Clinical Reference

Ophthalmic Drugs

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

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 conjunctivitis

Mechanism 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 ml

Dosage/Instructions

One drop four times a day in the operated eye as needed for up to 4 days following surgery

Safety 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 years

Contraindications, 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.

Acular LS®

Ketorolac Tromethamine (0.4%)

ophthalmic solution
NSAID

Prescribing Acular®

Indication

Relief of ocular itching due to seasonal allergic conjunctivitis, postoperative inflammation in cataract surgery patients

Mechanism of Action

Inhibits prostaglandin synthesis, reducing pain and vasopermeability. This action helps in reducing inflammation and associated symptoms in the eye.

Available Quantities

5 ml

Dosage/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 years

Contraindications, 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.

Acular®

Ketorolac Tromethamine (0.5%)

ophthalmic solution
NSAID

Prescribing Acuvail®

Indication

Treatment of pain and inflammation following cataract surgery

Mechanism 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 vials

Dosage/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 period

Safety 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 years

Contraindications, 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.

Acuvail®

Ketorolac Tromethamine (0.45%)

ophthalmic solution
Local Anesthetic

Prescribing Akten®

Indication

Ocular surface anesthesia during ophthalmologic procedures

Mechanism of Action

Blocks sodium ion channels required for initiation and conduction of neuronal impulses

Available Quantities

Single-patient use

Dosage/Instructions

Apply as directed by a healthcare professional

Safety Info for Akten®

Pregnancy & Nursing

Limited data; potential risks to the fetus not well established

Pediatric Use

All ages

Contraindications, 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.

Akten®

Lidocaine Hydrochloride 3.5%

ophthalmic gel
Allergy

Prescribing Alaway®, Zaditor®

Indication

allergic conjunctivitis

Mechanism of Action

Ketotifen antagonizes H1 histamine receptors, stabilizes mast cells, inhibits the release of pro-inflammatorymediators.

Available Quantities

5ml, 10ml

Dosage/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 day

Safety 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 years

Contraindications, 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.

Alaway®, Zaditor®

ketotifen 0.025%, 0.035%

ophthalmic solution
Local Anesthetic

Prescribing Alcaine®

Indication

Short-duration corneal anesthesia for procedures like tonometry, gonioscopy, foreign body removal

Mechanism of Action

Blocks sodium ion channels required for initiation and conduction of neuronal impulses

Available Quantities

15 ml bottle

Dosage/Instructions

1 to 2 drops in each eye before operating; 1 drop every 5 to 10 minutes for 5 to 7 doses for short procedures

Safety Info for Alcaine®

Pregnancy & Nursing

Limited data; potential risks to the fetus not well established

Pediatric Use

All ages

Contraindications, 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.

Alcaine®

Proparacaine Hydrochloride 0.5%

ophthalmic solution
Allergy

Prescribing Alocril®

Indication

allergic conjunctivitis

Mechanism of Action

Nedocromil inhibits the activation and release of inflammatory mediators such as histamine, prostaglandin D2, and leukotrienes c4 from different types of cells

Available Quantities

5ml

Dosage/Instructions

1 or 2 drops in each eye twice a day at regular intervals

Safety Info for Alocril®

Pregnancy & Nursing

Use during pregnancy only if clearly needed. Unknown if excreted into human milk

Pediatric Use

≥3 years

Contraindications, 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.

Alocril®

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

10ml

Dosage/Instructions

1-2 drops in affected eye four times daily for up to 3 months

Safety 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 needed

Pediatric Use

>2 years

Contraindications, 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.

Alomide®

lodoxamide tromethamine 0.1%

ophthalmic solution
Antiglaucoma

Prescribing Alphagan-P®

Indication

Lowering of intraocular pressure in open-angle glaucoma or ocular hypertension

Mechanism 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 ml

Dosage/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 dosage

Pediatric Use

≥2 years

Contraindications, 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.

Alphagan-P®

Brimonidine (0.1%, 0.15%, 0.2% B&L)

ophthalmic solution
Allergy, Steroid

Prescribing Alrex®

Indication

Seasonal allergic conjunctivitis

Mechanism of Action

Inhibits leukocyte migration, capillary dilation, fibroblast proliferation

Available Quantities

5ml, 10ml

Dosage/Instructions

1 drop 4 times/day

Safety Info for Alrex®

Pregnancy & Nursing

Embryotoxic in rabbits at high doses; no human data

Pediatric Use

≥18 years

Contraindications, 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.

Alrex®

Loteprednol Etabonate 0.2%

ophthalmic suspension
Diagnostic Dye, Local Anesthetic

Prescribing Altafluor®

Indication

Ophthalmic procedures requiring a disclosing agent and topical anesthetic

Mechanism of Action

Fluorescein for staining and Benoxinate for local anesthesia

Available Quantities

5 mL bottle

Dosage/Instructions

Instill 1 to 2 drops topically in the eye as needed

Safety Info for Altafluor®

Pregnancy & Nursing

Limited data; potential risks to the fetus not well established

Pediatric Use

All ages

Contraindications, 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.

Altafluor®

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 infections

Mechanism of Action

Amoxicillin acts through the inhibition of biosynthesis of cell wall mucopeptide. It is bactericidal against susceptible organisms during the stage of active multiplication4

Available Quantities

125 mg, 200 mg, 250 mg, 400 mg, 500 mg, 875 mg tablets

Dosage/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 hours

Safety Info for Amoxil®

Pregnancy & Nursing

Caution should be exercised when amoxicillin is administered to a nursing woman8

Pediatric Use

All ages

Contraindications, 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.

