Glycerol + Hypromellose + Polyethylene Glycol 400

Primary (approved / usual uses)

• Temporary relief of symptoms of dry eye (ocular dryness, foreign-body sensation, burning, grittiness, irritation) due to reduced tear production or increased tear evaporation.
• Protection of the corneal surface and lubrication for corneal epithelial defects or after minor corneal abrasion (adjunct to appropriate medical care).
• Rewetting of contact lenses — only when product labeling specifically states suitability for contact-lens rewetting.
• Symptomatic relief after exposure to wind, sun, smoke, air conditioning, or extended visual tasks (computer/reading).

Clinically accepted / adjunct uses (off-label / supportive)

• Temporary lubrication after ocular procedures (minor procedures or diagnostic tests) where a non-preserved lubricant is not required.
• As an adjunct for symptomatic management in mild ocular surface disease while other etiologies are investigated/treated.

Dosage forms: single-use preservative-free vials, multi-dose bottles (may contain preservative), gels, or ointments — check product labeling.

Adults & adolescents (typical):

• Eye drops (aqueous solution): instill 1–2 drops into the affected eye(s) as needed, commonly 4–6 times daily; severe symptoms may require more frequent dosing (e.g., hourly) while awake.
• Ophthalmic gel/ointment (if available): apply thin ribbon to the lower conjunctival sac at bedtime (may blur vision temporarily).

Pediatrics:

• Use pediatric dosing instructions on product label or follow prescriber guidance. Many preparations are similar to adults for older children; for infants/neonates use only products specifically indicated and under medical supervision.

Elderly:

• Use same dosing as adults; may require more frequent application due to decreased natural tears.

Special considerations / adjustments:

• Contact lenses: remove soft contact lenses prior to instillation if the product is not labeled safe for lens wear. If rewetting lenses is intended, use only a formulation explicitly approved for that use.
• Concurrent topical ocular medications: separate instillations by 5–10 minutes; apply other therapeutic drops first, then the lubricant.
• Long-term frequent dosing: prefer preservative-free formulations (single-use vials) to minimize preservative-related toxicity.

Administration technique: wash hands, tilt head back, pull down lower lid, instill drop into conjunctival sac, release lid and blink; avoid tip contact with eye to prevent contamination.

This combination provides symptomatic ocular lubrication and tear-film stabilization by three complementary actions: glycerol (a hygroscopic humectant) attracts and retains water at the ocular surface, improving hydration; hypromellose (HPMC) increases tear viscosity and forms a protective, mucoadhesive film over the corneal and conjunctival epithelium, reducing friction and allowing epithelial repair; polyethylene glycol 400 (PEG-400) acts as a wetting agent and lubricant that lowers surface tension and helps spread the formulation evenly across the tear film. Together they thicken, stabilize, and replenish the aqueous layer and surface mucin, reducing evaporation and mechanical irritation and improving comfort and vision clarity between blinks.

• Absorption: Minimal systemic absorption when used topically on the ocular surface. Small amounts may be absorbed through conjunctival vasculature; systemic exposure is negligible for clinical effect.
• Distribution: Primarily remains on pre-corneal tear film and ocular surface tissues; components distribute within tear film layers.
• Metabolism: Hypromellose is not systemically metabolized to active systemic products; PEG and glycerol are metabolized/handled by normal metabolic pathways if absorbed, but systemic amounts are tiny.
• Elimination: Residual material is removed by tear drainage into the nasolacrimal system and swallowed; any absorbed material is cleared renally.
• Onset & Duration: Symptomatic relief often begins within minutes; duration depends on formulation viscosity—aqueous drops provide shorter relief, gel/ointment and higher-viscosity formulations provide prolonged lubrication (hours, especially at night).

