SOFRADEX EAR/EYE DROPS SOLUTION

Active substance: GRAMICIDIN

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SUMMARY OF PRODUCT CHARACTERISTICS

1

NAME OF THE MEDICINAL PRODUCT
Sofradex Ear/Eye Drops, Solution

2

QUALITATIVE AND QUANTITATIVE COMPOSITION
Each bottle contains 0.5% w/v of Framycetin Sulphate, Dexamethasone
Sodium Metasulphobenzoate (equivalent to 0.050% w/v of Dexamethasone)
and 0.005% w/v of Gramicidin.
For a full list of excipients, see section 6.1.

3

PHARMACEUTICAL FORM
Ear/Eye Drops, Solution
A sterile, clear, bright, colourless, aqueous solution.

4

CLINICAL PARTICULARS

4.1

Therapeutic indications
In the Eye: For the short term treatment of steroid responsive conditions of the eye
when prophylactic antibiotic treatment is also required, after excluding the presence
of fungal and viral disease.
In the Ear: Otitis Externa

4.2

Posology and method of administration
DOSAGE
Adults (and the Elderly) and Children:
In the Eye:

One or two drops applied to each affected eye up to six times
daily or more frequently if required.

In the Ear:

Two or three drops instilled into the ear three or four times
daily.

ADMINISTRATION
Auricular and Ocular use.
Treatment duration should be short (not to exceed 7 days) (see section 4.4)
4.3

Contraindications
Viral, fungal, tuberculous or purulent conditions of the eye. Use is
contraindicated if glaucoma is present or herpetic keratitis (e.g. dendritic
ulcer) is considered a possibility. Use of topical steroids in the latter
condition can lead to extension of the ulcer and marked visual deterioration.
Otitis Externa should not be treated when the eardrum is perforated because of
the risk of ototoxicity.
Hypersensitivity to framycetin sulphate, dexamethasone sodium
metasulphobenzoate, gramicidin or to any of the excipients.

4.4

Special warnings and precautions for use
Topical corticosteroids should never be given for an undiagnosed red eye as
inappropriate use is potentially blinding.
Treatment with corticosteroid/antibiotic combinations should not be continued
for more than 7 days in the absence of any clinical improvement, since
prolonged use may lead to occult extension of infections due to the masking
effect of the steroid. Prolonged use may also lead to skin sensitisation and the
emergence of resistant organisms.
Prolonged use may lead to the risk of adrenal suppression in infants.
Treatment with corticosteroid preparations should not be repeated or
prolonged without regular review to exclude raised intraocular, pressure,
cataract formation or unsuspected infections.
Aminoglycosides antibiotics may cause irreversible, partial or total deafness
when given systemically or when applied topically to open wounds or
damaged skin. This effect is dose related and is enhanced by renal or hepatic
impairment. Although this effect has not been reported following ocular use,
the possibility should be considered when high dose topical is given to small
children or infants.

4.5

Interaction with other medicinal products and other forms of interaction
None relevant to topical use

4.6

Fertility, pregnancy and lactation
Safety for use in pregnancy and lactation has not been established. There is
inadequate evidence of safety in human pregnancy. Topical administration of
corticosteroids to pregnant animals can cause abnormalities of foetal development
including cleft palate and intrauterine growth retardation. There may therefore be a
very small risk of such effects in the human foetus. There is a risk of foetal
ototoxicity if aminoglycoside antibiotics preparations are administrated during
pregnancy.

4.7

Effects on ability to drive and use machines
May cause transient blurring of vision on instillation. Warn patients not to
drive or operate hazardous machinery unless vision is clear.

4.8

Undesirable effects
Hypersensitivity reactions, usually of the delayed type, may occur leading to
irritation, burning, stinging, itching and dermatitis.
Topical steroid use may result in increased intraocular pressure leading to
optic nerve damage, reduced visual acuity and visual field defects.
Intensive or prolonged use of topical corticosteroids may lead to formation of
posterior subcapsular cataracts.
In those diseases causing thinning of the cornea or sclera, corticosteroid
therapy may result in the thinning of the globe leading to perforation.

4.9

Overdose
Long-term intensive topical use may lead to systemic effects.

Oral ingestion of the contents of one bottle (up to 10ml) is unlikely to lead to
any serious adverse effects.

5

PHARMACOLOGICAL PROPERTIES

5.1

Pharmacodynamic properties
Pharmacotherapeutic group: ophthalmological and otological preparations,
corticosteroids and anti-infectives in combination, ATC Code: S03CA01.
Framycetin Sulphate is an aminoglycoside antibiotic with a spectrum of activity
similar to that of neomycin, this includes Staph. aureus and most clinically
significant gram negative organisms.
Gramicidin is an antimicrobial cyclic polypeptide active in vitro against many gram
positive bacteria. It is used for the local treatment of susceptible infections,
sometimes in combination with other antimicrobial agents and frequently with a
corticosteroid.
Dexamethasone is a synthetic glucocorticoid and has the general properties as other
corticosteroids.

5.2

Pharmacokinetic properties
Framycetin Sulphate absorption occurs from inflamed skin and wounds. Once
absorbed it is rapidly excreted by the kidneys in active form. It has been
reported to have a half life of 2-3 hours
Gramicidin has properties similar to those of Tyrothricin and is too toxic to be
administered systemically.
Dexamethasone is readily absorbed from the gastro-intestinal tract. It has a
biological half-life in plasma of about 190 minutes

5.3

Preclinical safety data
Not applicable.

6

PHARMACEUTICAL PARTICULARS

6.1

List of excipients
Citric Acid
Sodium Citrate
Lithium Chloride
Phenylethyl Alcohol
Industrial Methylated Spirits 95%
Polysorbate 80
Purified Water
Sodium Hydroxide (for pH-adjustment)
Hydrochloric Acid (for pH-adjustment)

6.2

Incompatibilities
Not applicable.

6.3

Shelf life
24 Months.
Discard contents 28 days after opening.

6.4

Special precautions for storage
Store below 25°C, do not refrigerate.

6.5

Nature and contents of container
Glass bottle fitted with a special dropper attachment: Pack size of 8 or 10ml.
Plastic dropper bottle: Pack size of 5, 8 or 10ml.
Not all pack sizes may be marketed.

6.6

Special precautions for disposal
No special requirements.

7

MARKETING AUTHORISATION HOLDER
Aventis Pharma Limited
One Onslow Street

Guildford
Surrey
GU1 4YS
UK
or trading as:Sanofi-aventis or Sanofi
One Onslow Street
Guildford
Surrey
GU1 4YS
UK

8

MARKETING AUTHORISATION NUMBER(S)
PL 04425/0210

9

DATE OF FIRST AUTHORISATION/RENEWAL OF THE
AUTHORISATION
Date of first authorisation: 1 January 1972
Date of latest renewal: 4 June 2005

10

DATE OF REVISION OF THE TEXT
14/11/2012

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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