroids like clobetasol are thought to work by inducing proteins called lipocortins. These lipocortins inhibit phospholipase A2, an enzyme that releases arachidonic acid from cell membrane phospholipids. By blocking this release, the production of inflammatory mediators like prostaglandins and leukotrienes is reduced, thereby decreasing inflammation, itching, and vasodilation in the affected area.
Available Quantities
3.5 mLDosage/Instructions
Instill one drop of Clobetasol Propionate Ophthalmic Suspension 0.05% into the affected eye twice daily beginning the day after surgery and continuing throughout the first 2 weeks of the post-operative period.
Safety Info for Byqlovi®
Pregnancy & Nursing
- No adequate, well-controlled studies in pregnant women
- Animal studies show teratogenic and fetotoxic effects at low systemic doses
- Use during pregnancy only if potential benefit justifies potential fetal risk
- Unknown if present in human milk; potential for growth suppression and interference with endogenous corticosteroid production in breastfed infants
- Consider benefits of breastfeeding along with mother’s clinical need and potential adverse effects on infant
Pediatric Use
≥12 yearsContraindications, side effects, etc.
Contraindicated in active viral eye diseases, mycobacterial eye infections, and ocular fungal diseases. Key warnings include potential for increased intraocular pressure, cataract formation, delayed healing, and corneal/scleral melting. Prolonged use may suppress immune response, increasing risk of secondary infections. It can exacerbate viral infections, especially herpes simplex. Use caution in patients with thinning cornea or sclera
Clobetasol Propionate 0.05%ophthalmic suspension - Antibiotic
Prescribing Ceclor®
Indication
Treatment of mild preseptal cellulitisMechanism of Action
Inhibits bacterial cell wall synthesis, leading to cell lysis and deathAvailable Quantities
250 mg, 500 mg capsules; 125 mg/5 mL, 250 mg/5 mL, 375 mg/5 mL oral suspensionDosage/Instructions
250 to 500 mg every 8 hours or 375 mg every 12 hoursSafety Info for Ceclor®
Pregnancy & Nursing
Generally considered safe in pregnancy. Acceptable in nursing mothersPediatric Use
≥16 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to cefaclor, any component of the formulation, or other cephalosporins. Warnings/Precautions: Use caution in patients with a history of gastrointestinal disease, particularly colitis. Cross-sensitivity with penicillins may occur. Common Side Effects: Diarrhea, nausea, rash, hypersensitivity reactions (e.g., urticaria, serum sickness-like reactions), and reversible interstitial nephritis.Cefaclororal capsule, oral suspension - Dry Eye/OSD
Prescribing Cequa®
Indication
Increasing tear production in cases of keratoconjunctivitis sicca where tear production is suppressed due to ocular inflammationMechanism of Action
Calcineurin inhibitor, modulates T-cell functionAvailable Quantities
0.25 ml vials (60 vials per box)Dosage/Instructions
1 drop in each eye twice daily, 12 hours apartSafety Info for Cequa®
Pregnancy & Nursing
No adequate studies in pregnant womenPediatric Use
≥18 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to cyclosporine or any components of the formulation. Warnings/Precautions: Not indicated for use in patients with active ocular infections. Caution in patients with a history of herpes keratitis. Contact lenses should not be worn during administration. Common Side Effects: Eye pain, stinging, redness, and tear film instability. Rarely, allergic reactions and growth of eyelashes.Cyclosporine 0.09%ophthalmic solution - Antibiotic
Prescribing Ciloxan® Ointment
Indication
bacterial conjunctivitisMechanism of Action
Inhibits bacterial DNA gyrase and topoisomerase IV, essential for bacterial DNA replication, transcription, repair, and recombination, effective against a wide range of Gram-positive and Gram-negative organisms.Available Quantities
3.5 gDosage/Instructions
Apply ~1/2 inch ribbon in the affected eye(s) 3 times a daySafety Info for Ciloxan® Ointment
Pregnancy & Nursing
Use only if potential benefit justifies the risk to the fetus; not known if excreted in human milkPediatric Use
≥1 yearContraindications, side effects, etc.
Contraindicated in patients with a history of hypersensitivity to ciprofloxacin or any other component of the medication. Common side effects include hives, difficulty breathing, swelling of face, lips, tongue, or throat, severe burning, stinging, or irritation after using this medicine, eye swelling, redness, severe discomfort of the eye, and crusting or drainage from the eye.ciprofloxacin HCL 0.3%ophthalmic ointment - Antibiotic
Prescribing Ciprofloxacin
Indication
bacterial conjunctivitis, corneal ulcerMechanism of Action
Inhibits bacterial DNA gyrase and topoisomerase IV, essential for bacterial DNA replication, transcription, repair, and recombination, effective against a wide range of Gram-positive and Gram-negative organisms.Available Quantities
2.5 ml, 5 ml, 10 mlDosage/Instructions
Corneal Ulcers: FIrst 6 hours: 2 drops every 15 minutes Remainder of the first day: 2 drops every 30 minutes Second day: 2 drops every hour Day 3 to 14: 2 drops every 4 hoursBacterial Conjunctivitis: Day 1-2: 1 or 2 drops every 2 hours Day 3-7: 1 or 2 drops every 4 hoursSafety Info for Ciprofloxacin
Pregnancy & Nursing
Use only if potential benefit justifies the risk to the fetus; not known if excreted in human milkPediatric Use
≥1 yearContraindications, side effects, etc.
Contraindications: History of heart attack, QT prolongation, long QT syndrome, kidney, heart, or lung transplant, kidney or liver problems, past tendon or joint problems, history of seizures or epilepsy. Warnings: Stop using if symptoms of a serious allergic reaction occur. Common Side Effects: Tendon problems, nerve problems, mental effects, seizures, severe allergic reactions, liver damage, aortic aneurysm and dissection, antibiotic-associated diarrhea.ciprofloxacin HCL 0.3%ophthalmic solution - Local Anesthetic
Prescribing Cocaine Hydrochloride
Indication
Corneal anesthesia, diagnosis of Horner’s syndromeMechanism of Action
Blocks reuptake of norepinephrine, causes vasoconstriction, and provides corneal anesthesia
Available Quantities
Not commercially available as ophthalmic solutionDosage/Instructions
1 drop of 2% solution for corneal anesthesia; duration approximately 20 minutesSafety Info for Cocaine Hydrochloride
Pregnancy & Nursing
Limited data; potential risks to the fetus not well established
Pediatric Use
No studiesContraindications, side effects, etc.
Contraindications: Hypersensitivity to cocaine hydrochloride or other ester-based local anesthetics.
Warnings/Precautions: May cause seizures, increase blood pressure and heart rate. Avoid use in patients with certain cardiovascular conditions and those on vasoconstrictors or monoamine-oxidase inhibitors.
Common Side Effects: Hypertension, tachycardia, and sinus tachycardia.Cocaine Hydrochloride 1% to 4%ophthalmic solution
