CILOXAN Eye drops

គុណភាពព្យាបាល
- Ciprofloxacine គឺជាពួកអង់ទីប៊ីយូទិក ក្នុងក្រុម Fluoro quinolone ដែលមានសកម្មភាពទូលាយប្រឆាំងនិងបាក់តេរី Gram+ និង Gram- ដែលបង្កជម្ងឺនៅក្នុងភ្នែក
- ឱសថនេះសំរាប់ព្យាបាលជម្ងឺភ្នែកបណ្ដាលមកពីមេរោគដូចជា:
・ដំបៅកែវភ្នែក (Corneal ulcers): Pseudomonas aeruginosa, Serratia marcescens, Staphylococus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus (Viridans Group)
・ជម្ងឺភ្នែកក្រហម (Conjunctivitis): Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae។
កំរិត និង របៀបប្រើ
- ដំបៅកែវភ្នែក:
・ថ្ងៃទី1: បន្តក់ 2 តំណក់ ចូលក្នុងភ្នែករៀងរាល់ 15 នាទី សំរាប់រយៈពេល6ម៉ោងដំបូង។ បន្ទាប់មក 2តំណក់ រៀងរាល់30នាទី រយៈពេល1ថ្ងៃ។
・ថ្ងៃទី2: បន្តក់ 2 តំណក់ ចូលក្នុងភ្នែករៀងរាល់ 1 ម៉ោងម្ដង។
・ថ្ងៃទី3: បន្តក់ 2 តំណក់ ចូលក្នុងភ្នែករៀងរាល់ 4 ម៉ោងម្ដង រយៈពេល14ថ្ងៃ។
- ជម្ងឺភ្នែកក្រហម:
・បន្តក់ 1ឬ2 តំណក់ ចូលក្នុងភ្នែក រៀងរាល់ 2ម៉ោង រយៈពេល2ថ្ងៃ
・បន្តក់ 1ឬ2តំណក់ ចូលក្នុងភ្នែក រៀងរាល់ 4ម៉ោងម្ដង រយៈពេល5ថ្ងៃ។

Indications

CILOXAN Ophthalmic Solution is indicated for the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions listed below:

Corneal Ulcers: Pseudomonas aeruginosa

Serratia marcescens ※

Staphylococcus aureus

Staphylococcus epidermidis

Streptococcus pneumoniae

Streptococcus (Viridans Group) ※

Conjunctivitis: Staphylococcus aureus

Staphylococcus epidermidis

Streptococcus pneumoniae

※Efficacy for this organism was studied in fewer than 10 infections.

Dosage

For Corneal ulcer: 1st day, 2 drops into the affected eye every 15 minutes for the first six hours

and then 2 drops every 30 minutes for the remainder of the first day.

2nd day, 2 drops every 1 hour.

3rd-14th day, 2 drops every 4 hours.

Treatment may be continued after 14 days if corneal re-epithelialization has not occurred.

For bacterial Conjunctivitis: 1st-2nd day, 1 or 2 drops instilled into the conjunctival sac(s) every 2 hours while awake

3rd-7th days, 1 or 2 drops every 4 hours while awake.

ហាមប្រើ
- អ្នកជម្ងឺមានប្រវត្តិងាយមានប្រតិកម្មទៅនឹងសារធាតុផ្សំណាមួយនៃឱសថនេះ
- ចំពោះអ្នកមានប្រវត្តិងាយប្រតិកម្មជាមួយពួកquinoloneផ្សេងទៀត។

A history of hypersensitivity to Ciprofloxacin or any other component of the medicine.

A history to hypersensitivity to other quinolones.

ផលរំខានខ្លះៗ
- ដំបៅកែវភ្នែក រលាកកញ្ចក់ភ្នែក អាល្លែកហ្ស៊ី រលាកត្របកភ្នែក ហូរទឹកភ្នែក ខ្លាចពន្លឺថ្ងៃ ចង្អោរ និងការថយចុះនៃគំហើញ។
- ការប្រើឱសថលើសកំរិតអាចអោយក្រហាយភ្នែក ដោយចេញទឹកភ្នែកក្ដៅ
- ការប្រើឱសថនេះមានប្រតិកម្មខ្លះដូចជា: ត្បៀតសរសៃឈាមបេះដូង(Cardiovascular collapse) បាត់បង់ស្មារតី(Loss of consciousness) ឈឺចាប់ផ្សេងៗ(Tingling) ហើមបំពង់កឬហើមមុខ(Pharyngeal or facial edema) ថប់ដង្ហើម(Dyspnea) កន្ទាលត្រអាក(Urticaria) រមាស់(Itching)
- ក្នុងករណីមានរោគសញ្ញាដូចខាងលើ ត្រូវបញ្ជូនអ្នកជម្ងឺទៅមន្ទីរពេទ្យជាបន្ទាន់
- ការប្រើរយៈពេលយូរអាចកើតមានពពួកផ្សិត(Fungi) និង មេរោគផ្សេងៗទៀត
- បញ្ឈប់ការប្រើឱសថនេះនៅពេលកើតមានប្រតិកម្ម ក្រហមស្បែក ឬសញ្ញាប្រតិកម្មផ្សេងទៀត។