Amoxil®

Amoxicillin

oral suspension, oral tablet
Mydriatics/Cycloplegics

Prescribing Atropine

Indication

Cycloplegia, Mydriasis, pupil dilation in acute iritis and uveitis, penalization of the healthy eye in amblyopia

Mechanism 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 ml

Dosage/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 harm

Pediatric Use

≥3 months

Contraindications, 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

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 tract

Mechanism 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 gm

Dosage/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 examination

Safety Info for Atropine Ointment

Pregnancy & Nursing

Use with caution during pregnancy and nursing; safety profile unknown

Pediatric Use

≥3 months

Contraindications, 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 Ointment

Atropine sulfate 1%

ophthalmic ointment
Antibiotic

Prescribing Augmentin®

Indication

Treatment of ocular infections like preseptal cellulitis, dacryocystitis

Mechanism of Action

Inhibits bacterial cell wall synthesis and is effective against beta-lactamase-producing organisms

Available 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 suspension

Dosage/Instructions

875 mg twice daily or 500 mg three times daily

Safety Info for Augmentin®

Pregnancy & Nursing

Generally considered safe in pregnancy. Caution should be exercised when administered to a nursing woman

Pediatric Use

All ages

Contraindications, 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.

Augmentin®

Amoxicillin/Clavulanate

oral 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 pneumoniae

Available Quantities

2.5 ml

Dosage/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/day

Safety 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 year

Contraindications, 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.

AzaSite®

azithromycin 1%

ophthalmic solution
Antiglaucoma

Prescribing Azopt®

Indication

Lowering intraocular pressure in ocular hypertension or open-angle glaucoma

Mechanism 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 ml

Dosage/Instructions

1 drop 3 times daily

Safety Info for Azopt®

Pregnancy & Nursing

There are no adequate and well-controlled studies in pregnant women. Use cautiously during pregnancy.

Pediatric Use

No studies

Contraindications, 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.

Azopt®

Brinzolamide 1%

ophthalmic suspension
Antibiotic

Prescribing Bacitracin Ointment

Indication

bacterial conjunctivitis, bacterial keratitis, bacterial keratoconjunctivitis

Mechanism 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 g

Dosage/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 ages

Contraindications, 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.

Bacitracin Ointment

500 units bacitracin per gram

ophthalmic ointment
Antibiotic

Prescribing Bactrim®

Indication

Treatment of preseptal cellulitis

Mechanism of Action

Inhibits bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid, blocking the production of tetrahydrofolic acid

Available 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 dose

Pediatric Use

≥2 months

Contraindications, 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.

Bactrim®

Trimethoprim/sulfamethoxazole

oral suspension, oral tablet
Allergy

Prescribing Bepreve®

Indication

allergic conjunctivitis

Mechanism 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, 10ml

Dosage/Instructions

Instill 1 drop into the affected eye(s) twice a day

Safety Info for Bepreve®

Pregnancy & Nursing

No controlled data in human pregnancy. The effects in nursing infants are unknown

Pediatric Use

≥2 years

Contraindications, 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.

Bepreve®

bepotastine besilate 1.5%

ophthalmic solution
Antibiotic

Prescribing Besivance®

Indication

bacterial conjunctivitis

Mechanism 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 ml

Dosage/Instructions

1 drop in affected eye(s) 3 times/day for 7 days

Safety Info for Besivance®

Pregnancy & Nursing

No adequate studies in pregnant women; unknown if excreted in milk

Pediatric Use

≥1 year

Contraindications, 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.

Besivance®

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 microorganisms

Available Quantities

30 ml

Dosage/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 established

Pediatric Use

All ages

Contraindications, 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.

Betadine® 5%

Povidone-Iodine 5%

ophthalmic solution
Antiglaucoma

Prescribing Betagan®

Indication

Lowering IOP in chronic open-angle glaucoma or ocular hypertension

Mechanism 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 ml

Dosage/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 studies

Contraindications, 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.

Betagan®

Levobunolol HCL (0.25%, 0.5%)

ophthalmic solution

Ophthalmic Drugs

Prescribing Acetylcysteine

Indication

Mechanism of Action

Available Quantities

Dosage/Instructions

Safety Info for Acetylcysteine

Pregnancy & Nursing

Pediatric Use

Contraindications, side effects, etc.

Acetylcysteine

Prescribing Acular LS®

Indication

Mechanism of Action

Available Quantities

Dosage/Instructions

Safety Info for Acular LS®

Pregnancy & Nursing

Pediatric Use

Contraindications, side effects, etc.

Acular LS®

Prescribing Acular®

Indication

Mechanism of Action

Available Quantities

Dosage/Instructions

Safety Info for Acular®

Pregnancy & Nursing

Pediatric Use

Contraindications, side effects, etc.

Acular®

Prescribing Acuvail®

Indication

Mechanism of Action

Available Quantities

Dosage/Instructions

Safety Info for Acuvail®

Pregnancy & Nursing

Pediatric Use

Contraindications, side effects, etc.

Acuvail®

Prescribing Akten®

Indication

Mechanism of Action

Available Quantities

Dosage/Instructions

Safety Info for Akten®

Pregnancy & Nursing

Pediatric Use

Contraindications, side effects, etc.

Akten®

Prescribing Alaway®, Zaditor®

Indication

Mechanism of Action

Available Quantities

Dosage/Instructions

Safety Info for Alaway®, Zaditor®

Pregnancy & Nursing

Pediatric Use

Contraindications, side effects, etc.

Alaway®, Zaditor®

Prescribing Alcaine®

Indication

Mechanism of Action

Available Quantities

Dosage/Instructions

Safety Info for Alcaine®

Pregnancy & Nursing

Pediatric Use

Contraindications, side effects, etc.

Alcaine®

Prescribing Alocril®

Indication

Mechanism of Action

Available Quantities

Dosage/Instructions

Safety Info for Alocril®

Pregnancy & Nursing

Pediatric Use

Contraindications, side effects, etc.