ACULAR

Acular is the brand name of a generic drug called Ketorolac Tromethamine. It is a prescription ophthalmic solution that FDA approved in 2003 to temporarily relieve itchy eyes caused by seasonal allergies. This medication is even given by an ophthalmic surgeon to reduce pain, swelling, and stinging or burning in patients who have undergone corneal refractive surgery or cataract surgery.

Acular eye drop contains 0.5% Ketorolac Tromethamine as its active ingredient. Ketorolac Tromethamine is a white to off-white crystalline substance that is soluble in water. Its chemical name is (±)-5-Benzoyl-2, 3-dihydro-1H pyrrolizine-1-carboxylic acid compound with 2-amino-2-(hydroxymethyl)-1,3-propanediol (1:1). Ketorolac tromethamine functions by inhibiting prostaglandin production. These compounds contribute to inflammation, pain, and swelling. In response to injury or certain conditions, the body produces these substances, which can cause blood vessels to dilate and increase blood flow to the affected area. Prostaglandins can contribute to inflammation and pain in the eye.

By inhibiting prostaglandin production, ketorolac tromethamine reduces inflammation and alleviates eye pain. This is accomplished by inhibiting the enzyme cyclooxygenase (COX), which is responsible for the synthesis of prostaglandins. By inhibiting COX, ketorolac tromethamine reduces the production of prostaglandins, thereby alleviating inflammation and its associated symptoms.

Each mL of Acular eye drop also contains inactive ingredients: octoxynol 40; edetate disodium 0.1%; sodium chloride; purified water; sodium hydroxide and/or hydrochloric acid to adjust the pH and a preservative: benzalkonium chloride.

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Acular Eye Drop comes under the class of ophthalmic non-steroidal anti-inflammatory drug (NSAID).

Nonsteroidal anti-inflammatory drugs are a class of medications that inhibit the production of prostaglandins, which are involved in inflammation, pain, and fever. NSAIDs are widely used to alleviate pain, reduce inflammation, and decrease fever in various parts of the body.

Acular Eye Drop, is formulated specifically for ophthalmic use and is intended for direct application to the eye. Ophthalmic NSAIDs are used to treat inflammatory and painful eye conditions, such as postoperative inflammation following eye surgery and seasonal allergic conjunctivitis. This may involve reducing the eye's redness, swelling, and discomfort.

• Acular Eye drop comes in a 10mL size bottle that contains 5mL of ketorolac tromethamine ophthalmic solution.
• This means the Acular ophthalmic solution is supplied only in strength 0.5% (5mg/mL).

• Seasonal allergic conjunctivitis: It is a part of hay fever, an inflammatory response to seasonal allergens like pet dander, pollen, and other airborne allergens landing on the conjunctiva.
• Cataract surgery: Cataract is a medical condition wherein the natural eye lens gets cloudy. Its surgery involves the replacement of the cloudy lens with an artificial clear lens.
• Corneal refractive surgery: It is a laser eye surgery that helps improve a patient’s vision by changing the cornea shape and how light gets reflected to the retina of the eye.

• The recommended dosage of Acular Eye drops for seasonal allergic conjunctivitis is one drop (0.25mg/mL) to the affected eyes 2-4 times daily for 2 to 4 weeks
• If using after cataract extraction, start applying after 24 hours of the surgery and continue using it for an initial 2 weeks post-operation
• For corneal refractive surgery, the suggested dosage is 4 times a day for up to 4 days after surgery
• To apply Acular Eye drop go as per directions on the product label and carefully follow the dosing instructions of the eye doctor. Do not use it on contact lenses.

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• The route of administration for the Acular Eye drop is the external eye.
• The patients instill this ophthalmic solution into the pocket formed by gently bringing down the lower eyelid and keeping their eyes closed after its application.
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Common side effects are:

• Watery eyes
• Blurred vision
• Slight headache
• Puffy or swollen eyelids
• Mild eye pain, redness, or transient ocular stinging/ burning
• Itchy eyes for 1-2 minutes after application.

Some of the serious side effects that require immediate medical attention include:

• Ocular pain, irritation, inflammation, or redness
• A non-healing wound
• Iritis
• Conjunctival hyperemia
• Changes in vision; increased sensitivity of eyes to light
• Severe stinging, burning, or itching of the eyes
• Superficial ocular infection or superficial punctate keratitis
• Drainage or crusting from the eyes
• Bleeding inside the eyes
• Corneal erosion, perforation, thinning, or ulcers (white patches on the cornea of the eye)
• Dry eyes
• Corneal epithelial degeneration
• Allergic reactions.

• Acular eye drops may interact with other drugs such as blood thinners.
• Therefore, the patients must use Acular eye drop only after telling their doctor about their current intake of medications and supplements and taking their consent for using Acular eye drops with other drugs.

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Acular Eye Drop is not indicated for:

• People suffering from hypersensitivity to Acetylsalicylic acid (ASA), NSAID, ingredients present in the formulation of Acular drug, or any other substances like preservatives, food, or dyes.
• Individuals suffering from medical conditions like arthritis, glaucoma, peptic ulcer, cornea defects, a bleeding or blood clotting disorder, diabetes, dry eye syndrome, or a condition that requires the use of blood thinners for treatment.
• Small children without medical advice
• Pregnant women after 6 months of their pregnancy or those intended to become pregnant
• Breastfeeding women.

Patients must take the following precautions while using Acular Eye drops:

• They must take out their contact lenses before applying the Acular eye drop.
• They must inform their doctors about their medical conditions, allergies, and their use of medications/supplements before taking Acular Eye drops to avoid potential risks and side effects.
• They must go exactly according to the directions given in the product leaflet for use and whatever their doctor prescribes.
• They must use one bottle of Acular Eye drop for one eye and not the same one for both eyes or share their bottles with others.
• They must not let the dispensing tip of the eye drop bottle get contaminated to avoid ocular infections.
• They must stop the product use only after talking to the doctor.
• They must check the expiry date of the product and its sealing or packaging before use.
• They must avoid alcohol consumption while taking Acular eye drops.

• Keep the Acular Eye drop bottle tightly closed after use.
• When not in use at a controlled room temperature, a cool place where the temperature is around 15-25℃.
• Store this ophthalmic solution away from direct light, heat, and moisture and out of reach of small children.
• Do not freeze it.

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