Alcaftadine

Alcaftadine

Alcaftadine is an anti-allergy eye drop. It is a sustained-released form of an antihistamine that helps to reduce itching, redness, and other allergic symptoms of the eyes. The active ingredient in alcaftadine is an H1 receptor antagonist, which works by blocking a particular kind of cell receptor responsible for inflammation. Alcaftadine is used to treat seasonal allergic conjunctivitis, a common eye condition.

Uses

Alcaftadine is used in the treatment of ocular itching, redness, and tearing due to allergies. It is also used for the symptomatic treatment of ocular itching due to allergic conjunctivitis. Alcaftadine is also used to reduce seasonal allergic symptoms, such as swollen eyes, itchy and runny nose, sneezing, and watery eyes.

Brand Name	Alcaftadine
Type
Weight
Generic	Alcaftadine
Manufacturer
Available in	English বাংলা

Mechanism of Action

The active ingredient in Alcaftadine , an H1 receptor antagonist, works by blocking the H1 histamine receptor and preventing the release of inflammatory mediators that causes allergenic symptoms such as itching, redness and tearing. By blocking the H1 histamine receptor, Alcaftadine can reduce the number of histamine receptors available and thus, reduce the severity of allergic symptoms.

How Long Does It Take to Work?

The effects of Alcaftadine usually begin to be felt within a few minutes after using an eye drop, with maximum effects occuring anywhere from 15 minutes to 2 hours after administration. However, some patients may take a few days of consistent use before the effects start to become noticeable.

Absorption

Alcaftadine is quickly and efficiently absorbed when administered in the form of eye drops. The time saved in absorption and result in a faster onset of action for symptom relief.

Route of Elimination

Alcaftadine is eliminated primarily through the bile and urine, as well as other metabolic pathways such as enzyme-mediated processes.

Dosage

Adults and children 2 years and over: Instill one drop in each eye once daily.

The appropriate dose of Alcaftadine will vary depending on the patient's age, weight, and medical condition. Generally, adult patients should use 1 drop in the affected eye(s) twice a day. Children aged 3 to 5 should use the child's dosage amount (0.25%).

Administration

Alcaftadine should be administered as an eye drop twice a day. To use the eye drop, remove the cap and tilt your head back. Gently pull down on the lower eyelid and look up. Place the dropper over the eye and use gentle pressure to release one drop into the eye. Close the eye for 1-2 minutes, then replace the cap and wipe away any excess fluid.

Side Effects

Common side effects associated with alcaftadine may include eye irritation, dry mouth, blurred vision, stinging or burning sensation in the eye, nausea, and headache. Less common side effects may include dizziness and dry skin. If any of these side effects worsen or persist, alert your doctor.

Toxicity

If too much alcaftadine is ingested at once, toxicity may occur. Symptoms of overdose may include drowsiness, nausea, vomiting, confusion, rapid or slow heartbeat, fainting, and seizures. If alcaftadine overdose is suspected, contact emergency services immediately.

Precautions

Before taking alcaftadine, tell your doctor if you have any allergies, eye problems, or any other medical conditions. The safety of alcaftadine has not been established in children below 3 years of age. It is not known whether alcaftadine may cause harm to an unborn baby. Do not use alcaftadine without first talking to your doctor if you are pregnant or plan to become pregnant during treatment.

Interactions

Alcaftadine may interact with other medications, including antifungals, antibiotics, diuretics, antidepressants, anti-anxiety medications, and oral contraceptives. Tell your doctor about all the medications you take, including prescription and non-prescription drugs, herbal supplements, and vitamins. Do not start a new medication without talking to your doctor.

Disease Interaction

Alcaftadine may interact with certain medical conditions, such as glaucoma, kidney or liver problems, enlarged prostate, or an overactive thyroid. Tell your doctor if you have any of these conditions before taking alcaftadine.

