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Question

Posted on: October 28 2015

How do I best work for: Ciclosporin 0.05% eye drops in 15 ml.

I assume I have to leave ampules, which contain ciclosporin and dilute them many times. What about the ethanol and castor oil, which will then end up in the eye? What about the sterility of the eye preparation if it is to be diluted as often?

Answer

I suggest that we deliver 10 ml of the 15 ml pre-sterilized eye droplet bottles are not available.

We   Depart indeed from a Sandimmun Ampoule 250 mg per 5 ml or 50 mg/ml. The amount of ciclosporin you need in the eye drops is 5 mg.  

With a sterile syringe (I) of 10 ml, provided with a sterile   needle, we suck 1 ml from the Sandimmun ampoule (= 50 mg ciclo) and then suck out an ampoule of water for injections 9 ml of water up to the mark 10 ml.  

We mix both floats by gently shaking the syringe. Then we take a second sterile syringe (II) with sterile needle and suck 9 ml of water for injections.   We put in a pre-sterilized collyrevial 1 ml of the solution in Syringe (I) and add the 9 ml water for injections present in syringe ( II). The eyedropper vial is closed and the   content is mixed.  

For the conditions in which you can carry out this preparation, I refer you to the monograph on Artificial tears in the TMF