|
DOSAGE
|
Corneal Keratitis: 1 gtt q1hr while awake, q2hrs at night for 3-4 days. Then taper to 1 gtt 6-8/day for 14-21 Days
|
|
Blepharitis/Conjunctivitis: Reduce initial dosage to 4-6/day
|
|
SIZE
|
15mL (Glass Bottle with Dropper)
|
|
(1) Antifungal Drops (Choose one): 1 gtt q1-2hr (around the clock), then taper over 4-6 weeks forNatamycin 5% (filamentous fungi), amphotericin B 0.15% (Candida) or topical fortified voriconazole 1%
|
|
(2) Cyclopentolate 1% TID
|
|
(4) If Deep corneal ulcer/suspected fungal endophthalmitis: Add on Oral Antifungal (Choose one) Fluconazole or itraconazole 200-400mg PO loading dosage, taper to 100-200mg PO qDay, or Vorixonazole 300mg PO BID
|
|
(5) Admission to hospital may be necessary due to longer delay in 100% healing.
|
|
INDICATIONS
|
NATACYN® (natamycin ophthalmic suspension) 5% is indicated for the treatment of fungal blepharitis, conjunctivitis, and keratitis caused by susceptible organisms including Fusarium solani keratitis. As in other forms of suppurative keratitis, initial and sustained therapy of fungal keratitis should be determined by the clinical diagnosis, laboratory diagnosis by smear and culture of corneal scrapings and drug response. Whenever possible the in vitro activity of natamycin against the responsible fungus should be determined. The effectiveness of natamycin as a single agent in fungal endophthalmitis has not been established
|
|
MECHANISM OF ACTION
|
Polyene amphoteric macrolide antifungal: Polyene amphoteric macrolide antifungal
|
|
MICROBIOLOGY
|
Natamycin is a tetraene polyene antibiotic derived from Streptomyces natalensis. It possesses in vitro activity against a variety of yeast and filamentous fungi, including Candida, Aspergillus, Cephalosporium, Fusarium and Penicillium. The mechanism of action appears to be through binding of the molecule to the sterol moiety of the fungal cell membrane. The polyenesterol complex alters the permeability of the membrane to produce depletion of essential cellular constituents. Although the activity against fungi is dose-related, natamycin is predominantly fungicidal. Natamycin is not effective in vitro against gram-positive or gram-negative bacteria. Topical administration appears to produce effective concentrations of natamycin within the corneal stroma but not in intraocular fluid. Systemic absorption should not be expected following topical administration of NATACYN® (natamycin ophthalmic suspension) 5%.
|
|
CONTRAINDICATIONS & WARNINGS
|
NATACYN® (natamycin ophthalmic suspension) 5% is contraindicated in individuals with a history of hypersensitivity to any of its components.
|
|
PEDIATRIC USE
|
Animal reproduction studies have not been conducted with natamycin. It is also not known whether natamycin can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. NATACYN® (natamycin ophthalmic suspension) 5% should be given to a pregnant woman only if clearly needed.
|
|
PREGNANCY
|
Pregnancy category C | Safety and effectiveness in pediatric patients have not been established.
|
|
NOTE
|
Drug is viscous, irritating, and has poor penetration . Alternatives include 1% voriconazole drops prepared from powder and orals voriconazole (Vfend)1 and fluconazole (Diflucan) or injected Amphotericin B (Fungizone, Bristol-Myers Squibb)
|
