Hydroxypropyl Methylcellulose

Allopathic
Indications
  • Approved Indications
    • Ophthalmic Uses:
      • Treatment of dry eye syndrome (keratoconjunctivitis sicca)
      • Relief of ocular irritation due to environmental factors, contact lens use, or minor trauma
    • Oral/Pharmaceutical Uses:
      • Used as a tablet binder, controlled-release agent, or suspending agent in oral formulations
      • Laxative for short-term relief of constipation
  • Off-label / Clinically Accepted Uses
    • Preoperative ocular lubrication
    • Supportive therapy in ocular surface disorders such as recurrent corneal erosion
    • Use as a vehicle for drug delivery in ophthalmic solutions and gels
Dosage & Administration
  • Ophthalmic
    • Adults & Elderly: Instill 1–2 drops in the affected eye(s) up to 4–6 times daily or as needed
    • Pediatrics: Safety not fully established; use with caution
  • Oral / Laxative
    • Adults: 2–6 g daily, divided doses with a full glass of water
    • Children ≥6 years: 1–3 g daily with adequate fluid intake
  • Special Populations
    • Renal or hepatic impairment: No dose adjustment required
  • Administration Route
    • Ophthalmic drops or gels
    • Oral tablets or suspensions
Mechanism of Action (MOA)

Hydroxypropyl methylcellulose is a hydrophilic polymer that acts primarily as a lubricant and protective agent. In the eye, it forms a viscous, protective film on the corneal and conjunctival surfaces, maintaining hydration and reducing friction from blinking. Orally, HPMC absorbs water in the gastrointestinal tract, forming a gel-like substance that softens stools and promotes bowel movement. Its polymeric structure also allows for controlled drug release in pharmaceutical formulations by slowing dissolution and absorption.

Pharmacokinetics
  • Absorption: Minimal systemic absorption when applied topically to the eye; negligible oral bioavailability
  • Distribution: Primarily remains localized at site of administration
  • Metabolism: Not metabolized by enzymes in the body; exerts effects locally
  • Excretion: Eliminated largely unchanged via feces when ingested orally
  • Onset: Immediate ocular lubrication; laxative effect within 12–72 hours depending on dose
  • Half-life: Not systemically absorbed; local persistence depends on formulation viscosity
Pregnancy Category & Lactation
  • Pregnancy: Considered safe (Category C not assigned) for topical ophthalmic use; systemic exposure is negligible
  • Lactation: Safe for use in breastfeeding; minimal systemic absorption, thus unlikely to affect the infant
  • Caution: Oral laxative formulations should be used with adequate fluid to prevent intestinal obstruction
Therapeutic Class
  • Primary Class: Ophthalmic lubricant / Bulk-forming agent
  • Subclass: Hydrophilic polymer / Cellulose derivative
Contraindications
  • Known hypersensitivity to hydroxypropyl methylcellulose or excipients
  • Oral use: Avoid in patients with intestinal obstruction or severe swallowing disorders
  • Ophthalmic use: Avoid in patients with eye infections unless combined with an antimicrobial agent
Warnings & Precautions
  • Ophthalmic:
    • Remove contact lenses before administration if using a gel or ointment formulation
    • Avoid contamination of the dropper tip to prevent eye infection
  • Oral:
    • Adequate fluid intake is necessary to avoid esophageal or intestinal obstruction
    • Use cautiously in patients with chronic constipation or bowel motility disorders
  • High-risk groups: Elderly or debilitated patients may require monitoring during prolonged use
Side Effects
  • Ophthalmic:
    • Mild transient blurred vision after instillation
    • Temporary burning or stinging
    • Rare: Allergic conjunctivitis
  • Oral:
    • Flatulence, abdominal bloating
    • Rare: Esophageal or intestinal obstruction if inadequate fluid intake
  • Timing: Usually occurs immediately after administration; dose-dependent reactions are uncommon
Drug Interactions
  • Ophthalmic: Minimal systemic absorption; interactions unlikely
  • Oral:
    • May interfere with absorption of oral medications (e.g., digoxin, warfarin) if taken simultaneously; administer other medications 1–2 hours before or after HPMC
  • No significant food or alcohol interactions
Recent Updates or Guidelines
  • Ophthalmology: Recommended as first-line therapy for dry eye syndrome in multiple international guidelines (AAO, TFOS DEWS II)
  • Pharmaceuticals: Increased use in sustained-release oral formulations due to predictable gel-forming and controlled-release properties
  • No major changes in dosing or safety warnings reported recently
Storage Conditions
  • Temperature: Store at 15–30°C (room temperature)
  • Light & Humidity: Protect from direct sunlight and excessive moisture
  • Handling: Keep container tightly closed; avoid contamination
  • Reconstitution: Not applicable for preformed ophthalmic drops; oral powder formulations require proper dissolution in water before use