Pharmacological properties
Combinil-Duo solution is used in ophthalmic practice as a local antimicrobial and anti-inflammatory agent. Its therapeutic effect is due to the presence of the fluoroquinolone antibiotic ciprofloxacin and the glucocorticosteroid dexamethasone.
Ciprofloxacin has an antibacterial effect and has a bactericidal effect. The effect of the substance inhibits the enzyme DNA gyrase of bacterial microflora, as a result of which DNA replication is disrupted and the synthesis of bacterial cellular proteins stops. Ciprofloxacin is active against reproducing microorganisms, as well as those in the dormant stage. Its antibacterial effect extends to Esherichia coli, Shigella spp., Salmonella spp., most species of Proteus spp., Morganella morganii, Klebsiella spp., Citrobacter spp., Enterobacter spp., Campylobacter spp., Vibrio spp., Hafnia spp., Haemophilus influenzae, Providencia stuartii, Pasteurella multocida, Gardnerella spp., Pseudomonas spp., Legionella pneumophila, Moraxella catarrhalis, Neisseria spp., Acinetobacter spp., Chlamidia spp., Brucella spp. (Gram-negative bacteria). And also: Staphylococcus spp., St. agalactiae, Streptococcus pyogenes, Corynebacterium diphtheria. The toxicity of the substance is negligible.
Dexamethasone is a synthetic glucocorticosteroid commonly used as an anti-inflammatory and immunosuppressive agent. When applied topically, its therapeutic activity is due to its anti-inflammatory, antiallergic, and antiproliferative properties. It reduces the permeability of capillary walls, local exudation, phagocytic activity, and cellular infiltration. Prevents collagen deposition and fibroblast activity, prevents the formation of scar tissue.
The auxiliary component hydroxypropyl betacyclodextrin contained in Combinil-Duo promotes long-term preservation of active substances on the surface of the eye, which increases the effectiveness of the solution.
Combinil eye drops: instructions for use, analogues
Combinil eye drops are a good anti-inflammatory and antibacterial drug with a wide spectrum of action. Such drops are prescribed for ophthalmological diseases and ear diseases.
The drug is active against many pathogens that cause diseases of the visual and ENT organs. Drops are low toxic.
The medicine quickly enters the tissues of the visual organ and is observed in large quantities in the fluid in the anterior chamber of the eye.
Compound
Combinil is a colorless, almost transparent solution, without a characteristic odor. It is a combination drug. The composition contains two active components - ciprofloxacin and dexamethasone. In addition, the drug also contains other substances - benzalkonium chloride, hydrochloric acid, mannitol and purified water.
Combinil is sold in plastic bottles with a capacity of 5 ml. Each bottle is packaged in individual cardboard packaging, along with instructions for use.
Combinil and Combinil Duo: what is the difference
Combinil and the drug Combinil duo are exactly the same thing. There is no difference between these medications. Since 2016, the manufacturer has changed the name of the drug to Combinil, for simplicity of sound and better perception by customers. The composition has not changed at all. The medicinal solution can be used in the same way to treat eye and ear diseases.
Pharmacodynamics and properties
Combinil is a combined medicinal solution that is used in ophthalmology and in the treatment of certain ENT pathologies. This medicine contains the antibiotic Ciprofloxacin and Dexamethasone.
Ciprofloxacin belongs to the group of broad-spectrum antibiotics. Promotes disruption of DNA synthesis of bacteria, thereby preventing their reproduction. It acts equally on both active microbes and those that are at rest. Active against many different types of bacteria, which most often cause eye diseases.
Dexamethasone effectively eliminates inflammation. This substance, when applied topically, has a powerful antiallergic effect.
Active substances are quickly adsorbed into the tissue of the eye, but the exception is the lens. The highest concentration of the drug is observed after 30 minutes in the fluid of the anterior chamber of the eye.
Instructions for use
The medicinal solution needs to be dripped into the conjunctival sac, 1-2 drops at a time. In the acute period, procedures can be performed every 2 hours. Then the drug is dripped three times a day.
The duration of use in each case is determined by the doctor individually. The average duration of treatment is as follows:
- Bacterial conjunctivitis and blepharitis – 10-14 days.
- Keratitis – treatment can take up to 4 weeks.
- In the postoperative period, to prevent various complications - up to a month.
If the medicinal solution is used for more than 10 days, it is necessary to regularly monitor intraocular pressure.
Use in children and pregnant women
The drug is not prescribed for pregnant women and children. If necessary, the doctor selects safer analogues. It is not known exactly whether the active substances pass into breast milk or not. Therefore, you should not prescribe the medicine to breastfeeding women. If the doctor does not see an alternative treatment, then breastfeeding is stopped during the period of treatment with Combinil.
