Aflumycin (Prednisolone and gentamicin) is used as eye drops or ointments for the treatment of superficial inflammatory conditions of the eyes. It is a combination of an antibiotic and corticosteroid.

• Prednisolone: This is a corticosteroid medication, which means it works by reducing inflammation and suppressing the immune system. It is commonly used to treat a variety of conditions, including allergic disorders, skin conditions, arthritis, lupus, breathing problems, certain cancers, eye problems, and immune system disorders. Prednisolone is available in various forms, including tablets, oral solution, and topical preparations.
• Gentamicin: This is an antibiotic medication from the aminoglycoside class. It works by inhibiting bacterial protein synthesis, leading to the death of susceptible bacteria. Gentamicin is often used to treat bacterial infections, particularly those caused by Gram-negative bacteria such as E. coli, Klebsiella, and Pseudomonas aeruginosa. It is commonly used to treat infections of the urinary tract, respiratory tract, skin, bones, joints, and bloodstream. Gentamicin is usually administered via injection, although topical formulations are also available for certain conditions.

Prednisolone and gentamicin Use:

• Inflammatory ocular conditions and superficial ocular infections:
  • It is indicated for the treatment of inflammatory conditions of the eyes with mild superficial bacterial infection or where the risk of bacterial infection exists.

Aflumycin (Prednisolone and gentamicin) Dose in Adults

Aflumycin (Prednisolone and gentamicin) Dose in the treatment of Inflammatory conditions and superficial ocular infections: Ophthalmic:

• Ointment: Apply a small amount (about the size of a quarter-inch ribbon) into the inside part of the affected eye(s) 1 to 3 times a day.
• Suspension: Put one drop into the inside part of the affected eye(s) 2 to 4 times a day. In the first day or two, if needed, you can increase the frequency up to one drop every hour.

Important points to remember:

• If your symptoms don't get better after two days of treatment, you should see your doctor again for further evaluation.

These medications are typically prescribed for conditions like eye inflammation and superficial eye infections.

Dose in Children:

Not indicated.

Pregnancy Risk Factor C

• This combination of medications hasn't been specifically studied in pregnant animals, so we don't have clear information about its effects during pregnancy.
• However, each medication on its own has been studied, and they are both classified as Pregnancy Risk Factor C, indicating that there may be potential risks to the fetus but the benefits may outweigh them in certain situations.

Use of prednisolone or gentamicin while breastfeeding

• It's uncertain whether using these medications topically leads to enough absorption to show up in breast milk.
• However, because there's a possibility of serious side effects in nursing infants, the manufacturer suggests deciding whether to stop breastfeeding or stop taking the medication, considering how important the treatment is for the mother.
• See individual agents.

Dose in Kidney disease:

• The manufacturer's labeling does not include specific dosage adjustments for individuals with kidney impairment.
• This means that there are no recommended changes to the dosage of the medication based solely on kidney function.

Dose in Liver disease:

• The manufacturer's labeling does not contain specific dosage adjustments for individuals with liver impairment.
• This means that there are no recommended changes to the dosage of the medication based solely on liver function.

Side effects of Aflumycin (Prednisolone and gentamicin):

• Dermatologic:
  • Contact Dermatitis
  • Skin Rash
• Gastrointestinal:
  • Dysgeusia
• Hypersensitivity:
  • Angioedema
  • Hypersensitivity Reaction
• Ophthalmic:
  • Allergic Conjunctivitis
  • Blurred Vision
  • Burning Sensation Of Eyes
  • Eye Discharge
  • Eye Irritation
  • Eye Pain
  • Foreign Body Sensation Of Eye
  • Increased Lacrimation
  • Ocular Edema
  • Ocular Hyperemia
  • Stinging Of Eyes
  • Superficial Punctate Keratitis
  • Visual Impairment

Contraindications to Aflumycin (Prednisolone and gentamicin):

• This medication should not be used if you have a known hypersensitivity or allergy to gentamicin, prednisolone, other corticosteroids, or any ingredient in the formulation.
• Additionally, it is not suitable for individuals with viral diseases affecting the cornea and conjunctiva, such as epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, or varicella.
• It should also be avoided in cases of mycobacterial or fungal infections of the eye.

Warnings and precautions

Infection

• Steroids can hide or worsen existing eye infections, including herpes simplex.
• Long-term use can make the eye more vulnerable to secondary bacterial or fungal infections due to weakened immune response.

Ocular effects

• Some people may experience eye irritation and small corneal lesions (punctate keratitis).
• Extended steroid use may lead to conditions like glaucoma, optic nerve damage, changes in vision sharpness and range, thinning of the cornea and sclera (potentially causing holes), and the development of cataracts.

Glaucoma:

• If you have glaucoma, be cautious when using this medication.
• Your eye pressure should be checked regularly.

Ocular herpes simplex

• Extreme care is needed when using this medication if you have ocular herpes simplex.
• Doctors might recommend frequent examinations using a slit lamp microscope to monitor your condition closely.

Prednisolone and gentamicin: Drug Interaction

Monitoring Parameters:

Monitor for the response to treatment. If clinical worsening is noted (as may occur in undiagnosed viral keratitis), treatment should be immediately discontinued.

How to administer Aflumycin (Prednisolone and gentamicin)?

Ophthalmic:

• Note: Avoid wearing contact lenses while using this medication.
• Application Tips: Don't let the bottle or tube tip touch your eyelids or any other surface to prevent contamination.

Ointment:

• How to Apply: Put the ointment in the space between your eyeball and lower eyelid.
• Procedure: Look downward before closing your eye after applying the ointment.

Suspension:

• Preparation: Shake the bottle well before use.
• Application: Tilt your head back, put the suspension into the space between your eyeball and eyelid, then close your eye(s).
• After Application: Gently press on the inner corner of your eye (near the nose) for about a minute after applying the suspension.

Mechanism of action of Prednisolone and gentamicin:

Gentamicin:

• Gentamicin works by disrupting bacterial protein synthesis.
• It accomplishes this by binding to the 30S ribosomal subunits in bacteria, causing defects in the bacterial cell membrane.

Prednisolone:

• Prednisolone is effective in reducing inflammation by targeting various processes in the body.
• It works by inhibiting edema (fluid accumulation), leukocyte migration (movement of white blood cells to the site of inflammation), fibrin deposition (clot formation), capillary proliferation and dilation (expansion of blood vessels), collagen deposition (formation of scar tissue), and scar formation.
• This comprehensive action helps to alleviate inflammation and its associated symptoms.

Refer to individual agents (Gentamicin or Prednisolone).

International Brand Names of Prednisolone and gentamicin:

• Pred-G
• Aflumycin
• Inflanegent
• Pharogentone

Prednisolone and gentamicin Eye Drops Brand Names in Pakistan: