Sodium Hyaluronate + Carboxymethylcellulose Sodium

• Dry Eye Syndrome (Keratoconjunctivitis Sicca): Used to relieve symptoms of mild to severe dry eyes by providing lubrication and moisture to the ocular surface.
• Ocular Surface Disorders: Supportive treatment for conditions involving corneal epithelial defects, conjunctival irritation, or inflammation.
• Postoperative Eye Care: Used after ocular surgeries such as cataract extraction, LASIK, or other corneal procedures to promote healing and reduce discomfort.
• Contact Lens Wearers: Alleviates dryness and irritation associated with prolonged contact lens use.
• Off-label: May be used to soothe ocular irritation caused by environmental factors like wind, dust, or air conditioning.

• Route: Topical ophthalmic (eye drops or gel)
• Adults and Pediatrics:
• Instill 1-2 drops in the affected eye(s) 4 to 6 times daily or as needed.
• For severe dry eye or postoperative use, dosing may be increased up to every 1-2 hours, as directed by a physician.
• Gel formulations can be applied once or twice daily, often at bedtime for prolonged moisture.
• Special Populations:
• No dosage adjustments required for elderly or patients with renal or hepatic impairment due to minimal systemic absorption.
• Use caution in patients with known hypersensitivity to components.

Sodium hyaluronate is a high molecular weight glycosaminoglycan that retains water and increases tear film viscosity, promoting hydration and lubrication of the ocular surface. Carboxymethylcellulose sodium is a cellulose derivative that acts as a mucoadhesive agent, stabilizing the tear film by mimicking the mucin layer. Together, they enhance tear film stability, reduce evaporation, protect the corneal and conjunctival epithelium from desiccation, and support epithelial healing, resulting in symptomatic relief of dry eye and improved ocular surface integrity.

• Absorption: Minimal systemic absorption after topical application.
• Distribution: Confined mainly to the tear film and ocular surface.
• Metabolism: Locally metabolized by ocular enzymes; sodium hyaluronate is degraded by hyaluronidases; carboxymethylcellulose is broken down by cellulase enzymes.
• Half-life: Retained on the ocular surface for several hours, with longer retention in gel formulations.
• Excretion: Eliminated through tear drainage and normal metabolic pathways; no significant systemic excretion.

• Pregnancy: No assigned FDA pregnancy category. Due to localized ocular use and minimal systemic absorption, risk to fetus is considered low. Use only if clearly needed.
• Lactation: Limited data available; systemic exposure is negligible, so it is unlikely to affect a breastfeeding infant. Use with caution.

• Primary therapeutic class: Ophthalmic lubricant / Artificial tear
• Subclass: Viscoelastic agent and mucin-mimetic tear stabilizer

• Known hypersensitivity to sodium hyaluronate, carboxymethylcellulose sodium, or any excipients.
• Presence of active ocular infections unless specifically treated.
• Use caution if severe ocular surface damage is present requiring other interventions.

• Maintain sterility; avoid contamination of the dropper tip.
• Discontinue use if eye pain, redness, swelling, or vision changes occur and seek medical advice.
• Caution in patients with a history of ocular allergies.
• Contact lens wearers should remove lenses before instillation and wait at least 15 minutes before reinsertion, unless product is compatible with lenses.
• Avoid use in the presence of corneal ulcers unless directed by a specialist.

• Common: Mild transient burning, stinging, or blurred vision immediately after instillation.
• Less common: Eye redness, itching, or irritation.
• Rare: Allergic reactions such as swelling, rash, or severe ocular discomfort.

• No significant drug interactions due to localized action and minimal systemic absorption.
• When used with other eye drops, space instillation by at least 5 minutes to prevent dilution.

• Current clinical guidelines recommend combination lubricants like sodium hyaluronate with carboxymethylcellulose for improved tear film stability and symptomatic relief in dry eye disease.
• Emphasis on preservative-free formulations to minimize ocular surface toxicity in chronic users.
• Increasing use of gel preparations for prolonged lubrication in severe cases.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from freezing and excessive heat.
• Keep container tightly closed and protected from light.
• Follow manufacturer instructions regarding opened bottle shelf-life.
• Ensure proper hygiene during use to avoid contamination.