The appropriateness of prescribing Combinil eye drops in each specific case is determined by the attending physician.
Side effects and overdose
Even when using the drug in therapeutic dosages, side effects often occur. The most commonly observed adverse reactions are:
- Itching and burning in the eyes.
- Redness of the conjunctiva.
- Keratitis, exacerbation of conjunctivitis.
- Feeling of a foreign body in the eyes.
- Swelling of the eyelids and areas around the eyes.
- Slight blurred vision, dry mucous membranes.
- Limitation of visual fields, damage to the optic nerve.
- Secondary infections, often fungal.
- Deterioration of vision.
- Damage to the eyeball, severe thinning of the cornea.
In addition, there may be allergic reactions. More often they appear as pinpoint rashes around the visual organs.
Side effects normally disappear within a few minutes. If they persist for too long, then we can talk about individual intolerance to the drug.
If the drug is used in dosages prescribed by a doctor, then an overdose is practically excluded. If a person drips the drug too often and in large quantities, the following symptoms of overdose may occur:
- Swelling and itching of the eyelids.
- Erythema.
- Profuse lacrimation.
- Blurred vision.
In this case, the eyes should be rinsed thoroughly with running water. If necessary, symptomatic treatment is used. There is no specific antidote.
If the medicinal solution is accidentally swallowed, the victim should be given plenty of water to drink and then induced to vomit. Next, the patient is given adsorbents.
To avoid drug poisoning, all medications should be kept out of the reach of children.
Interaction with other drugs
The risk of interaction between Combinil eye drops and other medications is very small, since the medicine is absorbed into the systemic circulation in small quantities. When Combinil is combined with other antimicrobial agents, synergism is often observed.
The medicinal solution can be prescribed simultaneously with systemic antibiotics.
If the doctor has prescribed several drugs to treat the eyes at once, then between their use it is necessary to take a break of at least 10 minutes. If eye ointment has been prescribed, it is used last.
This is due to the fact that ointments have a viscous structure, form a film on the mucous membrane and make it difficult to absorb medicinal solutions.
If a person regularly takes any medications, he should inform his doctor about this.
Conditions for release from pharmacies and storage
The medicine is dispensed according to a doctor's prescription. The shelf life, provided the packaging is intact, is 3 years. After opening the bottle, the solution can be used for no more than one and a half months.
Store the medicine in a place protected from light, at a temperature no higher than +25 and no lower than +15 degrees. It is best to store the opened bottle in the refrigerator, out of the reach of small children.
When instilling eye drops, it is important not to touch the dropper to your fingers or the mucous membranes of your eyes. After use, screw the bottle tightly. Store the medicine in its original packaging, along with instructions for use.
Directions for use and doses
The standard regimen for using the Combinil-Duo solution involves the conjunctival application of 1-2 drops of the drug every 4 or 6 hours. During the first two days, installations are prescribed every 2 hours.
Duration of treatment:
- Acute bacterial conjunctivitis and blepharitis - course 5 - 14 days.
- Keratitis - course 2 - 4 weeks.
- Prevention of surgical infections - course 5 - 30 days.
When using Combinil-Duo for more than 10 days, monitoring of intraocular pressure is mandatory.
Instructions for use and composition of Combinil Duo ear drops, analogues and differences
Inflammation of the eyes and ears causes a lot of inconvenience. In addition, the eyes and ears may suffer even more, as the disease can worsen and become chronic. You can cope with inflammation and pathogenic lesions of the eyes and ears, according to its instructions for use, with the help of Combinil Duo.
What kind of drug is this?
Combinil is a dual-purpose therapeutic combination medication. The action of the medication is aimed at eliminating inflammation and fighting bacteria.
The medication belongs to the group of local glucocorticosteroids. These are medications obtained synthetically or made from natural raw materials. They are analogues of endorphins - hormones of happiness. This group belongs to a subclass of adrenal hormones - namely glucocorticoids.
These hormones are produced in large quantities when the body is stressed or affected by illness. Hormones mobilize all vital forces.
Thanks to hormones, the body adapts to its new state and copes with stress, blood loss, infections, injuries and other negative external influences.
Medicines in this group are used against inflammation, intoxication, and severe shock. Medicines have an immunosuppressive and desensitizing effect.
Combinil also acts against microbes. The medication is prescribed for the treatment of eye diseases and for complex lesions of the nasal and auditory passages due to rhinitis and colds.
Dosage form and composition
Combinil is produced in the form of ear drops and white eye drops. Externally, the medicine looks like a transparent light solution (a slight shade of light yellowish color is possible). The drug is bottled in transparent or impenetrable plastic bottles. Volume - 5 milliliters. The vessel is packed in a cardboard box.