Drug Interaction

Alcaftadine may interact with certain medications, such as antifungals, antibiotics, diuretics, antidepressants, anti-anxiety medications, and oral contraceptives. Tell your doctor about all the medications you take, including prescription and non-prescription drugs, herbal supplements, and vitamins. Do not start a new medication without talking to your doctor.

Food Interactions

Alcaftadine may interact with certain foods or beverages. Tell your doctor about any food or beverage interactions before taking alcaftadine.

Pregnancy Use

Pregnant women should not take alcaftadine without first talking to their doctor. The safety of alcaftadine during pregnancy has not been established.

Lactation Use

It is not known if alcaftadine passes into breast milk. Breastfeeding women should not take alcaftadine without first talking to their doctor.

Acute Overdose

If too much alcaftadine is ingested at once, toxicity may occur. Symptoms of overdose may include drowsiness, nausea, vomiting, confusion, rapid or slow heartbeat, fainting, and seizures. If alcaftadine overdose is suspected, contact emergency services immediately.

Contraindication

Alcaftadine should not be used if you are allergic to any of its ingredients. It should not be used in eye infections, or used in conjunction with any other medication for treating eye infections, such as Bacitracin, Neomycin, Polymixin, or Corticosteroids.

Use Direction

Alcaftadine should be administered as an eye drop twice a day. To use the eye drop, remove the cap and tilt your head back. Gently pull down on the lower eyelid and look up. Place the dropper over the eye and use gentle pressure to release one drop into the eye. Close the eye for 1-2 minutes, then replace the cap and wipe away any excess fluid.

Storage Condition

Alcaftadine should be stored in a cool, dry place, away from heat and direct sunlight. It should be stored at room temperature and should not be frozen. It should also be kept out of reach of children and pets.

Volume of Distribution

The volume of distribution of alcaftadine is 7 to 11L.

Half Life

The half-life of alcaftadine is 6 to 8 hours.

Clearance

Alcaftadine is cleared from the body through renal and biliary pathways.

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Some Frequently Asked Questions About Alcaftadine

1. What is Alcaftadine ?

Alcaftadine is an antihistamine medication used as an ophthalmic solution to prevent itching of the eyes caused by allergic conjunctivitis. It is an H1 histamine receptor antagonist that also exhibits some activity against H2 and H4 receptors, reducing allergic symptoms like itching and redness. Approved by the FDA in July 2010, it is marketed under the brand name Lastacaft as a 0.25% eye drop solution and is available both by prescription and over-the-counter (OTC).

2. What class of drug is Alcaftadine ?

Alcaftadine belongs to the class of ophthalmic antihistamines and decongestants. It works primarily as an H1 receptor antagonist, blocking histamine’s effects in the eyes, and has additional mast cell-stabilizing properties that help prevent the release of allergy mediators, making it a dual-action agent for ocular allergies.

3. How does Alcaftadine work?

Alcaftadine prevents allergic symptoms by:

• Blocking histamine receptors: It inhibits H1 receptors (primarily), and to a lesser extent H2 and H4, reducing itching and redness.
• Stabilizing mast cells: It prevents histamine release, decreasing inflammation.
• Inhibiting eosinophils: It reduces chemotaxis and activation of these allergy-related cells.

This multi-action approach provides rapid and sustained relief from ocular itching.

4. What conditions does Alcaftadine treat?

Alcaftadine is indicated for:

• Allergic conjunctivitis: Preventing itching due to pollen, ragweed, grass, animal dander, or dust mites.

It is not used for other eye conditions like infections, glaucoma, or contact lens-related irritation unless specifically directed by a doctor.

5. Is Alcaftadine used for anything other than allergic conjunctivitis?

Its primary FDA-approved use is for allergic conjunctivitis itching prevention. Off-label, it might be explored for other ocular allergic conditions, but there’s no widespread evidence for this, and such use would require physician oversight.

6. How is Alcaftadine taken?

Alcaftadine is administered as an eye drop (0.25% solution). The typical dose is one drop in each affected eye once daily. Wash hands before use, tilt the head back, pull down the lower eyelid, and instill the drop without touching the dropper tip to the eye or any surface.

