Indocollyr eye drops 0.1%, 5 ml

• Inhibition of miosis during eye surgery;

• prevention of inflammatory complications after cataract surgery and in the anterior chamber of the eye;

• reduction of pain in the eye area in the postoperative period after photorefractive keratectomy on the first day after surgery.

The drug is used topically. You should carefully pull down the lower eyelid and, looking up, drop the drug into the conjunctival sac of the affected eye.

To inhibit miosis during surgery on the eyeball - 1 drop 4 times / day on the eve of the operation and 1 drop 4 times within 3 hours immediately before the operation.

For the prevention and treatment of inflammatory complications after cataract surgery and in the anterior chamber of the eye - 1 drop 4-6 times / day, starting 24 hours before the operation and until the symptoms of inflammation disappear completely after it.

To relieve pain (in the eye area) in the postoperative period after photorefractive keratectomy - 1 drop 4 times / day for the first few days.

Indomethacin 1 mg

Excipients: thiomersal, arginine, hydroxypropyl betacyclodextrin, concentrated hydrochloric acid, purified water

• History of bronchial asthma attacks in response to the use of acetylsalicylic acid or other NSAIDs;

• stomach ulcer;

• severe liver failure;

• severe renal failure;

• pregnancy (starting from the 6th month);

• breastfeeding period;

• age up to 18 years (data on efficacy and safety are not available);

• simultaneous use with indirect anticoagulants, other NSAIDs, incl. derivatives of salicylic acid (in doses of 3 g / day and above for adults);

• simultaneous use with diflunisal, heparin, lithium preparations, methotrexate in high doses (from 15 mg / week or more) and ticlopidine;

• hypersensitivity to acetylsalicylic acid (or other salicylates) and / or other NSAIDs;

• hypersensitivity to the active or auxiliary substances of the drug.

With care: patients prone to allergic reactions; with simultaneous use with diuretics, ACE inhibitors, methotrexate (in doses less than 15 mg / week), pentoxifylline, drugs that affect the gastrointestinal mucosa (salts, oxides and hydroxides of magnesium, aluminum and calcium), zidovudine, beta-blockers, cyclosporine, desmopressin, thrombolytics; when implanting intrauterine devices.

pharmachologic effect

NSAIDs, has anti-inflammatory and analgesic effects.

The main mechanism of action of the drug is the inhibition of the synthesis of prostaglandins, which play an important role in the pathogenesis of inflammation and pain.

Pharmacokinetics

There is confirmed evidence that the drug enters the anterior chamber of the eye. With a single instillation, the active substance of the drug is determined in the moisture of the anterior chamber for several hours.

Systemic absorption of indomethacin when applied topically is low.

Side effect

From the side of the organ of vision: rarely - local reactions of hypersensitivity in the form of itching and hyperemia, a feeling of moderate burning and / or temporary loss of clarity of vision immediately after instillation of eye drops, increased photosensitivity, superficial punctate keratitis; very rarely, corneal ulceration, which can be complicated by corneal perforation, especially in patients with damaged cornea or treated with corticosteroids.

Application during pregnancy and lactation

Indocollir can be used during the first 5 months of pregnancy only if the intended benefit to the mother outweighs the potential risk to the fetus. Starting from the 6th month of pregnancy, the use of Indocollir eye drops is contraindicated due to the risk of cardiotoxic effects on the fetus (premature closure of the ductus arteriosus and the development of pulmonary arterial hypertension), as well as a decrease in renal function (up to the development of oligohydramnios).

The use of the drug Indocollir increases the risk of edema in the mother. The use of the drug Indocollir before delivery can cause prolongation of bleeding time in the mother and newborn.

Since NSAIDs, including indomethacin, pass into breast milk, you should stop breastfeeding during treatment with Indocollyr or exclude its use during breastfeeding.

Application for violations of liver function

The use of the drug is contraindicated in severe hepatic insufficiency.

Application for impaired renal function

The use of the drug is contraindicated in severe renal failure.

Application in children

The use of the drug under the age of 18 is contraindicated (data on effectiveness and safety are not available).

special instructions

Indocollir contains thiomersal, which can cause allergic reactions. If signs of individual intolerance appear, the drug should be canceled.

Like other NSAIDs, Indocollir can slow down the healing of the cornea.

In the presence of infection or the threat of its development, adequate antibiotic therapy is prescribed at the same time.

With the combined use of NSAIDs with lithium preparations (as prescribed by a doctor), it is necessary to adjust the dose of the latter before, during and after treatment with NSAIDs, depending on the concentration of lithium in the blood.