Composition of the drug:
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- ciprofloxacin hydrochloride (3 milligrams);
- dexamethasone (1 milligram);
- benzalkonium chloride;
- hydroxypropyl betadex;
- sugar alcohol;
- purified water;
- disodium salt;
- hydrogen chloride solution.
Ciprofloxacin is an antibacterial, antimicrobial element. The product acts on the DNA of the microorganism, inhibiting cell enzymes. Under the influence of the substance, the morphological structure of the cell membrane of pathogenic organisms is destroyed, cell growth and division stops. As a result, the bacterium dies.
Dexamethasone is a glucocorticosteroid obtained artificially. It acts as an immunosuppressant.
Effect of the substance:
- reduces inflammation;
- softens the manifestations of allergies;
- prevents cell proliferation.
The remaining components of Combinil are auxiliary. The difference between Combinil and Combinil-Duo is only in the name. The active substances are contained in equal proportions, the proportion and list of auxiliary elements are the same for both medications. The effectiveness and method of use of the drugs are identical. Combinil is produced in India.
The effect of the medication is not the same in time for the eyes and ears. When instilled into the eyes, Combinil begins to act almost immediately, reaching a maximum after half an hour. In order for Combinil to work after getting into the ear, you will have to wait about 3 hours. Such differences are due to the fact that in a humid environment, droplet penetration occurs faster.
Indications for use
Indications in ophthalmology for the use of Combinil are acute inflammatory pathologies of the eye, lacrimal and motor apparatus, provoked by infection with harmful microorganisms, as well as the prevention of these diseases. List of diseases for which the medication is effective:
- conjunctivitis in acute and moderate form;
- anterior uveitis;
- keratitis;
- blepharitis, as well as other inflammatory pathologies of the eyelid;
- preventive treatment of injuries and wounds to avoid the spread of infection;
- therapy after surgery on the eyes in general and ocular appendages in particular.
List of otorhinolaryngological diseases that the medication will help cope with:
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- acute developed external otitis;
- acute ear otitis media, complicated by overgrowth of the damaged area and purulent, bloody or watery discharge from the ear cavity (if a shunt is installed in the eardrum);
- acute or chronic otitis media with complex eardrum bypass.
Combinil is also prescribed as a means of prevention. The goal in this case is to prevent the disease from spreading to other tissues.
Contraindications
List of diseases when the use of medication is prohibited:
- with eye tuberculosis;
- for fungal eye infections;
- when the eardrum ruptures;
- in case of infection of the ear canal caused by viruses;
- at the initial stage of cataract;
- with severe glaucoma;
- for chronic eye and ear diseases;
- with high sensitivity to the constituent elements of the drug.
Combinil is prohibited for use by women who are preparing to become mothers, during the period of continued breastfeeding, and also before reaching adulthood.
Dosage and available methods of safe use
The instructions for use of Combinil provide the following information: for extensive infectious lesions of the eye, lacrimal and musculoskeletal system, complicated by an acute inflammatory process, you need to drop at least 1-2 drops into the area of the conjunctival sac. During the procedure, you should try not to touch the eye surface with the end of the pipette. The first two days (in acute inflammation) the intervals between procedures are 1-2 hours. Next breaks are from 4 to 6 hours. Duration of the therapeutic course for eye diseases:
- acute bacterial conjunctivitis, blepharitis - from 5 days to 2 weeks;
- keratitis - from 2 to 4 weeks;
- prevention of inflammation after surgery or after injuries have occurred - from 5 to 30 days.
If Combinil is used for more than 10 days, control of intraocular pressure is required, otherwise complications are possible. Immunity also decreases, which leads to relapse of the disease.
Attention! You can't put eye drops in your eyes before you get behind the wheel! Possible blurred vision!
For ear pathologies, Combinil should be instilled externally, into the ear canal of the affected ear. Dosage of Combinil - 4 drops per single dose.
Before the procedure, the ear and ear canal should be washed and dried thoroughly. Warm the bottle in your palms to room temperature.
In order for Combinil to completely penetrate the ear canal, you should slightly tilt your head to one side, towards the opposite shoulder, so that the auricle takes a close to horizontal position. You can lie down. After instilling Combinil, you need to hold this position for 2 minutes. This time is enough for Combinil to completely penetrate the ear canal.
The drops should be used twice a day. The course of treatment is 1 week. For prophylactic purposes, Combinil is administered in the usual dosage 2-3 hours before surgery. After half an hour, the procedure is repeated.
Side effects and overdose
The following adverse reactions to Combinil are possible on the part of the visual organs:
- compactions in the cornea;
- burning, redness of the eyeball, itching;
- feeling of an unpleasant presence of a foreign object in the eye;
- keratitis;
- conjunctivitis;
- periorbital edema;
- photophobia;
- fog before the eyes;
- swelling of the eyelids;
- dry mucous membranes;
- conjunctival hyperemia;
- damage to the main optic nerve;
- glaucoma;
- a decrease in the acuity of existing vision, including a sudden narrowing of the field of vision;
- recurrence of infection by bacteria or fungi;
- formation of the initial form of cataract;
- thinning of the cornea and disruption of the integrity of the structures of the eyeball.