7. What is the typical dosage for adults?

For adults, the standard dosage is one drop of Alcaftadine 0.25% in each affected eye once daily. This applies to both prescription and OTC use, with no more frequent administration recommended unless directed by a healthcare provider.

8. What is the dosage for children?

For children aged 2 years and older, the dose is the same as for adults: one drop in each affected eye once daily. Safety and efficacy are not established for children under 2, so use in this age group requires a doctor’s approval.

9. Can Alcaftadine be taken with food?

Since Alcaftadine is an eye drop applied topically to the eyes, food intake does not affect its use or absorption. It acts locally, with minimal systemic absorption, so timing with meals is irrelevant.

10. What should I do if I miss a dose?

If you miss a dose, apply it as soon as you remember unless it’s nearly time for the next dose. Skip the missed dose if it’s close to the next scheduled dose, and do not double up, as this could increase irritation without added benefit.

11. How quickly does Alcaftadine work?

Alcaftadine provides rapid relief, with effects on itching noticeable within 3 minutes of application after an allergen challenge. Peak plasma levels occur within 15 minutes, and its action can last up to 16 hours, supporting once-daily dosing.

12. What are the common side effects?

Common side effects include:

• Eye irritation: Mild burning, stinging, or redness upon instillation.
• Itching: Temporary increase in ocular itching.
• Non-ocular effects: Headache, nasopharyngitis, or flu-like symptoms (less common).

These are usually mild and resolve quickly.

13. What are the serious side effects?

Serious side effects are rare but include:

• Allergic reactions: Rash, swelling (face/tongue/throat), or breathing difficulty.
• Severe eye symptoms: Persistent pain, vision changes (unlikely but reportable).

Seek medical help immediately if these occur.

14. Why does Alcaftadine cause eye irritation?

Eye irritation (burning/stinging) may occur due to the solution’s preservatives (e.g., benzalkonium chloride) or the drug’s local action on sensitive ocular tissues. This is typically transient and not a sign of harm.

15. Can Alcaftadine cause allergic reactions?

Yes, though rare, allergic reactions like rash or swelling can occur, particularly in those sensitive to Alcaftadine or its components (e.g., benzalkonium chloride). Discontinue use and seek help if severe symptoms arise.

16. Who should not take Alcaftadine ?

It’s contraindicated for:

• Allergy: To Alcaftadine or any ingredient in the solution.

Caution is advised in children under 2, and it’s not for contact lens-related irritation.

17. Is Alcaftadine safe during pregnancy?

It’s Category B—animal studies (rats, rabbits) show no fetal harm at high doses, but human data are limited. Use only if clearly needed, weighing benefits against potential risks with a doctor’s advice.

18. Can I take Alcaftadine while breastfeeding?

It’s unknown if Alcaftadine passes into breast milk or affects infants. Given its low systemic absorption, risk is likely minimal, but consult a doctor to balance benefits and potential infant exposure.

19. Does Alcaftadine interact with other medications?

No significant drug interactions are documented. It’s not metabolized by CYP450 enzymes and has low systemic absorption, reducing interaction risks. However, separate other eye drops by 5 minutes.

20. Can I drink alcohol while using Alcaftadine ?

Alcohol doesn’t interact with Alcaftadine due to its topical application and minimal systemic effects. Drinking won’t affect its efficacy, though alcohol may worsen allergy symptoms indirectly.

21. Does Alcaftadine cause weight gain?

No, it doesn’t affect metabolism or cause weight gain. Its action is localized to the eyes, with negligible systemic impact.

22. Can Alcaftadine be used at night?

Yes, it can be used at night or any consistent time daily. Its 16-hour duration means timing is flexible, though evening use might align with peak allergy exposure for some.

23. How long do I need to use Alcaftadine ?

Use continues as long as allergy symptoms persist or during allergen exposure (e.g., pollen season). Stop if symptoms resolve, but consult a doctor if needed beyond a few weeks.

