Epinastine (Ophthalmic)

Overview

Epinastine is manufactured by Allergan. The drug is an ophthalmic solution that is used in the form of eye drops. Epinastine is essentially a type of antihistamine that is used in the eye to help treat and control allergic conjunctivitis. This drug is only to be used for the treatment of allergic conjunctivitis. It is not effect for the treatment of conjunctivitis that is caused by a virus, bacteria or fungal agents. The drug should not be used to treat any type of contact lens irritation. Also, this drug is only for use in the eye. It should not be used in the ear or swallowed.

Allergic reactions are often caused when pollens and irritants cause the histamine receptors to overreact. This is what causes redness in the eyes, watering of the eyes and itching that causes many to rub their eyes which only increase the irritation. Epinastine works to block the reaction of the histamine receptors so that pollens and irritants do not set up a reaction in the eye.

As with most drugs, there are several side effects that are associated with using epinastine. Most of these side effects occur in the eye, and they are usually of mild to moderate severity. Some side effects that are not ophthalmic in nature have also been reported.

Since this drug is used in the eye, those that wear contact lenses will need to take special precautions when using the drug. There is also a protocol that needs to be followed when using epinastine so that the tip of the eye drop bottle does not become contaminated resulting in the introduction of an infective agent into one or both eyes.

Conditions Treated

  • Allergic conjunctivitis
  • Ophthalmic pruritis
  • Non-invective eye redness

Type Of Medication

  • Ophthalmic antihistamine

Side Effects

The most serious side effect associated with the use of epinastine is an allergic reaction to the drug that causes a systemic reaction. This type of reaction is very rare. However, if an allergic reaction is suspected, the patient should discontinue using the drug, and they should notify their physician or healthcare provider immediately.

Most of the side effects reported with the use of epinastine are related to the eye or eyes in which the drug is used. Upwards of 10 percent of the patients who have used the drug report that they have a burning sensation in the eyes when the drops are placed in the eyes. In many cases, the burning sensation is short lived. Often, the drug does not need to be discontinued in these circumstances as the burning sensation often decrease or goes away entirely over the course of the treatment time.

Another common side effect occurring in as many as 10 percent of patients is increased redness in the eye. This is often transitory and does not always cause the drug to be discontinued.

Itching, pain and swelling in and around the eye have also been reported in 1 to 10 percent of patients. Depending on the severity of the side effect, the drug may need to be discontinued.

Folliculitis has also been noticed as a common side effect. This is not a side effect that directly effects the eye. It effects the eyelashes. Itching, redness and pimple looking bumps may occur on or around the eyelashes during the course of using epinastine.

There have been several other side effects noticed in patients using epinastine that are not related to the eye or the surrounding areas. For instance, one of the more common side effects occurring in approximately 10 percent of all patients is an infection. This infection is usually associated with the virus that causes the common cold. However, some patients will develop an upper respiratory infection while they are using the drug. The cause of this type of side effect has of yet to be determined.

In approximately 1 to 3 percent of those using epinastine, headaches have been reported. About the same number of patients have also reported pain in the face that resembles sinusitis while using the product. The same range of patients also reported that they noticed having a runny nose and nasal congestion. Pharyngitis was also noted in about 1 to 3 percent of those using epinastine.

While these are the most commonly reported side effects with epinastine, there have been other side effects reported by those using the drug. Some patients have reported that they experienced body aches and pains resembling those associated with the flu while on the drug. Some patients even reported that they started running a fever while on epinastine.

Less common side effects also include shortness of breath and difficulty breathing. This may be associated with an allergic reaction to the drug itself. At times, the shortness of breath has included tightness in the chest and wheezing that resembles asthma.

A few less common side effects have been reported in the region in and around the throat. Patients have reported voice changes and trouble swallowing while using the drug. Hoarseness and difficulty speaking have been reported. There have been a few reports of swollen glands in the neck in epinastine users.

Dosage

The dosage of epinastine is dependent on the age of the patient using the drug. Patients who are under the age of two need to have their dosage individually determined by their own doctor.

For adults and children who are over the age of two, the normal dosage is one drop of epinastine in each eye twice a day. The patient should remain on epinastine until the pollen season is at an end. For those who have other types of allergic conjunctivitis, the drug may have to be used for an extended period of time. In these cases, the drug should be used until the symptoms have completely abated.

When each dosage of the drug is administered, there are certain precautions that need to be taken. Patients should thoroughly wash their hands before administering the drug. After this, the bottle should be turned upside down and shaken one time only. The patient should open the bottle with the tip pointed down. The patient needs to tilt his/her head back and use one finger to slightly pull down the lower eyelid. The drop should then be administered. The patient should keep the eye closed for about two minutes. After this, the procedure is to be repeated in the other eye.

It is important not to touch the tip of the bottle to the eye when administering the drug. This may cause contamination and later lead to possible infections in the eye.

Interactions

There are no drugs that are known to interact with epinastine. It is important that all patients notify their healthcare providers regarding all prescription and nonprescription drugs that are being used.

Warnings

Patients should notify their healthcare providers if they have had any allergic reactions to antihistamine eye drops in the past. They may have a similar reaction when using epinastine.

Epinastine has not been tested in patients who are under the age of two. The child's doctor will need to determine if the drug is safe for that particular child.

Epinastine is listed as a Pregnancy Category C drug. Extensive testing has not been performed on pregnant women. Women who are pregnant should be cautious when using epinastine.

In animal studies, epinastine was excreted in breast milk. This has not been tested in human mothers, so those who are breastfeeding should take appropriate precaution and consult with their physician.

Contact lens wearers should note that a preservative used in epinastine is absorbed by contact lenses. Contact lenses should be removed before the drug is administered.

Storage

This drug should be stored at room temperature. The cap should always be screwed down tightly.

Summary

Epinastine is an ophthalmic drop that is used to treat allergic conjunctivitis. It does not treat bacterial, viral nor fungal infections. It is for use only in the eye.

The drug is an antihistamine type drug that prevents allergic reactions in the eye to pollen and other irritants. It helps to reduce itching and redness in the eyes.

Most of the side effects associated with the use of epinastine are associated with the eyes. These side effects include a burning sensation in the eye as well as itching, swelling and redness. Some have reported cold type symptoms with the drug as well as upper respiratory infections.

Those using epinastine should allows make sure to keep the tip of the bottle from being contaminated. Do not touch the tip, and do not let the tip touch the eye. Patients should wash their hands before and after administering the drug.