NSAIDs can prolong bleeding time during eye surgery, especially in patients with bleeding disorders or receiving anticoagulants. The combined use of the drug Indocollir with indirect anticoagulants, heparin and ticlopidine for medical reasons should be carried out under close medical supervision and laboratory control, incl. bleeding time.

With a combination of the drug Indocollir with methotrexate at a dose of less than 15 mg / week. during the first weeks of joint use, the number of blood cells should be monitored, as well as closely monitoring patients with symptoms of renal failure and elderly patients.

The time between taking the drug Indocollir and any antacid should be at least 2 hours.

When used together with diuretics and ACE inhibitors, it is necessary to monitor renal function and prevent dehydration of the patient's body.

Before using the drug, contact lenses should be removed and reinstalled no earlier than 15 minutes after using the drug.

An interval of 15 minutes should be observed while using Indocollir with other eye drops.

Do not touch the tip of the bottle to any surface to avoid contamination of the bottle and its contents.

The bottle must be closed after each use.

Influence on the ability to drive vehicles and use mechanisms

In some patients, the use of the drug Indocollir may be accompanied by a temporary loss of clarity of visual perception (immediately after instillation of eye drops), therefore, care must be taken when performing potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions (driving, working with moving mechanisms) ...

Overdose

There are currently no reported cases of overdose.

Treatment: in case of a local overdose of the drug, you should rinse your eyes with warm water. In case of suspicion of oral use of the drug, treatment is symptomatic.

Drug interactions

Despite the fact that the systemic absorption of indomethacin when applied topically in the form of eye drops is negligible, the risk of drug interactions with other drugs cannot be completely excluded.

Indirect anticoagulants, other NSAIDs, diflunisal, heparin. It is known that the use of indomethacin in other dosage forms simultaneously with indirect anticoagulants, other NSAIDs at a dose of 3 g / day and higher (including derivatives of salicylic acid, for example, acetylsalicylic acid), diflunisal and heparin increases the risk of gastrointestinal ulcers and bleeding, and in combined with diflunisal up to fatal. In turn, diflunisal can increase the concentration of indomethacin in the blood plasma.

Lithium preparations. Indomethacin can increase the concentration of lithium in the blood to toxic levels, due to a decrease in the excretion of lithium by the kidneys.

Methotrexate (at a dose of 15 mg / week and more). Due to a decrease in the excretion of methotrexate by the kidneys, when used simultaneously with indimentacin and / or other anti-inflammatory drugs, its hematotoxic effect increases. Indomethacin is used with caution with methotrexate (at a dose of less than 15 mg / week) - weekly monitoring of blood counts in the first weeks of combined administration is necessary, as well as monitoring of renal dysfunction, especially in the elderly.

Ticlopidine. Indomethacin enhances the antiplatelet effect of ticlopidine and increases the risk of bleeding.

Indomethacin, when used together with beta-blockers, can weaken their effect.

Indomethacin may increase the nephrotoxic effect of cyclosporine, especially in elderly patients.

NSAIDs can increase the antidiuretic effect of desmopressin.

Caution should be exercised with the simultaneous use of indomethacin with diuretics and ACE inhibitors, since patients with dehydration have a risk of acute renal failure (due to a decrease in glomerular filtration by inhibiting vasodilating prostaglandins after taking NSAIDs) and a decrease in the antihypertensive effect. In such situations, it is necessary to provide the patient with water and monitor kidney function at the beginning of treatment.

Combined use with pentoxifylline - an increased risk of bleeding from the gastrointestinal tract (use under medical supervision and control of the duration of bleeding).

Drugs that affect the gastrointestinal mucosa (salts, oxides and hydroxides of magnesium, aluminum and calcium) reduce the absorption of indomethacin from the gastrointestinal tract; separate administration with antacids is recommended (if possible, an interval of more than 2 hours).

NSAIDs, incl. indomethacin, can lead to an increase in the toxic effect of zidovudine on reticulocytes with a transition to acute anemia 8 days after starting NSAID therapy.

Combined use with thrombolytics - an increased risk of bleeding.

There is an assumption that when using indomethacin, there is a risk of rupture of the implantable intrauterine device.

With the simultaneous use of the drug Indocollir with other eye drops, incl. containing corticosteroids, to eliminate the effect of 'washout' (decrease in concentration), the drugs should be administered at intervals of at least 15 minutes.

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