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Classes

Artificial Tears and Ocular Lubricants
High Dextrans
Ocular Decongestants, Sympathomimetics

Administration
Ophthalmic Administration

For topical ophthalmic application only. Do not ingest internally.
Wash hands well before use.
Remove contact lenses prior to use unless the product specifies that contact lenses may be worn in application (e.g., Clear Eyes CLR).
 
Artificial Tears ophthalmic solutions:
If the patient has other eye drops of any type prescribed along with artificial tears, separate the application of the different eye drops by roughly 5 minutes. This ensures that the eye drops do not interfere with each other. If the patient is administered both eye drops and an eye ointment, use the eye drops 10 minutes before the eye ointment so that the eye ointment does not interfere with the action of the drops.
Tilt the head back slightly and pull the lower eyelid down with the index finger to form a pouch. Squeeze the prescribed number of drops into the pouch and close eyes for 1—2 minutes.
Have the patient close the eye(s) gently for a few moments to allow contact.
Care should be taken to avoid contamination. Do not touch the tip of the dropper to the eye, fingertips, or other surface. Replace cap when not in use.
Use only one open bottle per patient to avoid contamination.
If the solution changes color or becomes cloudy, discontinue use and obtain a new bottle.
 
Artificial Tears ophthalmic ointments:
If the patient is administered both eye drops and an eye ointment, use the eye drops 10 minutes before the eye ointment so that the eye ointment does not interfere with the action of the drops.
Gently pull down the lower lid of the affected eye(s) and apply a small amount of ointment (roughly one-fourth (1/4) of an inch) to the inside of the eyelid.
Have the patient close the eye(s) gently for a few moments to allow contact.
Wipe away any excessive residue with a clean tissue.
Care should be taken to avoid contamination. Do not touch the tip of the tube to the eye, fingertips, or other surface. Replace cap when not in use.
Use only one open tube per patient to avoid contamination.

Adverse Reactions
Moderate

blurred vision / Early / Incidence not known
contact dermatitis / Delayed / Incidence not known

Common Brand Names

Advanced Eye Relief, Akwa Tears, Alcon Tears, Artificial Tears, Bion Tears, Blink Tears, Clear eyes, Clear eyes Advance Dry and Itchy Relief, Clear eyes Outdoor Dry Eye Protection, Eye Lubricant, FreshKote, Gen Teal Moderate to Severe, GenTeal, GenTeal Moderate, GenTeal Tears Mild, GenTeal Tears Severe Dry Eye, Gonak, Goniosoft, Hypo Tears, Isopto Tears, LiquiTears, LubriFresh P.M., Moisture Eyes, Moisture Eyes Preservative Free, Murine, Natural Balance Tears, Nature's Tears, Opti-Free, Refresh, Refresh Celluvisc, Refresh Lacri-Lube, Refresh Liquigel, Soothe Lubricant Dry Eye Therapy, Systane, Systane Balance, Systane Complete, Systane Ultra, Teargen, Tears Naturale Free, Tears Naturale II, TheraTears, Visine Dry Eye Relief, Visine Pure Tears, Visine Tears

Dea Class

OTC, Rx

Description

Lubricant ophthalmic solutions or ointments for the temporary relief of xerophthalmia (dry eyes) or minor ocular irritations. Artificial tears products are of varying formulations; some products are preservative-free.

Dosage And Indications
For the treatment and prevention of dry eye disease. Ophthalmic dosage (eye solution and eye gel) Adults

1 to 2 drops in the affected eye(s) once daily or more as needed.

Infants, Children, and Adolescents

1 to 2 drops in the affected eye(s) once daily or more as needed.

Ophthalmic dosage (eye ointment) Adults

One-fourth inch in the affected eye(s) once daily or more as needed.

Infants, Children, and Adolescents

One-fourth inch in the affected eye(s) once daily or more as needed.

Dosing Considerations
Hepatic Impairment

No dosage adjustments are needed.

Renal Impairment

No dosage adjustments are needed.

Drug Interactions

There are no drug interactions associated with Artificial Tears products.

