The process of preparing fortified eye drops is not difficult. One needs to take sterile syringes and mix dry powder or solution. Depending on the concentration required, the preparation will use different variations each time. If a patient is suffering from a severe ocular infection, fortified antibiotic eye drops are essential.
Safety concerns about preparing fortified eye drops
Although compounding of ophthalmic medication is uncommon, sterile formulations must meet stringent requirements and adherence to the guidelines of the U.S. Pharmacopeia Chapter 797, the final preparation must be manufactured under strict sterile conditions. In order to prepare fortified eye drops, the pharmacist must use aseptic techniques to ensure safety.
We can compound ophthalmic preparations using commercially available antibiotics. A pharmacist or technician should follow the U.S. Pharmacopeia Chapter 797 guidelines to ensure the highest quality and sterility.
Some of the USP797 rules are:
The sterile room should be maintained at an optimum temperature and humidity level for at least 8 hours. The disinfectant should be changed on a regular basis and the clean room must be regularly tested for bacteria, endotoxins, and other contaminants.
Using fortified antibiotic eye drops in clinical practice is a common practice for antibiotics. They are non-marketed concentrations and compositions that contain commercially available antibiotics.
Fortified eye drops storage conditions
We should store the fortified antibiotic eye drops at 2°C – 8°C. Besides the fortified antibiotic eye drops, the containers should be protected from light and UV radiation. It is best to store the fortified antibiotic in a dark, dry place.
Fortified eye drops preservatives
Generally, commercially available antibiotic eye drops are fortified with a preservative. In commercial products, benzalkonium chloride (BAK) is the most common preservative used in ophthalmic preparations. Its broad spectrum of antimicrobial activity makes it suitable for ophthalmic solutions. But some patients may have allergies to these chemicals and require non-preservative ophthalmic solutions.
How to create a fortified eye drop?
Fortified Eye Drop | Materials Needed |
Procedure |
---|---|---|
Fluconazole eye drops 2mg/ml | 1 vial Fluconazole 2mg/ml 1 bottle Tears Naturale eye drops 10CC syringe |
1.Discard Tears Naturale content. 2.Put 10ml of Fluconazole soln. into the empty bottle. 3.Label the bottle properly. |
Fortified Gentamicin 15mg/ml |
1 bottle Gentamicin (0.3%) E.D. 1 amp.Gentamicin 80mg/2ml 2 pieces 3CC syringes |
1. Add the 2 ml of Gentamicin amp.(80mg) to 4 ml of Gentamicin eye drops. 2. Label the bottle properly. |
Fortified Amikacin 20mg/ml |
1 amp.Amikacin 100mg/2ml 1 bottle tears natural E.D. 1 piece 10CC syringe 1 piece 3CC syringe |
1. Discard 12 ml of tears naturalE.D. 2. Add the 2 ml Amikacin to the remaining 3 ml of tears natural E.D. 3. Label the bottle properly |
Fortified Cefuroxime 50mg/ml |
1 vial Cefuroxime 750mg (Zinacef 750mg) 1 amp. water for injection 1 bottle tears natural E.D. 2 pieces 3CC syringe |
1. Dilute Cefuroxime with 2.5 ml sterile water 2. Discard 2.5 ml of teras natural E.D. 3. Add the diluted Cefuroxime to the remaining 12.5 ml tears natural E.D. 4. Label the bottle properly |
Fortified Cefazolin/Ceftazidime 50mg/ml |
1 vial Cefazolin/Ceftazidime 500mg 1 amp water for injection 1 bottle tears natural E.D. 1 piece 10CC syringe 1 piece 3CC syringe |
1. Dilute the antibiotic with 2.5 ml sterile water 2. Discard 7.5 ml of teras natural E.D. 3. Add the diluted antibiotic to the remaining 7.5 ml of tears natural E.D. 4.Label the bottle properly |
Fortified Vancomycin 50mg/ml |
1 vial Vancomycin 0.5 gm 1 amp water for injection 1 bottle teras natural E.D. 1 piece 10CC syringe |
1. Dilute Vancomycin with 10 ml sterile water 2. Discard all the content of tears natural E.D. 3. Put the diluted Vancomycin into the empty bottle of tears natural E.D. 4. Label the bottle properly |
Cyclosporine Eye Drop 10mg/ml |
1 capsule Cyclosporine 100mg 1 bottle teras natural E.D. 1 piece disposable needle |
1. Pick the capsule with sterile needle 2. Mix the content of the capsule with 10 ml tears natural E.D. 3. Label the bottle properly |
Anti-vascularization Treatment |
2 bottle tears natural E.D. 4 vials Kenacort 40mg/ml 2 capsules Doxydar (Tabocine 100mg) |
1. Add 4 ml of Kenacort to 4 ml of tears natural E.D. 2. Add the content of 2 capsule of Doxydar to 10 ml of tears natural E.D. 3. Label the two bottle properly |
EXPIRATION DATE: 24 HOURS AT ROOM TEMPERATURE, 96 HOURS IN REFRIGERATOR.