Sulfacetamide and prednisolone are both medications used in the treatment of various eye conditions.

Sulfacetamide is an antibiotic that works by inhibiting the growth of bacteria. It is commonly used to treat bacterial infections of the eye, such as conjunctivitis (pink eye) and blepharitis (eyelid inflammation). Sulfacetamide eye drops are usually applied directly to the affected eye several times a day as prescribed by a healthcare professional.

Prednisolone, on the other hand, is a corticosteroid medication that helps reduce inflammation. It is often used in combination with other drugs to treat inflammatory eye conditions such as uveitis, iritis, and keratitis. Prednisolone eye drops are typically used for short-term treatment and should be used exactly as directed by a doctor, as prolonged use can lead to side effects such as increased eye pressure and cataract formation.

Blephamide (Sulfacetamide and prednisolone) is a combination of a steroid and anti-infective medicine that is used to treat inflammatory ocular conditions.

Blephamide (Sulfacetamide and Prednisolone) Uses:

• Inflammatory ocular conditions:
  • Treatment of
    • steroid-responsive inflammatory ocular conditions (where either a superficial bacterial ocular infection or the risk of bacterial ocular infection exists) of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe;
    • chronic anterior uveitis;
    • corneal injury from chemical, radiation, or thermal burns;
    • penetration of foreign bodies

Blephamide dose in Adult

Blephamide dose in the treatment of Inflammatory ocular conditions:

• Ointment: Apply a small amount, like a half-inch strip, under your lower eyelid, inside the pouch, 3 to 4 times a day, and 1 to 2 times at night.
• Solution: Put 2 drops in your eye every 4 hours during the day.
• Suspension: Use 2 drops every 4 hours during the day and before bed.

Blephamide dose in Children

Blephamide dose in the treatment of Inflammatory ocular conditions:

• Children ≥6 years and Adolescents:
  • Ophthalmic: Refer to adult dosing.

Pregnancy Risk Category: C

• We haven't studied how this combo affects animal pregnancies.
• Taking sulfonamide drugs by mouth during pregnancy can harm the baby by causing kernicterus.
• Check the info on each drug for details.

Sulfacetamide and prednisolone use during breastfeeding:

• We're not sure if applying these drugs to the skin around the eyes leads to enough absorption to show up in breast milk.
• Using sulfonamide drugs by mouth while breastfeeding can harm the baby by causing kernicterus, but we don't know how much of these drugs get into breast milk when applied to the eyes.
• Because there's a risk of serious side effects for the baby, the manufacturer suggests deciding whether to stop breastfeeding or stop taking the drug, considering how important the treatment is for the mother.
• Check the info on each drug for more details.

Blephamide dose in kidney disease:

• The manufacturer's instructions don't include any adjustments to the dosage for people with kidney problems.

Blephamide dose in Liver disease:

• The manufacturer's instructions don't mention any changes to the dosage for people with liver issues.

Side effects of Blephamide:

• Also see individual agents.
• Dermatologic:
  • Stevens-Johnson Syndrome
  • Toxic Epidermal Necrolysis
• Hematologic & Oncologic:
  • Agranulocytosis
  • Aplastic Anemia
• Hepatic:
  • Fulminant Hepatic Necrosis
• Hypersensitivity:
  • Hypersensitivity Reaction
• Infection:
  • Secondary Infection (Bacterial
  • Fungal)
• Local:
  • Local Irritation
• Ophthalmic:
  • Accommodation Disturbance
  • Anterior Uveitis (Acute)
  • Blepharoptosis
  • Eye Perforation
  • Glaucoma
  • Increased Intraocular Pressure
  • Mydriasis
  • Optic Nerve Damage (Infrequent)
  • Subcapsular Posterior Cataract
• Miscellaneous:
  • Wound Healing Impairment

Contraindications to Blephamide (Sulfacetamide and prednisolone):

• This medication shouldn't be used if you have a hypersensitivity to sulfacetamide, prednisolone, other sulfonamides or corticosteroids, or any part of the formulation.
• It's also not suitable for treating viral diseases like herpes simplex keratitis, or fungal and mycobacterial infections in the eye.
• Additionally, in Canada, it's contraindicated for untreated purulent ocular infections.
• Although the FDA labels it as contraindicated with other sulfonamide-containing drugs, there's ongoing debate about this.
• For more details, refer to the "Warnings/Precautions" section.

Warnings and Precautions

Blood dyscrasias:

• Severe reactions like agranulocytosis, aplastic anemia, and other blood problems have been reported with sulfonamide drugs, regardless of how they're taken.
• While these reactions are rare, they can be serious and even fatal.
• If you notice any serious signs of a reaction, stop using the medication immediately and seek medical attention.

