Temovate
Temovate
Generic Name
Temovate
Mechanism
- Quinolone antibacterial – Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription, repair, and chromosome segregation.
- Broad‑spectrum activity – Effective against Gram‑positive (e.g., *Staphylococcus aureus*, *Streptococcus pneumoniae*) and Gram‑negative organisms (e.g., *Haemophilus influenzae*, *Pseudomonas aeruginosa*) commonly implicated in ocular infections.
- Rapid bactericidal action – The drug’s high ocular penetration enables quick reduction of bacterial load, facilitating rapid symptom relief.
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Pharmacokinetics
| Parameter | Typical Value (Ocular) |
| Absorption | Absorbed via the corneal epithelium and conjunctiva, reaching peak intra‑ocular concentrations within 30‑60 min. |
| Distribution | Broad distribution in aqueous and vitreous humors; limited systemic absorption (~2‑4 % of instilled dose). |
| Metabolism | Minimal ocular metabolism; major systemic route is hepatic glucuronidation. |
| Elimination | Primarily renal (≈80 % of the absorbed dose).
| Half‑life (ocular) | ~2 h; systemic elimination half‑life ~8–10 h. |
| Special populations | Pregnancy: Category B; lactation: excretion into breast milk is minimal (<0.2 %); renal impairment: dosage adjustment not required for ophthalmic use. |
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Indications
- Bacterial conjunctivitis (acute, uncomplicated).
- Corneal ulceration caused by susceptible microorganisms.
- Post‑operative prophylaxis after cataract or refractive surgery.
- Pre‑operative preparation in cases of active ocular infection to reduce postoperative complications.
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Contraindications
| Category | Details |
| Contraindications |
• Allergy to levofloxacin, other fluoroquinolones, or any excipient. • Active ocular surface disease that could impede absorption. |
| Warnings |
• Systemic fluoroquinolone toxicity (tendinitis, tendon rupture, CNS effects). • Photosensitivity – avoid intense UV exposure or phototherapy during treatment. • Potential for ocular surface irritation or allergic contact dermatitis (rare). |
| Precautions |
• Use carefully in patients with a history of neuropsychiatric disorders. • Avoid concurrent use with raw silicone elastomer lenses to reduce potential lens surface toxicity. |
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Dosing
| Regimen | Note(s) |
| Adults & Children ≥12 y | Instill 1 drop into each affected eye every 6 h (q6h) for 7‑10 days. |
| Children <12 y (if clinically indicated) | Use under pediatric supervision; dose frequency may be increased to q4–6h based on severity. |
| Post‑operative prophylaxis | Instill 1 drop q6h during the first 2‑3 days after surgery. |
| Storage | Store at room temperature (20–25 °C). Avoid freezing. Close the bottle after each use. |
| Pre‑administration | Rinse the eye with sterile saline to clear debris; gently close the lids after instillation. |
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Adverse Effects
| Category | Example Adverse Effects |
| Common | • Burning, stinging, tearing, mild ocular irritation. |
| Serious | • Ocular surface allergy, corneal microtrauma, systemic fluoroquinolone toxicity (rare). |
| Other | • Increases risk of myopia progression in pediatric patients – rare. |
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Monitoring
- Visual acuity – Verify baseline and monitor at the beginning of therapy to detect any visual changes.
- Ocular surface assessment – Check for signs of keratitis, corneal ulcer, or toxicity after 48 h of therapy.
- Patient education – Instruct patients to report any persistent burning, vision changes, or systemic symptoms (e.g., tendon pain, depression).
- Drug–drug interactions – Monitor for concurrent use of other topical antibiotics or systemic fluoroquinolones that might increase systemic exposure.
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Clinical Pearls
| Tip | Rationale |
| Use a cold bottle | Cold fluid slightly improves ocular comfort and may mitigate stinging. |
| Avoid overnight dosing | If an eye drops during sleep, the contact lens remains wet and may increase ocular surface turbulence. |
| Continue therapy even if symptoms resolve | A full course prevents bacterial regrowth and resistance. |
| Store in a cool, dry place away from sunlight | UV exposure can degrade the drug and increase photosensitivity risk. |
| Inform about mild systemic side effects | Patients may develop tendon pain or mood changes; early recognition ensures prompt management. |
| Use preservative‑free formulations in contact lens wearers | Preservatives can irritate lenses or degrade them over time. |
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