How Supplied

Advanced Eye Relief/Akwa Tears/Artificial Tears/Clear eyes/Clear eyes Advance Dry and Itchy Relief/Dextran 70, Glycerin, Hypromellose/FreshKote/Glycerin, Hypromellose, Polyethylene Glycol 400/Gonak/Goniosoft/Hypromellose/LiquiTears/Moisture Eyes Preservative Free/Polyvinyl Alcohol/Propylene Glycol/Soothe Lubricant Dry Eye Therapy/Systane Balance/Systane Complete/Teargen/Visine Dry Eye Relief/Visine Maximum Redness Relief/Visine Pure Tears/Visine Tears Ophthalmic Sol: 0.25%, 0.6%, 0.95%, 1.4%, 2.5%, 0.1-0.2-0.3%, 0.2-0.2-1%, 0.3-1%, 0.6-0.6%, 2.7-2%
Akwa Tears/Artificial Tears/Eye Lubricant/Lanolin, Mineral Oil, White Petrolatum Base/LubriFresh P.M./Mineral Oil, White Petrolatum Base/Refresh Lacri-Lube Ophthalmic Ointment: 15-83%, 2-15-83%, 42.5-56.8%
Bion Tears/Blink Tears/Clear eyes/Dextran 70, Hypromellose 2910/GenTeal Moderate/Hypo Tears/Hypromellose/Murine/Refresh/Refresh Celluvisc/Refresh Liquigel/Systane/Systane Ultra/Tears Naturale Forte/TheraTears Ophthalmic Drops: 0.25%, 0.3%, 0.5%, 1%, 0.1-0.2-0.3%, 0.1-0.3%, 0.4-0.3%, 0.5-0.6%, 1-0.2-0.3%, 1-1%, 1.4-0.6%
Carboxymethylcellulose Sodium/Dextran, Hypromellose/Gen Teal Moderate to Severe/GenTeal Tears Severe Dry Eye/Moisture Eyes/Moisture Eyes Preservative Free/Systane/TheraTears Ophthalmic Gel: 0.3%, 1%, 0.1-0.8%, 0.25-0.3%

Maximum Dosage
Adults

No maximum dosage limit applies.

Elderly

No maximum dosage limit applies.

Adolescents

No maximum dosage limit applies.

Children

>= 6 years: No maximum dosage limit applies.
< 6 years: No maximum dosage limit applies; consult health care professional before use.

Mechanism Of Action

The surface active properties of the vehicles found in artificial tears solutions act to stabilize the tear film and increase tear viscosity to prevent tear evaporation and retard tear drainage. Agents like povidone additionally mimic the action of mucin, the inner tear film layer that promotes wetting and adhesion of tears to the ocular surface. The vehicles found in bland lubricant artificial tear ointments also enhance the tear film and additionally have a prolonged duration of action in the eye versus artificial tear solutions.

Pharmacokinetics

Artificial tears solutions and ointments are applied topically to the eye.

Other Route(s)

Ophthalmic Route
Ointments are not systemically absorbed and contain no medicated ingredients. No pharmacokinetic data are available for ophthalmic solutions; it is expected that the formulas act locally and are not systemically absorbed.

Pregnancy And Lactation
Pregnancy

Artificial tears products have not been assigned a specific FDA pregnancy risk category rating. These ophthalmic products are not expected to pose significant problems during pregnancy due to lack of systemic absorption of the active vehicles. As with any drug in pregnancy, use should be determined by medical necessity and only under the direction of a health care provider. Select preservative-free products when possible, and limit use to the lowest dosage and shortest duration feasible to treat the condition.

Artificial tears ophthalmic products are not expected to pose significant problems during breast-feeding due to lack of systemic absorption of the active vehicles. As with any drug in breast-feeding, use should be determined by medical necessity and only under the direction of a health care provider. Select preservative-free products when possible, and limit use to the lowest dosage and shortest duration feasible to treat the condition. To minimize the amount of drug that reaches systemic circulation and breast milk, apply pressure over the tear duct by the corner of the eye for 1 minute after each application.