olopatadine hydrochloride: clinical use

Prescribing considerations

• Confirm symptoms are consistent with seasonal allergic conjunctivitis rather than infection or another painful red-eye disorder.
• The selected product is licensed for adults only.
• Review promptly if symptoms worsen or fail to improve.
• Consider preservative-related ocular-surface toxicity in dry eye, frequent use or compromised corneas.
• Systemic exposure is minimal after ocular administration.

Contraindications and cautions

• Hypersensitivity to olopatadine or any excipient
• Children and adolescents under 18 years for the selected product

Monitoring

• Clinical response and any worsening redness, pain or visual disturbance
• Corneal surface in patients with dry eye or compromised corneas, particularly with frequent or prolonged use
• Hypersensitivity or significant local intolerance

Clinical pharmacology

Olopatadine is a selective H1-antihistamine with additional antiallergic activity, including inhibition of histamine-related inflammatory signalling and mast-cell mediator release. Ocular administration produces minimal systemic concentrations; absorbed drug is eliminated mainly in urine.

Formulation and product differences

• The selected multidose solution contains benzalkonium chloride, which can irritate the ocular surface and discolour soft contact lenses.
• It contains phosphate; very rare corneal calcium deposits have been reported with phosphate-containing drops in severely damaged corneas.
• The opened bottle must be discarded four weeks after first opening.

Eye drops

Route: Ophthalmic

Strengths: 1 mg/mL