Hypro Extra

Approved Indications:

• Dry Eye Syndrome (Keratoconjunctivitis Sicca): For the temporary relief of burning, irritation, and discomfort due to dryness of the eye or exposure to wind or sun.
• Ocular Surface Disorders: Supports eye lubrication in conditions causing insufficient tear production such as Sjögren’s syndrome, meibomian gland dysfunction, or blepharitis.
• Post-Surgical Use: Used after ocular surgeries (e.g., LASIK, cataract surgery) to relieve ocular irritation and promote healing.
• Contact Lens Discomfort: Reduces discomfort and dryness associated with wearing hard or soft contact lenses.

Clinically Accepted (Off-label) Uses:

• Computer Vision Syndrome (Digital Eye Strain): Relieves symptoms of dryness, burning, or eye fatigue due to prolonged screen exposure.
• Allergic Conjunctivitis (as adjunct): Provides symptomatic relief from dryness and irritation accompanying allergic reactions.

Adults and Elderly:

• Standard Dose: Instill 1–2 drops in the affected eye(s) as needed, up to 4–6 times daily.
• Severe Dry Eye: May be used every hour if prescribed, particularly in chronic keratoconjunctivitis sicca.

Pediatric Use:

• Generally considered safe for children under medical supervision; same dosage as adults in case of symptomatic dry eye.

Contact Lens Wearers:

• Remove contact lenses before administration. Wait at least 15 minutes before reinserting lenses.

Route of Administration:

• Topical (Ophthalmic) – Instilled into the conjunctival sac of the eye.

Administration Tips:

• Shake the bottle gently before use if suspension.
• Avoid touching the dropper tip to prevent contamination.
• Keep eyes closed for 1–2 minutes post-instillation.

Special Populations:

• Renal/Hepatic Impairment: No dose adjustment required.
• Pregnancy/Lactation: Use only if clearly needed under medical advice.

Carboxymethylcellulose Sodium (CMC) and Hypromellose are inert, viscoelastic polymers that act as artificial tears. CMC has high water retention and bioadhesive properties, forming a protective and lubricating film over the cornea. Hypromellose (Hydroxypropyl Methylcellulose) enhances tear film stability by increasing viscosity and reducing evaporation of natural tears. Together, they improve ocular surface hydration, protect corneal epithelial cells, and provide symptomatic relief from dryness and irritation.

• Absorption: Minimal systemic absorption occurs due to topical ocular use.
• Distribution: Localized to the ocular surface; does not penetrate into systemic circulation in significant amounts.
• Metabolism: Not metabolized systemically.
• Excretion: Excreted via tear drainage into the nasolacrimal duct and nasal cavity.
• Onset of Action: Within minutes of instillation.
• Duration of Effect: Typically lasts 1–2 hours depending on severity and tear film condition.
• Bioavailability: Negligible systemic bioavailability.

• Pregnancy: Not assigned a formal FDA category. Considered safe for use during pregnancy due to minimal systemic absorption. Use only if clearly indicated.
• Lactation: Compatible with breastfeeding. Systemic exposure is minimal, and no harmful effects on the nursing infant are expected.
• Recommendation: Can be used under physician supervision; limited data available but low risk.

• Primary Class: Ocular Lubricant
• Subclass: Artificial Tear Substitute / Ophthalmic Viscosity Enhancer

• Known hypersensitivity to Carboxymethylcellulose, Hypromellose, or any excipients in the formulation.
• Ocular infection: Avoid use in the presence of an untreated eye infection unless directed by a physician.

• Contamination Risk: Do not touch the dropper tip to any surface, including the eye, to prevent contamination.
• Preservative Sensitivity: Some formulations contain benzalkonium chloride, which may irritate or discolor soft contact lenses.
• Use with Other Eye Medications: Maintain at least a 5-minute interval between multiple ophthalmic products.
• Prolonged Symptoms: Seek medical attention if symptoms persist beyond 3 days or worsen.
• Blurred Vision: Temporary blurred vision may occur after administration—do not drive until vision clears.

Common (usually mild and transient):

• Ocular burning or stinging
• Temporary blurred vision
• Foreign body sensation
• Increased tear production

Less Common:

• Eye redness
• Eyelid edema
• Allergic conjunctivitis
• Sticky eyelids

Rare but Serious:

• Hypersensitivity reactions
• Severe eye irritation
• Visual changes (report immediately)

Onset: Adverse effects generally appear within minutes after instillation and are often self-limited.

• Drug–Drug: No clinically significant systemic interactions due to negligible absorption.
• Drug–Preservative: Formulations containing benzalkonium chloride may interact with soft contact lenses.
• Recommendation: If used with other eye drops, wait 5–10 minutes between administrations to avoid dilution or washout.

• EMA/FDA/Ophthalmology Societies: Emphasis on preservative-free formulations for chronic users to reduce ocular surface toxicity.
• Clinical Practice: Combination of CMC + Hypromellose shown to be effective in treating moderate to severe dry eye and post-surgical discomfort, aligning with updated dry eye disease management guidelines.

• Temperature: Store at 20°C to 25°C; excursions permitted to 15°C–30°C.
• Humidity: Keep the bottle tightly closed and protected from excessive moisture.
• Light: Store in original container; protect from direct sunlight.
• Refrigeration: Not required unless specifically instructed on the label.
• Handling: Discard bottle 30 days after opening (unless unit-dose).
• Shake before use if the formulation is a suspension.