The following additional adverse reactions have been identified during postmarketing use of Celluvisc in clinical practice. Because postmarketing reporting of these reactions is voluntary and from a population of uncertain size, it is not always possible to reliably estimate the frequency of these reactions.

The following additional adverse reactions have been identified during postmarketing use of Celluvisc 1.0% in clinical practice.Make sure that the single-dose container is intact before use. The solution should be used immediately after opening. To avoid contamination or possible eye injury, do not let the open-end of the single-dose container touch your eye or anything else. Wash your hands before use. If you forget to use your eye drops, use them when you need them next or when it’s time for your next dose. What if I use too much?

Carmellose sodium eye drops can be stored at room temperature and do not need to be kept in a fridge. What if I forget to use it? It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management. Single-dose droppers should usually be used as soon as you open them. But you can reseal some brands and use them again up to 12 hours later, for example Carmize, Cellusan and Melophthal. The following adverse reactions have been identified during clinical studies of 0.5% w/v and 1.0% w/v Celluvisc Eye drops, solution, unit dose. At the time of writing there is limited published experience regarding the safety of carmellose sodium in human pregnancy, however, carmellose sodium eye drops have been used for many years with no adverse effects reported and the manufacturer states no special precautions are necessary during pregnancy. Schaefer advises that artificial tears may be used for all appropriate indications during pregnancy (Schaefer 2007).

8. Common questions about carmellose sodium

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London. Use the carmellose sodium eye drops within the expiry date on the bottle. Use them within 4 weeks of opening, unless your drops come with different instructions. This will help to prevent the risk of eye infections and the eye drops not working so well. Ask a pharmacist if you are not sure. Summary of Product Characteristics: Celluvisc 0.5% w/v eye drops solution. Allergan Ltd. Revised May 2010.

At the time of writing there is limited published experience regarding the safety of carmellose sodium in breastfeeding, however, carmellose sodium eye drops have been used for many years with no adverse effects reported and the manufacturer states no special precautions are necessary during breastfeeding. Carmellose has a high molecular weight and would be unlikely to be present in breastmilk. Schaefer considers that most eye drops are compatible with breastfeeding and that artificial tears are not amongst those ophthalmic preparations likely to raise concern (Schaefer 2007). If you use carmellose sodium with other eye drops, wait at least 5 minutes before using your other eye drops. The second eye drops can wash out the carmellose sodium and it may not work as well. Please take care that the dropper doesn't touch your eye, your fingers, or any other surface. This could contaminate the drops left in the bottle.Uncommon: Lacrimation increased, vision blurred, eye discharge, eyelid margin crusting and/or medication residue, foreign body sensation in eye, ocular hyperemia, visual impairment. If you find it hard to use eye drops, ask a pharmacist for advice. They may be able to recommend an eye drop dispenser. Using eye drops correctly can be difficult, but there are several useful devices (compliance aids) available to help. Speak to your pharmacist to see which device would best suit your eye drops. Brands include,Autodrop, Opticare and Drop Aid Single Dose. Expiry dates and storage Common: Eye irritation (including burning and discomfort), eye pain, eye pruritus, visual disturbance. Carmellose sodium comes in a bottle with an eye dropper, or as a box of single-dose droppers. The single-dose droppers do not contain preservatives. How to use the eye drops The usual dose for adults and children is 1 drop into the affected eye(s), 4 times a day, or as needed.