antazoline sulfate + xylometazoline hydrochloride: clinical use

Prescribing considerations

• Confirm that redness and itching are consistent with allergic conjunctivitis rather than infection or another red-eye disorder.
• Consider systemic sympathomimetic and antimuscarinic effects despite topical administration.
• Use caution with hypertension, cardiovascular disease or arrhythmia, long-QT syndrome, hyperthyroidism, diabetes, phaeochromocytoma, urinary retention and concurrent sympathomimetics.
• Seek specialist or prescriber review before use in dry eye or corneal disease because benzalkonium chloride may increase irritation.
• Frequent or prolonged use may cause rebound hyperaemia.

Contraindications and cautions

• Hypersensitivity to the active substances or excipients.
• Narrow-angle glaucoma.
• Use with contact lenses.
• Current or recent monoamine oxidase inhibitor treatment.

Monitoring

• Review persistent, worsening or atypical symptoms and consider infection or another ocular diagnosis.
• Monitor for ocular irritation, increasing redness, blurred vision and hypersensitivity.
• In susceptible patients, monitor for hypertension, palpitations, tachycardia or arrhythmia.

Clinical pharmacology

Xylometazoline is an alpha-adrenergic sympathomimetic vasoconstrictor. Antazoline is an H1-receptor antagonist with additional anticholinergic and local-anaesthetic properties. Formal pharmacokinetic studies have not been conducted.

Formulation and product differences

• The selected product is a clear, colourless multidose eye-drop solution.
• It contains benzalkonium chloride and boric acid, with disodium edetate and sodium tetraborate.
• The bottle remains sterile until its original closure is broken and has a 28-day in-use shelf life.