• Pregnancy: Topical ocular use results in negligible systemic exposure. When clinically necessary, use may be considered during pregnancy because systemic absorption is minimal. Routine use is generally regarded as low risk.
• Lactation: Minimal systemic absorption suggests low transfer into breast milk and negligible risk to the breastfed infant. Use topical lubricants as needed during breastfeeding; consult a clinician for high-dose or frequent administration.
• Note: Data in pregnancy/lactation are limited but topical ocular lubricants are widely used and considered safe when used appropriately.

• Primary class: Ophthalmic lubricant / artificial tears
• Subclasses: Aqueous tear supplement; muco-adhesive viscosity agent (hypromellose); humectant/wetting agent combination.

• Known hypersensitivity or allergy to glycerol, hypromellose, polyethylene glycol 400, or any excipient/preservative in the formulation.
• Not for injection or intraocular use — intended only for topical ocular application.

• Contamination risk: do not touch dropper tip to eye or other surfaces. Discard single-use vials immediately after one use. Multi-dose bottles should be handled per label to minimize contamination.
• Preservative toxicity: frequent or long-term use of preservative-containing drops may cause ocular surface toxicity; prefer preservative-free drops for chronic, frequent, or severe dry eye.
• Contact lenses: some formulations are not compatible with soft contact lenses — remove lenses prior to instillation unless label states “suitable for use with contact lenses.”
• Infectious keratitis: if eye pain, changes in vision, significant redness, or persistent irritation occur, discontinue and seek ophthalmic evaluation to exclude infection or other serious conditions.
• Surgery: inform your ophthalmic surgeon before ocular procedures; some surgeons advise stopping certain lubricants prior to surgery.

Common / usually mild and transient

• Temporary blurry vision immediately after instillation (especially with gels/ointments).
• Mild stinging, burning, or transient irritation.
• Eye watering (reflex tearing) for a short period.

Uncommon / rare

• Allergic or hypersensitivity reactions: conjunctival hyperemia, pruritus, eyelid swelling, rash.
• If signs of infection (increasing pain, purulent discharge, vision loss) appear—stop use and seek care.

Onset & dose dependence: adverse effects are usually immediate and short-lived; frequency relates to individual sensitivity and preservatives in the product.

• Topical ocular medications: can dilute or wash out concurrently applied topical eye drugs. Wait 5–10 minutes between different topical ophthalmic agents (apply therapeutic drops first, then lubricant).
• Contact lens solutions / medicated lenses: use caution — some excipients may interact with lens materials. Use only lubricants labeled safe for use with lenses if intending simultaneous wear.
• Systemic medications: no clinically relevant systemic drug interactions expected due to negligible systemic absorption.

• Current ocular surface disease guidance emphasizes artificial tears as first-line therapy for most forms of dry eye; preservative-free formulations are preferred for frequent or long-term use to avoid preservative-induced toxicity.
• TFOS DEWS II (International Dry Eye Workshop) and contemporary ophthalmology practice support a stepwise approach: start with lubricants (aqueous supplementation), then escalate to higher-viscosity or lipid-containing products, anti-inflammatories, or procedural therapies depending on underlying etiology and severity.
• For evaporative dry eye (meibomian gland dysfunction), clinicians may preferentially choose lipid-containing lubricants; glycerol/PEG/HPMC aqueous formulations remain appropriate for aqueous-deficient or mixed dry eye and for short-term symptomatic relief.

• Temperature: store at room temperature, typically 15–25°C (59–77°F) unless the product label specifies otherwise.
• Protect from: direct sunlight, extreme heat, and freezing (freezing may alter viscosity and sterility).
• Handling precautions:
• Single-use vials: use immediately after opening and discard any remaining solution.
• Multi-dose bottles: keep cap/tip clean, replace cap after use, follow manufacturer instructions for discard period (commonly 28 days for many multi-dose ocular products, but check product label).
• Do not use if solution changes color or becomes cloudy.
• Refrigeration/reconstitution: generally not required; do not freeze. No reconstitution required for ready-to-use formulations.