Professional Information

Hydroxypropyl Cellulose (Ophthalmic)

VA CLASSIFICATION
Primary: OP500^{05}

Commonly used brand name(s): Lacrisert.

Note: For a listing of dosage forms and brand names by country availability, see Dosage Forms section(s).

Category:

Protectant (ophthalmic)—

tears (artificial)—

Indications

Note: Bracketed information in the Indications section refers to uses that are not included in U.S. product labeling.

Accepted

Keratoconjunctivitis sicca (treatment)^{01}^{03}^{07}^{08}^{09}—Hydroxypropyl cellulose is indicated in patients with moderate to severe dry eye syndromes associated with deficient tear production, including keratoconjunctivitis sicca. ^{01} ^{03} ^{07} ^{08} ^{09} It is indicated especially in patients who remain symptomatic following an adequate trial of therapy with artificial tear solutions. ^{01} ^{03} ^{07} ^{08} ^{09} ^{11} ^{12}

Corneal erosions, recurrent (treatment)¹ ^{01}^{07}^{08}^{12}
Corneal sensitivity, decreased (treatment) or^{01}^{03}^{07}^{08}^{09}^{11}^{12}
Keratitis, exposure (treatment)^{01}^{03}^{07}^{08}^{09}^{11}^{12}—Hydroxypropyl cellulose is indicated in the treatment of recurrent corneal erosions, decreased corneal sensitivity, and exposure keratitis.

[Keratitis, neuroparalytic (treatment)]¹ ^{07}—Hydroxypropyl cellulose is used in the treatment of neuroparalytic keratitis. ^{10}

[Ocular lubrication]¹ ^{07}—Hydroxypropyl cellulose is used as an ocular lubricant for artificial eyes. ^{10}

¹ Not included in Canadian product labeling.

Pharmacology/Pharmacokinetics

Mechanism of action/Effect:

Acts to stabilize and thicken the precorneal tear film and prolong the tear film breakup time, which is usually shortened in dry eye conditions. ^{01} ^{03} Also acts to lubricate and protect the eye. ^{01} ^{03}

Precautions to Consider

Carcinogenicity/Mutagenicity

No histospathologic changes or other negative effects occurred when hydroxypropyl cellulose was fed to rats at levels of up to 5% of their diet. ^{08}

Pregnancy/Reproduction

Problems in humans have not been documented.

Breast-feeding

Problems in humans have not been documented.

Pediatrics

Appropriate studies on the relationship of age to the effects of hydroxypropyl cellulose have not been performed in the pediatric population. However, pediatrics-specific problems that would limit the usefulness of this medication in children are not expected.

Geriatrics

Appropriate studies on the relationship of age to the effects of hydroxypropyl cellulose have not been performed in the geriatric population. However, geriatrics-specific problems that would limit the usefulness of this medication in the elderly are not expected.

Medical considerations/Contraindications
The medical considerations/contraindications included have been selected on the basis of their potential clinical significance (reasons given in parentheses where appropriate)— not necessarily inclusive (» = major clinical significance).

Risk-benefit should be considered when the following medical problem exists
Sensitivity to hydroxypropyl cellulose

Side/Adverse Effects

Note: Side/adverse effects of hydroxypropyl cellulose are usually mild and transient. ^{03}

The following side/adverse effects have been selected on the basis of their potential clinical significance (possible signs and symptoms in parentheses where appropriate)—not necessarily inclusive:

Those indicating need for medical attention only if they continue or are bothersome
Incidence less frequent

Blurred vision^{01}^{03}^{08}^{09}

eye redness or discomfort or other irritation not present before therapy^{01}^{03}^{08}^{09}

increased sensitivity of eyes to light^{01}^{03}^{08}^{09}

matting or stickiness of eyelashes^{01}^{03}^{08}^{09}

swelling of eyelids^{01}^{03}^{08}^{09}

watering of eyes^{03}^{09}

Patient Consultation
As an aid to patient consultation, refer to Advice for the Patient, Hydroxypropyl Cellulose (Ophthalmic).

In providing consultation, consider emphasizing the following selected information (» = major clinical significance):

Before using this medication
»   Conditions affecting use, especially:
Sensitivity to hydroxypropyl cellulose

Proper use of this medication
Proper administration technique:

• Reading patient instructions carefully before use

• Importance of inserting ocular system properly

• Checking with physician if administration technique not understood

Accidentally expelled ocular system:

• Not inserting in eye again, because of possible contamination

• Inserting another ocular system if necessary

» Proper dosing
Missed dose: Inserting as soon as possible

» Proper storage

Precautions while using this medication
» Caution if blurred vision occurs

Possible increased sensitivity of eyes to light; wearing sunglasses for relief

» Removing eye system and checking with physician if eye symptoms worsen or new symptoms appear

General Dosing Information
Some patients may have difficulty in understanding the proper administration technique of this ocular system; therefore, it is important that the administration technique be thoroughly explained.

If the hydroxypropyl cellulose ocular system is inadvertently expelled, as sometimes occurs in patients with shallow conjunctival fornices or when the eye is rubbed, another ocular system may be inserted if necessary. ^{01} ^{03} ^{08} ^{09}

If experience with the ocular system indicates that transient blurred vision occurs, the ocular system may be removed a few hours after insertion to prevent this. ^{01} ^{03} ^{08} Then another ocular system may be inserted, if necessary. ^{01} ^{03} ^{08}

Some persons may require several weeks of therapy before symptoms improve. ^{01} ^{02} ^{03} ^{09}

Ophthalmic Dosage Forms

HYDROXYPROPYL CELLULOSE OCULAR SYSTEM USP

Usual adult and adolescent dose
Artificial tears or
Ophthalmic protectant
Topical, to the conjunctiva, 1 ocular system delivering 5 mg, once a day. ^{01} ^{03} ^{08} ^{09} ^{11} ^{12}

Note: Some patients may require 5 mg two times a day for optimal results. ^{01} ^{03} ^{08} ^{09} ^{12}

Usual pediatric dose
See Usual adult and adolescent dose.

Strength(s) usually available
U.S.—

5 mg (Rx) [Lacrisert^{08}^{12}]

Canada—

5 mg (Rx) [Lacrisert^{11}]

Packaging and storage:
Store below 30 °C (86 °F), ^{01} ^{04} unless otherwise specified by manufacturer.

Auxiliary labeling:
   • For the eye.

Note: Include patient instructions when dispensing. ^{02} ^{04}

Revised: 06/21/1993

References