hypromellose: clinical use

Prescribing considerations

• Confirm whether symptoms are consistent with uncomplicated dry eye; pain, marked redness, photophobia or visual change warrants further assessment.
• Check contact-lens use and whether the preparation contains benzalkonium chloride.
• Consider a preservative-free lubricant where preservative intolerance, compromised cornea or frequent long-term use is a concern.
• Avoid contact between the applicator tip and the ocular surface to reduce contamination.

Contraindications and cautions

• Hypersensitivity to hypromellose or any excipient.
• The selected benzalkonium chloride-containing products must not be applied while soft contact lenses are worn.

Monitoring

• Review persistent or worsening irritation, headache, eye pain, visual change or continuing redness.
• With prolonged use of benzalkonium chloride-containing drops, monitor patients with dry eye or a compromised corneal surface.
• Consider corneal assessment in patients with significant corneal damage using phosphate-containing formulations.

Clinical pharmacology

Hypromellose is a pharmacologically inert, viscous cellulose derivative that lubricates the ocular surface, supplements the tear film and can increase the ocular contact time of other topical preparations. Systemic absorption is expected to be negligible.

Formulation and product differences

• The selected Hypromellose Eye Drops BP contains hypromellose 0.3% w/v and benzalkonium chloride 0.10 mg/ml.
• The selected Isopto Plain contains hypromellose 0.5% w/v, benzalkonium chloride and phosphate excipients; eMC marks this presentation as discontinued.
• Preservatives and phosphate buffers differ between products and may affect suitability for contact-lens wearers or patients with a compromised cornea.
• Follow each product's after-opening storage and disposal instructions.

Eye drops

Route: Ophthalmic

Strengths: 0.32%, 0.32% w/v