Optagel

• 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

• 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

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.

• 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: 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

• Primary Class: Ophthalmic lubricant / Bulk-forming agent
• Subclass: Hydrophilic polymer / Cellulose derivative

• 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

• 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

• 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

• 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

• 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

• 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