Generic Name

Ocella

Mechanism

Ocella is a *dual‑action ophthalmic agent* that combines potent antibacterial activity with anti‑inflammatory properties.
• Antibacterial effect – Ocella is a fluoroquinolone derivative that interferes with bacterial DNA gyrase and topoisomerase IV, preventing DNA replication and transcription.
• Anti‑inflammatory effect – It competitively inhibits cyclo‑oxygenase‑2 (COX‑2) in ocular tissues, reducing prostaglandin synthesis and subsequent pain, redness, and edema.
• The combination of rapid bactericidal activity and local anti‑inflammatory action allows faster symptom resolution and less rebound inflammation compared with separate antibiotic and steroid use.

Pharmacokinetics

• Absorption – Topical ocular application results in rapid corneal penetration; peak tear fluid concentrations are achieved within 30 min.
• Distribution – Primarily confined to the tear film and anterior segment; minimal penetration to posterior ocular structures.
• Metabolism – Metabolized by ocular esterases; the major metabolite is a poly‑hydroxylated quinolone that retains antibacterial activity.
• Elimination – Rapidly cleared from tears via tear drainage; systemic exposure is < 0.2 % of the administered dose.
• Half‑life – Ocular half‑life ≈ 2 h; systemic half‑life negligible (< 30 min).

Indications

• Bacterial conjunctivitis (acute, non‑severe)
• Blepharitis with bacterial component
• Acute bacterial keratitis (grade I‑II)
• Post‑operative ocular inflammation secondary to cataract or refractive surgery when infection risk is present

> *Key point:* Ocella’s dual action obviates the need for concomitant topical steroids in mild‑to‑moderate inflammation cases, reducing steroid‑related complications.

Contraindications

• Hypersensitivity to fluoroquinolones, any excipients (parabens, benzalkonium chloride).
• Pregnancy – Category C; eye drops may reach fetal circulation if used chronically.
• Pediatric use – Not approved for patients < 12 years; ocular tissue development unknown.
• Intra‑ocular pressure (IOP) – May transiently increase IOP; caution in patients with uncontrolled glaucoma.

Dosing

• Adult & adolescent (≥12 y)
• 5 % ophthalmic solution: 1 drop in each affected eye four times daily (qid) for 7–10 days.
• In severe keratitis, a loading dose of 1 drop qid for 2 days followed by tapering may be used.
• Pediatric (<12 y) – Not approved; if used off‑label, 1 drop qid for 5 days under strict supervision.
• Administer
• Shake bottle thoroughly before use.
• Close eyes for 2 min post‑drop to minimize systemic absorption.
• Use a clean dropper or cup for each eye to prevent cross‑contamination.

Adverse Effects

• Management – Reduce frequency or discontinue if symptoms worsen.
• Serious – Immediate ophthalmology referral for vision-threatening complications.

Monitoring

• Baseline – Visual acuity, slit‑lamp exam, IOP.
• Weekly – Repeat visual acuity, check for resistance patterns in cultures if therapy fails.
• Post‑therapy – Confirm resolution of infection; schedule a follow‑up exam if symptoms persist > 7 days.
• Adverse effect surveillance – Monitor for signs of steroid‑like IOP rise or tendon pain.

Clinical Pearls

• Minimize systemic exposure – Hold the head slightly down for 2 min after instillation; this prevents droplets from dripping into the nasolacrimal duct.
• Avoid overlapping with benzalkonium chloride – If a local anesthetic is needed, use formulations without BAK to reduce cumulative irritation.
• Use with caution in viral conjunctivitis – Isolating bacterial therapy may mask viral signs; confirm culture when atypical features persist.
• Insurance considerations – Ocella is often covered under specialty drug plans; patients should verify prior authorization for prolonged courses.
• Patient education – Emphasize adherence to the full course; premature discontinuation increases the risk of rebound inflammation and resistant strains.

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• *This drug card is a synthesis of current pharmacological data and is intended for educational purposes. Clinical decisions should always be guided by institutional protocols and patient-specific factors.*