Dermatologic reactions:

• Serious skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis can occur with sulfonamide drugs, regardless of how they're taken.
• Although these reactions are rare, they can be severe and even fatal.
• If you notice any rash or skin reaction, stop using the medication right away and seek medical help.
• It's essential to act quickly to prevent further complications.

Hepatic necrosis:

• Severe reactions like fulminant hepatic necrosis, a form of liver damage, have been reported with sulfonamide drugs, regardless of how they're taken.
• While these reactions are rare, they can be serious and even fatal.
• If you notice any serious signs of a reaction, stop using the medication immediately and seek medical attention.
• Early intervention is crucial for preventing further harm.

Hypersensitivity reactions:

• Hypersensitivity reactions, like skin rashes or other serious reactions, can happen with this medication.
• If you experience any signs of a hypersensitivity reaction, stop using the medication immediately.
• It's also important to note that cross-sensitivity among corticosteroids, which means being sensitive to more than one corticosteroid, can occur.

Infection:

• Using corticosteroids for a long time can raise the risk of getting a secondary infection.
• They might also hide signs of a new infection, like fungal ones, or make viral infections last longer or worsen.
• Don't use corticosteroids to treat ocular herpes simplex, and be very careful if you've had it before.
• If you have a persistent corneal ulcer and have been using corticosteroids, there's a chance it could be a fungal infection.

Ocular effects:

• Using steroids for a long time can lead to the formation of cataracts and raise the pressure inside the eye, which can cause problems like ocular hypertension or glaucoma.
• This increased pressure can damage the optic nerve and affect your vision, causing changes in visual acuity and the field of vision.
• Some people, especially those of black ethnicity, might develop acute anterior uveitis while using steroids.
• If you have glaucoma, be cautious because steroids can increase eye pressure further.
• Also, there's a risk of corneal or scleral perforation with topical steroids if you have conditions that make these tissues thin.
• If you use this product for more than 10 days, it's essential to monitor your eye pressure.

Sulfonamide ("sulfa") allergy:

• Traditionally, there were concerns about allergic reactions to compounds containing the sulfonamide structure ("sulfa"), including both antibiotic and nonantibiotic sulfonamides.
• However, recent understanding suggests that cross-reactivity between antibiotic and nonantibiotic sulfonamides is unlikely, especially in terms of allergic reactions involving antibody production (anaphylaxis).
• Nonantibiotic sulfonamides are less likely to cause such reactions.
• Still, some caution is advised, particularly with sulfasalazine, which contains a structure that might cross-react with antibiotic sulfonamides.

Dry eye:

• Be cautious when using this medication in patients with severe dry eye.
• Dry eye can make the treatment less effective or even cause discomfort.
• It's essential to monitor the patient's response closely and consider alternative treatments if necessary.

Sulfacetamide and prednisolone: Drug Interaction

Monitoring parameters:

• Improvement Signs: Look for signs of improvement like reduced redness or less discomfort after 2 days of treatment.
• Secondary Infection: Watch out for any new signs of infection like increased redness, swelling, or discharge.
• Eye Pressure: Check the pressure inside the eye, especially in patients with glaucoma or if using the medication for more than 10 days.
• Lens Examination: Periodically examine the lens for any changes, especially with long-term use of the medication.

How to administer Blephamide (Sulfacetamide and prednisolone)?

• For Topical Ophthalmic Use Only: Use only as directed for the eyes.
• Avoid Contamination: Don't let the container tip touch your eyelids or any other surfaces to prevent contamination.
• Avoid Silver Preparations: Don't use this medication with silver preparations.
• Discontinue if Symptoms Persist: If symptoms don't improve after 2 days, stop using the medication and consult a healthcare provider.
• Prescription Limit: Don't prescribe more than 20 mL or 8 g without re-evaluating the patient.
• Ointment Application: Apply the ointment into the pocket between the eyeball and lower lid. The patient should look downward before closing the eye.
• Solution/Suspension Application: Tilt your head back, put the solution or suspension into the conjunctival sac, and close your eye(s). Gently press on the lacrimal sac for 1 minute after applying. Shake the suspension well before using.

Mechanism of action of Blephamide (Sulfacetamide and prednisolone):

• This medication works by stopping bacteria from growing in your body.
• It does this by blocking a process needed for bacteria to make folic acid, a vitamin they need to survive.
• It also helps reduce inflammation by stopping certain cells from moving to where they're needed, and by stopping leaks in small blood vessels.
• Additionally, it calms down your immune system by making it less active, which can help treat conditions where your immune system is causing problems.

International Brands of Sulfacetamide and prednisolone:

• Blephamide
• Blefamide
• AK Cide Oph
• Dioptimyd
• Blefamide SF
• Blefamide SOP
• Deltamid Ofteno
• Metimyd
• Phenamide-P
• Premid
• Sterilid-V

Sulfacetamide and prednisolone Brand Names in Pakistan:

No Brands Available in Pakistan.