Emadine
Classes
Ocular Anti-Allergics, Antihistamines
Administration
Emedastine is administered topically to the eye.
Wash hands before and after use. Tilt the head back slightly and pull the lower eyelid down with the index finger. Instill the prescribed number of drops into the conjunctival sac and gently close eyes for 1—2 minutes. Do not blink.
Care should be taken to avoid contamination. Do not touch the tip of the dropper to the eye, fingertips, or other surface.
Patients should wait at least ten minutes after instilling the ophthalmic solution before inserting contact lenses.
Do not share ophthalmic drops between patients.
Adverse Reactions
keratitis / Delayed / 0-5.0
corneal deposits / Delayed / 0-5.0
hyperemia / Delayed / 0-5.0
blurred vision / Early / 0-5.0
headache / Early / 11.0-11.0
dysgeusia / Early / 0-5.0
sinusitis / Delayed / 0-5.0
lacrimation / Early / 0-5.0
rhinitis / Early / 0-5.0
foreign body sensation / Rapid / 0-5.0
pruritus / Rapid / 0-5.0
xerophthalmia / Early / 0-5.0
ocular irritation / Rapid / 0-5.0
asthenia / Delayed / 0-5.0
Common Brand Names
Emadine
Dea Class
Rx
Description
Ophthalmic H1-blocker for allergic conjunctivitis. Not intended to treat contact lens related irritation.
Dosage And Indications
1 drop in the affected eye(s) up to 4 times per day.
Dosing Considerations
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.
Renal ImpairmentSpecific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
Drug Interactions
There are no drug interactions associated with Emedastine products.
How Supplied
Emadine Ophthalmic Sol: 0.05%
Maximum Dosage
4 drops/day ophthalmic solution in each affected eye.
Elderly4 drops/day ophthalmic solution in each affected eye.
Adolescents4 drops/day ophthalmic solution each affected eye.
Children >= 3 years: 4 drops/day ophthalmic solution in each affected eye.
< 3 years: Safety and efficacy have not been established.
Mechanism Of Action
Emedastine is a relatively selective antagonist at H1-receptors. Following topical ocular administration, emedastine blocks H1-receptors and inhibits histamine-stimulated vascular permeability in the conjunctiva. As a result, emedastine relieves the ocular pruritus associated with allergic conjunctivitis. The drug appears to exert no effects on adrenergic, dopaminergic, or serotonergic receptors.
Pharmacokinetics
Emedastine is administered topically to the eye. In oral administration studies of emedastine, it was shown that approximately 44% of the oral dose is excreted in the urine over 24 hours with only 3.6% of the dose excreted as parent drug. Two primary metabolites, 5- and 6-hydroxyemedastine, are excreted in the urine as both free and conjugated forms. The 5'-oxoanalogs of 5- and 6-hydroxyemedastine and the N-oxide are also formed as minor metabolites. The plasma elimination half-life is approximately 3—4 hours.
Other Route(s)Ophthalmic Route
Following ocular administration of emedastine, there appears to be low systemic exposure; plasma concentrations were generally below the level of detection of the assay (< 0.3 ng/mL).
Pregnancy And Lactation
Emedastine is classified as FDA pregnancy risk category B. There are no adequate and well-controlled studies in pregnant women, and its ability to cause fetal harm or affect reproductive capacity is unknown. Animal studies have failed to revealed any teratogenic effects at concentrations 15,000-times the maximum recommended ocular human concentration. Because animal studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Data are limited regarding use of emedastine during breast-feeding, and its excretion into human milk is unknown. The manufacturer advises caution when administering to lactating mothers; however, exposure of a nursing infant is considered unlikely because systemic absorption is generally below detectable limits (< 0.3 ng/ml) when administered via the ophthalmic route. To minimize the amount of drug that may reach systemic circulation and breast milk, instruct the patient to apply pressure over the tear duct by the corner of the eye for 1 minute after each administration. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, health care providers are encouraged to report the adverse effect to the FDA.