Author: Liu Chunxia
Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Zengcheng Branch
Director of the Pharmacy Section
Lead:
Grandma Deng suffered from mild cataracts, in the hospital prescribed potassium iodide eye drops treatment, after more than a month of use, continue to use eye drops when eye irritation pain, children quickly sent to the hospital for examination, it turned out that the grandmother used expired eye drops caused. Children don't understand: how can eye drops expire when they are clearly within the validity period?
In fact, don't look at the small bottle of eye drops, there is still a lot of learning hidden in it. Today we will come to science popularization.
Ophthalmic preparations:
When it comes to eye drops, we have to talk about the concept of "eye preparations".
Ophthalmic formulations refer to sterile preparations that are directly used in the eye to exert a therapeutic effect, and are one of the most commonly used drug dosage forms for the treatment of ophthalmic diseases. Common eye drops, eye ointments, eye gels, eye masks and so on.
Ophthalmic formulations are usually multi-dose formulations, i.e. the minimum sales unit contains multiple doses and can be taken multiple times. For example, a bottle of eye drops can be used multiple times, and there will still be surplus after a period of use after opening.
So the question is, if the remaining eye drops are still within the validity period specified in the drug instructions, can they continue to be used? How long can I continue to use it?
Validity and post-opening period of use:
This involves two concepts that should be paid attention to when using ophthalmic preparations: expiration date and post-opening period of use.
Expiration date: the date marked on the drug label and label, which refers to the expiration date when the ophthalmic preparation is not opened. Period of use after opening: refers to the storage time after opening the ophthalmic preparation.
The 2015 edition of the Chinese Pharmacopoeia "General Principles of Preparations" has clear provisions on the use period of eye preparations (eye drops, eye washes, eye ointments, eye creams, eye masks, etc.) after use, that is, the use period after use is not more than 4 weeks. Therefore, even if it is still within the validity period of the drug, the ophthalmic preparation can usually be used for up to 4 weeks after opening.
Why is there such a provision for ophthalmic preparations?
Although most ophthalmic preparations are supplemented with bacteriostatic agents to inhibit bacterial growth, their bacteriostatic efficacy may vary during storage due to factors such as the composition of the drug or the packaging container. At the same time, once the ophthalmic preparation is opened as a multi-dose preparation, it is easy to be contaminated by microorganisms and tears during storage and use, so that the drug deteriorates or causes pollution, thus causing safety hazards to the eyes. This explains why in the above case, Grandma's use of eye drops that had been turned on for more than a month caused discomfort in her eyes.
Precautions for the use of ophthalmic preparations:
1. The storage conditions of ophthalmic preparations are usually: cool, airtight and normal temperature. Specifically, it should be preserved with reference to the conditions specified in the specification.
2. If the ophthalmic preparation is not opened, the validity period is subject to the drug packaging box; if it is opened, it is usually used for no more than 4 weeks under the correct storage conditions.
Specifically, the instructions should refer to the provisions of the instructions, such as amiodopeptide eye drops, which are valid for 24 months, but the instructions stipulate that they should be used up within 1 week after opening (there are also manufacturers who stipulate 10 days), and patients should be prompted to use it after 1 week (or 10 days) and should not be stored for a long time.
3. For drugs that cannot be used up in a short period of time, it is best to indicate the opening time on the packaging, so that the next time you use it, you can clearly know whether the drug has exceeded the use period.
4. Once it is found that if various types of suspended solids appear in the eye drops, they should be regarded as contaminated and should not be used anymore.
Duration and expiration date of common eye drops after opening:
Drug name
Expiration date
expiration date
Precautions
Reduced glutathione eye drops
3 weeks
24 months
Dissolve the eye drops with the attached special solvent, and store at low temperature (2 ~ 10 ° C) after dissolution.
Glutathione eye drops
4 weeks
Dissolve with the attached special solvent and leave the eye drops, and store in a cool place after dissolution.
Ganciclovir eye drops
Patients with mental illness and neurotoxic symptoms should use with caution, and excessive medication is strictly prohibited.
Piroxine eye drops
20 days
Room temperature storage (1 ~ 30 °C); this product can be due to improper storage methods, resulting in particles are not easy to disperse when shaking, so it is necessary to store upright upwards.
Bing Zhen defy eye drops
15 days
Patients with inflammation in the eyes should be used with caution; after medication, there is itching of the eyes, flushing of the eyelid skin, eye swelling, allergies, or obvious vision loss, and the drug should be stopped immediately and go to the hospital for treatment.
Ice Zhen clear eye drops
Use with caution in people with inflammation in the eye area. After taking the drug, there is sand astringent grinding pain, frequent tearing, or eye oxygen, eyelid skin flushing, eye swelling, or obvious vision loss, should be stopped and go to the hospital for treatment. Symptoms do not resolve after 7 days of medication and should be seen in the hospital.
Chloramphenicol eye drops
12 months
Long-term use in large doses (more than 3 months) can cause optic neuritis or papillitis optica (especially in children). Patients who have been using this product for a long time should have an eye examination in advance, and pay close attention to the patient's visual function and symptoms of optic neuritis, and stop the drug as soon as it appears. Take vitamin C and B vitamins at the same time
Ofloxacin eye drops
All eye drops, do not touch the mouth of the bottle when eye drops; the cap should be tightened after use to avoid contaminating the drug.
Tobramycin eye drops
If the patient receives systemic use of aminoglycoside antibiotics at the same time, the blood concentration of this product and the aminoglycoside antibiotic should be monitored.
Recombinant human epidermal growth factor eye drops
1 week
Before use, the liquid medicine should be carefully checked, such as the liquid is turbid and flocculated, and should not be used.
Calf heproteinization extract eye gel
In order to ensure the biological activity and therapeutic effect of this product, it should be avoided to put this product in a high temperature environment.
Trevoprost eye drops
6 weeks
18 months
Pigmentation of the iris and perioral tissues (eyelids) can be increased and eyelashes color and growth can be increased, and these changes may be permanent. For patients receiving treatment for one eye, there may be differences in color, eyelash length, and density in both eyes.
Emestine fumarate eye drops
1 month
This drug can not be used to treat eye irritation caused by contact lenses; the preservative benzalkonium chloride in this medicine can be absorbed by soft contact lenses.
Carbomer eye drops
36 months
Use of this product may cause transient blurred vision. Patients should be careful when driving or operating machines.
Attached: Correct use of ophthalmic preparations:
Eye drops:
(1) Wash your hands and face, tilt your head slightly back, and look up at your eyes;
(2) Pull down the eyelids, hold the eye drop bottle in your right hand, make the bottle mouth 1 to 2 cm from the eye, avoid the eye drop bottle from touching the eyelashes and eyes, and drip the eye drops into the conjunctival sac;
(4) Gently close your eyes and press the nasolacrimal duct for 1 to 2 min to reduce absorption throughout the body.
Eye ointment:
(2) Gently pull down the eyelid with the index finger, expose the conjunctival sac, apply about 1 cm long eye ointment into the conjunctival sac, and gently close the eyes for about 1 minute. Eye ointments and eye gels melt quickly in the eye, and blinking helps to spread the eye balm.
bibliography:
[1] Chinese Pharmacopoeia 2015 edition
Sun Chao et al.Content analysis of 103 eye drops instructions[J].Chinese Pharmaceutical Affairs,2015,29(11):1216-1218.
[3] Xu Gan,Zhang Shige. Duration of use and drug safety management of non-injectable multi-dose formulations after initiation[J].Journal of Adverse Drug Reactions,2016,18(5):352-355.