India has experienced an exponential increase in the number of cataract surgeries. An estimated 0.5 million cataract surgeries were done in 1981–1982; this increased to 4.8 million in 2006 with 90% intraocular lens acceptance. Inflammation has always been accepted as a natural consequence of the cataract surgical procedures and also these procedures are associated with a risk of infection. These consequences are generally treated with anti-inflammatory (steroids) and anti-infective eye drops. But the adverse consequences associated with long term use of steroids and the resistance and efficacy issues associated with the use of older generation anti-infectives warrants the need for a combination wherein Power Will Breed Safety .

MOXICIP KT contains Moxifloxacin, a genetically smart, broad spectrum fluoroquinolone and Ketorolac a potent anti-inflammatory and analgesic non steroidal anti inflammatory. The combination of these drugs has positive therapeutic effect on postoperative inflammation and prevention of postoperative infection following cataract surgery. Also the presence of an anti-inflammatory and antibiotic agent in a single ophthalmic product overcomes any potential 'washout effect' that may be seen when separate medications are used. In addition, the combination also leads to better compliance, patient comfort and safety. The reduced number of administrations with this combination may be of particular benefit for elderly patients, who make up the majority of cataract surgery cases.

MOXICIP KT contains Moxifloxacin 0.5% (anti-infective) and Ketorolac 0.5% (anti-inflammatory non steroidal). It is the World's first antibiotic and NSAID combination to be preservative free and with HEC (Hydroxyethyl cellulose). HEC is a polymer which acts as a viscosity enhancer improving the retention time of the drug.

INDICATIONS
For NSAID-responsive inflammatory ocular conditions for which a NSAID is indicated and where bacterial infection or a risk of bacterial ocular infection exists.

The use of a combination drug with an anti- infective component is indicated where the risk of superficial ocular infection is high or where there is an expectation that potentially dangerous numbers of bacteria will be present in the eye.

DOSAGE AND ADMINISTRATION
One drop in affected eye three times a day

MOXICIP KT: Highlights

• First a Combination of
  • Moxifloxacin: A broad spectrum, potent, 8 methoxy fluoroquinolone.
  • Ketorolac: A potent anti inflammatory and analgesic agent
• A combination with HEC advantage which increases the drug retention time
• A combination with no preservative which results in No corneal toxicity
• A combination which can be used for wide array of indications
• A combination which will provide Patient compliance and Long term usage.

December 2010

Inflammation is the body's protective response to a stimulus it recognizes as offensive. While inflammation is protective for the body as a whole, the inflammatory processes can cause scarring and damage to the surrounding healthy tissue. Corticosteroids are used to preserve the normal structure of the tissues. They were developed in the 1940s, and till date remain the most potent agents for managing inflammation. Fluorometholone is one such steroid used for the management of inflammatory and allergic conditions of the eye.

Earlier fluorometholone was available as an alcohol derivative but now even the acetate derivative is available. The derivatives of steroid base (acetate, alcohol and phosphate) influence the bioavailability i.e. they determine the ability of steroid to penetrate the anterior chamber. Acetate and Alcohol derivatives are soluble in hydrophobic media whereas phosphate derivative is soluble in hydrophilic media. In the normal eye, an acetate derivative penetrates the best through the cornea, followed by alcohols, and then phosphates.

The derivatives of steroid base (acetate, alcohol and phosphate) also influence the bioactivity of that steroid so accordingly fluorometholone acetate shows superior anti inflammatory activity in the cornea than fluorometholone alcohol.

FLOSOFT contains Fluorometholone acetate 0.1%. It is the World's first formulation with SOC (Stabilized Oxychlorocomplex) as the preservative. SOC is introduced as an ophthalmic preservative in 1996. Once it enters the eye, it breaks into water and salt i.e. sodium and potassium ions (NaCl), these components are already found in natural tears. Also it has no effect on mammalian cells. Hence it is more comfortable than other preservatives (Benzalkonium chloride).

INDICATIONS
FLOSOFT (fluorometholone acetate ophthalmic suspension) is indicated for use in the treatment of steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the eye.

DOSAGE AND ADMINISTRATION
Shake Well Before Using. One to two drops instilled into the conjunctival sac(s) four times daily. During the initial 24 to 48 hours the dosage may be safely increased to two drops every two hours. If no improvement after two weeks, consult physician. Care should be taken not to discontinue therapy prematurely.

FLOSOFT: Highlights

1. World's first formulation of Fluorometholone acetate with SOC as a preservative
2. Particle Size between 1-3 µ: Uniform Particle distribution and No agglomeration
3. As effective as Prednisolone and Dexamethasone in reducing corneal inflammation
4. Shows superior anti inflammatory effect in the cornea as compared to Fluorometholone alcohol
5. Fluorometholone acetate has low propensity to elevate IOP, therefore
   • Can be given to old age patients suffering from glaucoma
   • Can be given to Steroid responders
   • Can also be given in chronic therapy, requiring longer period of time

September 2010

Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface.

A number of anti-inflammatory agents have been evaluated for treatment of patients with dry eye, including cyclosporine-A, pimecrolimus, tacrolimus, and corticosteroids.

Cyclosporine may represent the first product for dry eye that actually treats the cause and not the symptoms of dry eye.

To improve delivery of cyclosporine to ocular tissues, a microemulsion formulation in castor oil is developed that produces sustained cyclosporine concentrations sufficient for immunomodulation .

IMUDROPS : Technology features

• Unique micro emulsion technology provides cyclosporine particle size of less than 1 micron
• Better, faster absorption and penetration
• Negligible local irritation, burning and stinging reaction

Topical cyclosporine emulsion has also been investigated for the treatment of other ocular surface disorders that may have an immune – based inflammatory component. In these trials , cyclosporine 0.05% ophthalmic emulsion has shown efficacy for management of posterior blepharitis , ocular rosacea , post-L ASIK dry eye , contact lens intolerance , atopic keratoconjunctivitis, graft versus host disease and herpetic stromal keratitis . As these disorders are often refractory to another available treatments , ophthalmic cyclosporine is a welcome non toxic adjunct or replacement to potentially toxic topical or systemic immunosuppressive therapies.

Cyclosporine ( IMUDROPS) Key HIGHLIGHTS

• Potent immunomodulator that acts selectively and locally
• US FDA approved treatment for KCS
• Significant breakthrough in the management of dry eyes
• Immunomodulatory, lacrimogenic and mucin enhancing property
• Restores the body's ability to produce natural healthy tears
• Stops the progression of dry eye disease
• Significant decrease in the artificial tears use

IMUDROPS : Indications and Usage
To increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca.

IMUDROPS : Dosage and Administration

• Invert the unit dose vial a few times to obtain a uniform, microemulsion before using.
• Instill one drop of Imudrop ophthalmic microemulsion twice a day in each eye approximately 12 hrs apart.
• Imudrops can be used concomitantly with artificial tears, allowing a 15 minute interval between products.
• Discard vial immediately after use.

September 2010