QOTD 29: Which is the Top Ranking Eye Drop for Hay fever?

Spring brings about a higher pollen count, which can lead to susceptible individuals experiencing symptoms of hay fever, such as red, watery and itchy eyes. Which is the most suitable eye drop to use throughout spring for a person who is currently experiencing the symptoms listed above?

Choose from one of the following

Visine Allergy Eye Drops [Naphazoline + Pheniramine]

Livostin Eye Drops [Levocabastine]

Opticrom Eye Drops [Sodium Cromoglycate]

Zaditen Eye Drops [Ketotifen]

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Created by KW

Participant's Submissions

Answer: Zaditen

DEFINITIONS

1. Hay fever: An allergy caused by pollen or dust in which the mucous membranes of the eyes and nose are inflamed, causing running of the nose and watery eyes

2. Antihistamine: Drugs that combat the histamine released during an allergic reaction by blocking the action of the histamine on the tissue

Extra Information

Visine Allergy Eye Drops [Naphazoline + Pheniramine] ^{1, 2}

• Can only be used for up to 5 days only therefore it is not the most suitable option to use throughout the spring season
• Safe to use in children above 12years old
• Avoid use in pregnancy due to lack of data
• Avoid use in breastfeeding due to lack of data

Livostin Eye Drops [Levocabastine]^{3, 4}

• Can be used for the entire spring season; however Zaditen has the added benefit of mast cells stabilisation which makes it the preferred choice
• Safe to use in children above 6 years old
• Avoid use in pregnancy due to lack of data
• Avoid use in breastfeeding due to lack of data

Opticrom Eye Drops [Sodium Cromoglycate]^{5, 6}

• This medicine has a delayed onset of action therefore it is not the preferred choice for a patient who has already started to experience symptoms. Ideally, this medicine should be commenced 2-4 weeks before the onset of the hay fever season
• Safe to use in pregnancy
• Considered safe to use in breastfeeding

Zaditen Eye Drops [Ketotifen]^{7, 8}

• This medicine is the preferred choice due to its dual acting properties (i.e. antihistamine plus mast cell stabilising effects)
• Safe to use in children above 3 years old
• Avoid use in pregnancy due to lack of data
• Avoid use in breastfeeding due to lack of data

In conclusion, Zaditen (Ketotifen) is the best choice for a person who is and will be experiencing red, watery, and itchy eyes due to hay fever throughout the season. In the event that a person is pregnant or breastfeeding, Opticrom (Sodium Cromoglycate) should be considered due to its safety rating over the other medicines.

References

1. Australian Medicines Handbook [Internet]. Adelaide SA: Australian Medicines Handbook; [updated 2017; cited 2017 Sept 11]. Available from: https://amhonline.amh.net.au/chapters/chap-11/allergic-inflammatory-conditions/vasoconstrictors-eye/naphazoline?menu=vertical
2. eMims Cloud. Medicines Information [Internet]. Mims Australia; [updated September 2017; cited 11 September 2017]. Available from: http://www.emims.com.au/Australia/drug/info/Visine%20Allergy%20with%20Antihistamine/Visine%20Allergy%20with%20Antihistamine?type=full
3. Australian Medicines Handbook [Internet]. Adelaide SA: Australian Medicines Handbook; [updated 2017; cited 2017 Sept 11]. Available from: https://amhonline.amh.net.au/chapters/chap-11/allergic-inflammatory-conditions/antihistamines-eye/levocabastine-eye?menu=vertical
4. eMims Cloud. Medicines Information [Internet]. Mims Australia; [updated September 2017; cited 11 September 2017]. Available from: http://www.emims.com.au/Australia/drug/info/Livostin%20Eye%20Drops/Livostin%20Eye%20Drops?type=full
5. Australian Medicines Handbook [Internet]. Adelaide SA: Australian Medicines Handbook; [updated 2017; cited 2017 Sept 11]. Available from: https://amhonline.amh.net.au/chapters/chap-11/allergic-inflammatory-conditions/mast-cell-stabilisers/cromoglycate-eye?menu=vertical
6. eMims Cloud. Medicines Information [Internet]. Mims Australia; [updated September 2017; cited 11 September 2017]. Available from: http://www.emims.com.au/Australia/drug/info/Opticrom/Opticrom?type=brief
7. Australian Medicines Handbook [Internet]. Adelaide SA: Australian Medicines Handbook; [updated 2017; cited 2017 Sept 11]. Available from: https://amhonline.amh.net.au/chapters/chap-11/allergic-inflammatory-conditions/antihistamines-eye/ketotifen?menu=vertical
8. eMims Cloud. Medicines Information [Internet]. Mims Australia; [updated September 2017; cited 11 September 2017]. Available from: http://www.emims.com.au/Australia/drug/info/Zaditen/Zaditen?type=full

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