Nesudil-Plus
Generic Name
Nepafenac + Moxifloxacin Ophthalmic Solution
Manufacturer
Unimed Unihealth Pharma
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nesudil plus 002 eye drop | ৳ 750.00 | N/A |
Description
Overview of the medicine
Nesudil-Plus 0.02 Eye Drop is a combination medication containing Nepafenac and Moxifloxacin, used to treat post-operative ocular inflammation, pain, and bacterial eye infections.
Uses & Indications
Dosage
Adults
Instill one drop into the affected eye(s) 3 times daily, or as directed by a physician. The duration of treatment depends on the severity of the condition.
Elderly
No specific dose adjustment is required for elderly patients.
Renal_impairment
No dosage adjustment is necessary for patients with renal impairment, as systemic absorption from topical ophthalmic application is minimal.
How to Take
For topical ophthalmic use only. Wash hands thoroughly before administration. Tilt your head back, pull down your lower eyelid to form a pocket, and instill one drop into the affected eye(s). Close your eye gently for a few moments. Avoid touching the dropper tip to your eye or any other surface to prevent contamination.
Mechanism of Action
Nepafenac acts as a prodrug which is rapidly converted to Amfenac by ocular hydrolases. Amfenac inhibits prostaglandin synthesis by blocking cyclooxygenase-1 and cyclooxygenase-2 (COX-1 and COX-2) enzymes, thereby reducing inflammation. Moxifloxacin inhibits bacterial DNA gyrase and topoisomerase IV, essential enzymes involved in bacterial DNA replication, transcription, repair, and recombination, leading to bacterial cell death.
Pharmacokinetics
Onset
Anti-inflammatory effects of Nepafenac may begin within hours; antibacterial effects of Moxifloxacin are rapid, usually within hours of initial dosing.
Excretion
Amfenac and Moxifloxacin are primarily eliminated systemically via renal excretion, though systemic absorption from topical ophthalmic application is minimal.
Half life
Amfenac (active metabolite of Nepafenac) has a short half-life in the aqueous humor (approx. 1 hour). Moxifloxacin has a prolonged presence in ocular tissues, leading to sustained antibacterial effects.
Absorption
Nepafenac is well absorbed through the cornea and converted to amfenac. Moxifloxacin penetrates ocular tissues and fluids well after topical administration.
Metabolism
Nepafenac is a prodrug, extensively metabolized to amfenac via hydrolases in ocular tissues. Moxifloxacin is minimally metabolized in the eye.
Side Effects
Contraindications
- Hypersensitivity to Nepafenac, Moxifloxacin, or any component of the formulation.
- Hypersensitivity to other NSAIDs (e.g., aspirin, ibuprofen) or other quinolone antibiotics.
- Patients with a history of recurrent herpes simplex keratitis (for NSAIDs).
Drug Interactions
Topical Ophthalmic Corticosteroids
Concomitant use with topical ophthalmic NSAIDs (Nepafenac) may increase the risk of corneal adverse events in patients with compromised corneas.
Other Topical Ophthalmic Medications
If more than one topical ophthalmic medication is used, they should be administered at least 5 minutes apart.
Storage
Store at room temperature (below 30°C), protected from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
An overdose of Nesudil-Plus 0.02 Eye Drop is unlikely with topical ophthalmic use. If excessive amounts are applied, flush the eye(s) with lukewarm water.
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether topical Nepafenac or Moxifloxacin are excreted in human milk. Exercise caution when administering to a nursing mother. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to Nepafenac, Moxifloxacin, or any component of the formulation.
- Hypersensitivity to other NSAIDs (e.g., aspirin, ibuprofen) or other quinolone antibiotics.
- Patients with a history of recurrent herpes simplex keratitis (for NSAIDs).
Drug Interactions
Topical Ophthalmic Corticosteroids
Concomitant use with topical ophthalmic NSAIDs (Nepafenac) may increase the risk of corneal adverse events in patients with compromised corneas.
Other Topical Ophthalmic Medications
If more than one topical ophthalmic medication is used, they should be administered at least 5 minutes apart.
Storage
Store at room temperature (below 30°C), protected from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
An overdose of Nesudil-Plus 0.02 Eye Drop is unlikely with topical ophthalmic use. If excessive amounts are applied, flush the eye(s) with lukewarm water.
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether topical Nepafenac or Moxifloxacin are excreted in human milk. Exercise caution when administering to a nursing mother. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months unopened; use within 4 weeks after opening.
Availability
Available in pharmacies and hospitals
Approval Status
Approved in Bangladesh
Patent Status
Generic/Off-patent
Clinical Trials
Efficacy and safety data are supported by clinical trials conducted on individual components (Nepafenac and Moxifloxacin) for their respective indications. Combination product trials may also exist to support specific formulations.
Lab Monitoring
- Not routinely required for topical ophthalmic administration.
Doctor Notes
- Advise patients about the importance of completing the full prescribed course of treatment.
- Inform patients about potential temporary blurring of vision and to avoid activities requiring clear vision until resolved.
- Emphasize proper administration technique to prevent contamination and maximize efficacy.
Patient Guidelines
- Remove contact lenses before applying the eye drop and wait at least 15 minutes before reinserting them (for Moxifloxacin, it's generally advised not to wear contact lenses during treatment for bacterial infections).
- Do not discontinue treatment early, even if symptoms improve, to ensure complete eradication of infection and inflammation.
- Avoid touching the dropper tip to any surface to prevent contamination.
Missed Dose Advice
If you miss a dose, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medication may cause temporary blurring of vision. Do not drive or operate machinery until your vision is clear.
Lifestyle Advice
- Avoid rubbing your eyes, especially during treatment.
- Maintain good hand hygiene to prevent further eye irritation or infection.
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Global Brand Names
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