From all hearing organs:
- ear congestion;
- itching;
- pain;
- feeling of discomfort.
In addition, when treated with Combinil, skin rashes, swelling of the face, perversion and changes in taste habits are possible. Wounds can heal very slowly.
There is no systemic data on the symptoms of overdose with Combinil. Local signs of drug overdose:
- increased tearfulness;
- burning, redness of the eyes;
- the occurrence of acute punctate keratitis;
- redness of the skin;
- itching and swelling of the eyelids.
If these signs are detected, rinse your eyes with plenty of water and seek medical help. Stop taking Combinil.
Drug interactions
When Combinil and psychotropic and antiepileptic medications are used at the same time, the metabolism of glucocorticoids increases, which has a bad effect on the functioning of the immune system, the processes of protein, fat and hydrocarbon metabolism. When Combinil is combined with antifungal, antimicrobial drugs and antibiotics, their effect is enhanced. It is possible to successfully use Combinil with the following medications:
- Azlocillin, Ceftazidime - for infections caused by free-living opportunistic bacteria (distributed everywhere).
- Mezlocillin and some other beta-lactam antibiotics - for streptococcal infections.
- Vancomycin and isoxazolylpenicillins - against staphylococci.
- Metronidazole and Clindamycin - for toxic infections of wounds and injuries caused by anaerobic microorganisms.
Each individual case of joint use of medications with Combinil requires consultation with a specialist. If the patient is already taking some medicine, it is necessary to inform the doctor who prescribed Combinil about this.
Storage and shelf life
After each use of Combinil, wipe the pipette with dry paper or a napkin. Close the cap tightly.
Store Combinil in a place isolated from direct sunlight at a temperature strictly no higher than 25 °C. Do not allow the medicine to fall into the hands of children, hide it from pets. The shelf life of a closed package of Kombinil-DUO is 2 years, Kombinil is 3 years. After opening, be sure to use no longer than 30 and 45 days, respectively.
Important! After 30 (Kombinil-DUO) or 45 (Kombinil) days, the solution from the opened bottle cannot be used! Need to buy new packaging!
Conditions for dispensing from a pharmacy
Combinil is a prescription medication. Dispensed from pharmacies only as prescribed by a doctor.
Similar drugs
Combinil Duo has few analogues. The most reliable substitute is Combinil. There are other medications whose therapeutic effect is similar to that of the one in question:
- Tobropt - eye drops;
- Uniflox - for eyes and ears;
- Dexa-Gentamicin - against eye pathologies;
- Sofradex - for ears and eyes;
- Garazon - ear and eye drops;
- Albucid is an antibacterial agent for the eyes;
- Sulfacyl - against eye infections;
- Oftadek - eye drops;
- Neodex - for eyes, ears and nose.
For the treatment of blepharitis specifically, you can find many substitutes for Combinil. Various ointments are also used to treat ear and eye diseases.
Source: https://lechim-gorlo.ru/gorlo/instruktsiya-po-primeneniyu-i-sostav-ushnyh-kapel-kombinil-duo-analogi-i-otlichiya
Side effects
- Infiltrates in the cornea, burning, itching, redness of the eye.
- Conjunctivitis, keratitis.
- Swelling of the face, periocular edema, sensation of a foreign body in the eye.
- Photophobia, blurred vision, dry eye syndrome.
- Redness of the conjunctiva, swelling of the eyelids.
- Glaucoma, cataracts, optic nerve damage.
- Thinning of the cornea, narrowing of the fields and decreased visual acuity, perforation of the eyeball.
- Secondary infection (bacteria, fungi).
- Distortion of taste.
- Skin rash.
special instructions
Unreasonably long-term use of Combinil-Duo solution can lead to an increase in intraocular pressure, which leads to damage to the optic nerve, the formation of cataracts and a decrease in visual acuity.
When acute purulent eye infections are treated with corticosteroids, the symptoms of the disease may worsen or be masked.
Patients using contact lenses should remove them before each instillation of Combnil-Duo. They can be put on again only 20 minutes after the procedure, since the preservative in the solution can have a negative effect on contact correction devices.
After using the drug, you should not immediately get behind the wheel or start working with complex mechanisms due to the resulting temporary visual impairment.
The bottle should be tightly closed after each use. Do not touch the dispenser to any surfaces.
Store the Combinil-Duo solution at room temperature in a dark place. Not given to children.
The shelf life of the unopened solution is 2 years. The opened solution is good for one month.