24. Can Alcaftadine be stopped suddenly?

Yes, stopping poses no withdrawal risk since it’s not habit-forming. Symptoms may return if allergens remain present.

25. Does Alcaftadine affect blood sugar?

No, it has no effect on blood sugar due to its topical nature and minimal systemic absorption.

26. Can Alcaftadine cure allergies?

No, it prevents and relieves symptoms (e.g., itching) but doesn’t cure the underlying allergy, which requires allergen avoidance or immunotherapy.

27. What should I avoid while using Alcaftadine ?

Avoid:

• Contact lenses: If eyes are red, or wait 10 minutes after use if not red (due to benzalkonium chloride).
• Touching the dropper: To prevent contamination.

28. Can Alcaftadine cause fatigue?

Fatigue isn’t a common side effect. Any tiredness might relate to allergies, not the drug, given its local action.

29. Is Alcaftadine safe for elderly patients?

Yes, studies show no safety or efficacy differences in the elderly versus younger adults. Use as directed.

30. Does Alcaftadine affect the liver?

No significant liver effects are expected. It’s metabolized by non-CYP enzymes to a carboxylic acid metabolite, with minimal systemic impact.

31. Can Alcaftadine be used in children?

Yes, it’s safe for children 2 years and older at one drop daily per eye. Under 2, safety isn’t established.

32. What’s the maximum dose of Alcaftadine ?

The maximum is one drop per eye once daily (0.25% solution). Higher doses aren’t recommended or studied.

33. Can Alcaftadine cause dizziness?

Dizziness isn’t a reported side effect. Its topical use limits systemic effects that could cause this.

34. How is Alcaftadine different from other antihistamine eye drops?

Compared to olopatadine or ketotifen, Alcaftadine offers broader receptor antagonism (H1, H2, H4) and faster onset (3 minutes). It’s dosed once daily versus twice for some alternatives.

35. Can Alcaftadine prevent redness?

Yes, it reduces conjunctival redness alongside itching, with clinical significance shown at 0.25% within 7–15 minutes.

36. Does Alcaftadine affect cholesterol?

No, it has no impact on cholesterol due to its localized action.

37. Can Alcaftadine be used with other eye drops?

Yes, but administer other eye drops at least 5 minutes apart to avoid dilution or interaction.

38. What tests should I get while using Alcaftadine ?

No routine tests are needed for short-term OTC use. For prolonged use, an eye doctor might check for efficacy or side effects.

39. Can Alcaftadine cause depression?

No, it’s not linked to depression or mood changes due to its topical application.

40. Is Alcaftadine addictive?

No, it’s not addictive or habit-forming.

41. Can Alcaftadine be diluted?

No, it’s pre-formulated at 0.25%. Diluting it could reduce efficacy—use as provided.

42. Does Alcaftadine cause hair loss?

No, hair loss isn’t a reported side effect.

43. Can Alcaftadine be used for infections?

No, it’s not for bacterial, viral, or fungal eye infections—only allergic conjunctivitis.

44. What’s the half-life of Alcaftadine ?

The carboxylic acid metabolite’s half-life is about 2 hours after ocular use. The parent drug’s levels drop below detection by 3 hours.

45. Can Alcaftadine cause blurred vision?

Temporary blurring may occur right after instillation but resolves quickly. Persistent issues warrant a doctor’s visit.

46. Does Alcaftadine affect exercise?

No direct effect, though relieved symptoms might improve comfort during activity.

47. Can Alcaftadine be used with contact lenses?

Not if eyes are red. Otherwise, remove lenses before use and wait 10 minutes before reinserting due to preservative absorption risk.

48. Is Alcaftadine expensive?

OTC versions cost $15–$30, while prescription prices vary by insurance. Generics may be cheaper.

49. Can Alcaftadine cause eye pain?

Mild stinging is common, but persistent pain isn’t expected—consult a doctor if it occurs.

50. How should Alcaftadine be stored?

Store at room temperature (15–25°C or 59–77°F), away from heat and moisture, tightly closed. Use until the expiration date after opening.