17% of patients: local burning or discomfort,

less than 10% of patients: lid margin crusting, crystals/scales, foreign body sensation, itching, conjunctival hyperemia, bad taste following instillation

less than 1% of patients: corneal attaining, keratopathy/keratitis, allergic reactions, lid edema, tearing, photophobia, corneal infiltrates, nausea, decreased vision.

Specific drug interaction studies have not been conducted with ophthalmic ciprofloxacin. However, the systemic administration of some quinolones has been shown to elevate plasma concentrations of theophylline, interfere with the metabolism of caffeine, enhance the effects of the oral anticoagulant, warfarin, and its derivatives and have been associated with transient elevations in serum creatinine in patients receiving cyclosporine concomitantly.

Reproduction studies have been performed in rats and mice at doses up to 6 times the usual daily human oral dose and have revealed no evidence of impaired fertility or harm to the fetus due to ciprofloxacin. In rabbits, as with most antimicrobial agents, ciprofloxacin (30 and 100mg/kg orally) produced gastrointestinal disturbances resulting in maternal weight loss and an increased incidence of abortion. No teratogenicity was observed at either dose. After intravenous administration at doses up to 20mg/kg, no maternal toxicity was produced and no embryotoxicity or teratogenicity was observed. There are no adequate and well controlled studies in pregnant women.

CILOXAN Ophthalmic Solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing Mother: It is not known whether topically applied ciprofloxacin is excreted in human milk. However, it is known that orally administered ciprofloxacin is excreted in the milk of lactating rats, and oral ciprofloxacin has been reported in human breast milk after a single 500mg dose. Caution should be exercised when CILOXAN Ophthalmic Solution is administered to a nursing mother.

ការប្រុងប្រយ័ត្ន
- ឱសថនេះប្រើសំរាប់បន្តក់ភ្នែកតែប៉ុណ្ណោះ
- ហាមចាក់ចូលក្នុងភ្នែក
- ការប្រើឱសថនេះ ជួនកាលបណ្ដាលអោយមានគ្រោះថ្នាក់ធ្ងន់ធ្ងរ (anaphylactic) ឬស្លាប់
- យក Contact lenses ចេញមុនពេលប្រើឱសថនេះ
- មិនត្រូវអោយចុងដបប៉ះលើផ្ទៃភ្នែក ដើម្បីជៀសវាងការឆ្លងមេរោគ
- មិនត្រូវប្រើឱសថនេះក្រោយបើកប្រើ1ខែ។

Precautions

General: Prolonged use of ciprofloxacin may result in overgrowth of non-susceptible organisms, including fungi. If superinfection occurs, appropriate therapy should be initiated. Whenever clinical judgment dictates, the patient should be examined with the aid of magnification, such as slit lamp biomicroscopy and, where appropriate, fluorescein staining.

Ciprofloxacin should be discontinued at the first appearance of a skin rash or any other sign of hypersensitivity reaction.

In clinical studies of patients with bacterial corneal ulcer, a white crystalline precipitate located in the superficial portion of the corneal defect was observed in 35 (16.6%) of 210 patients. The onset of the precipitate was within 24 hours to 7 days after starting therapy. In one patient, the precipitate was immediately irrigated out upon its appearance. In 17 patients, resolution of the precipitate was seen in 1 to 8 days (seven within the first 24-72 hours); in five patients, resolution was noted in 10-13 days. In nine patients, exact resolution days were unavailable: however, at follow-up examinations, 18-44 days after onset of the event, complete resolution of the precipitate was noted. In three patients, outcome information was unavailable. The precipitate did not preclude continued use of ciprofloxacin, nor did it adversely affect the clinical course of the ulcer or visual outcome.

microbiology

Ciprofloxacin has in vitro activity against a wide range of gram-negative and gram-positive organisms. The bactericidal action of ciprofloxacin results from interference with the enzyme DNA gyrase which is needed for the synthesis of bacterial DNA.