NOVESIN WANDER 0,4 %

Indications

• Surface anaesthesia for ophthalmic procedures
• Local anaesthesia for minor surgical interventions
• Anaesthesia for diagnostic procedures

Dosage

Children: Refer to the BNF for Children for specific dosing information.

Adults: Refer to the BNF for specific dosing information.

Mechanism of action

Oxybuprocaine binds to sodium channels and reversibly stabilizes the neuronal membrane, decreasing its permeability to sodium ions. This action inhibits depolarization of the neuronal membrane, effectively blocking the initiation and conduction of nerve impulses.

Pharmacodynamics

As a local anaesthetic, oxybuprocaine provides pain relief by blocking nerve conduction in the area where it is applied. It is noted to be less irritating than tetracaine, with an onset and duration of action comparable to that of tetracaine.

Pharmacokinetics

Oxybuprocaine is absorbed locally at the site of administration. Its pharmacokinetic profile includes a relatively rapid onset of action, with effects typically lasting for a sufficient duration depending on the concentration used and the specific application site. The metabolism and excretion details are not extensively documented but are expected to follow the general pathways of ester local anaesthetics.

Pregnancy

Oxybuprocaine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Consult a healthcare professional for guidance.

Breast-feeding

Oxybuprocaine is excreted in breast milk. Caution is advised when administering to breastfeeding mothers.

Storage

Store at room temperature, protected from light. Keep out of reach of children.

Formulations

• Ophthalmic solution
• Topical gel

Indications

• Local anaesthesia for ocular procedures
• Mydriasis (pupil dilation) during cataract surgery
• Minor surgical procedures involving the eye

Dosage

Children: Apply as required.

Adults: Apply as required.

Mechanism of action

Oxybuprocaine hydrochloride works by blocking sodium channels in the neuronal cell membranes. By inhibiting the influx of sodium ions, it prevents the generation and conduction of nerve impulses, leading to a reversible loss of sensation in the area where it is applied. This mechanism is typical of local anaesthetics and is crucial for its efficacy in procedures involving the eye.

Pharmacodynamics

The pharmacodynamic profile of oxybuprocaine hydrochloride includes its local anaesthetic effects, characterized by a rapid onset of action within minutes and a duration that typically lasts for about 15 to 30 minutes. This makes it particularly useful for short procedures. The drug is effective in providing local analgesia without affecting consciousness, allowing for a painless surgical experience.

Pharmacokinetics

Oxybuprocaine hydrochloride has a relatively low systemic absorption when applied topically to the eye. The drug is metabolized in the liver, and its systemic effects are minimal, reducing the risk of systemic side effects. However, caution is advised in patients with conditions that may lead to increased systemic absorption. The half-life and elimination characteristics are not well established but are typically short due to the local application.

Contra-indications

• History of acute, narrow-angle glaucoma
• Hypersensitivity to amide-type anesthetics or atropine derivatives
• Preterm neonates

Adverse effects

• Headache
• Hyperemia
• Hypertension
• Keratitis
• Dermatitis
• Eye disorders

Interactions

• Anaesthetics, local
• Antiarhythmics
• Sympathomimetics
• Vasoconstrictors
• Preservatives

Precautions

• Conditions where systemic exposure to phenylephrine or lidocaine could be harmful
• Risk of floppy iris syndrome
• Counsel patients about effects on driving and skilled tasks

Pregnancy

Manufacturer advises to avoid-systemic uptake cannot be excluded; insufficient data available for phenylephrine and tropicamide in pregnancy.

Breast-feeding

Manufacturer advises to avoid-no data available for phenylephrine or tropicamide; lidocaine present in milk in small amounts.

Storage

Store at room temperature, protect from light. Do not freeze.

Formulations

• Oxybuprocaine hydrochloride 0.4% eye drops (Bausch & Lomb UK Ltd) - 0.5ml unit dose
• Oxybuprocaine hydrochloride 4 mg per 1 ml Minims

Mechanism of action

Oxybuprocaine binds to sodium channel and reversibly stabilizes the neuronal membrane which decreases its permeability to sodium ions. Depolarization of the neuronal membrane is inhibited thereby blocking the initiation and conduction of nerve impulses.

Pharmacodynamics

Oxybuprocaine is a local anaesthetic. It may be less irritating than tetracaine, and the onset and duration of action are similar to tetracaine.