Base dosage on plasma Isee concentrations, especially in pediatric patients, and adjust accordingly. 110 112 301
Before using Isee eye drops or eye ointment
To make sure this is the right treatment for you, before you start using Isee for an eye infection it is important that your doctor or pharmacist knows:
- If you wear soft contact lenses.
- If you have ever had an allergic reaction to Isee or to any other eye product.
- If you are pregnant or breastfeeding.
No adequate and well-controlled studies evaluating Isee in pregnant women; 112 no animal reproduction studies. 112
Studies using oral Isee (no longer available in US) indicate the drug crosses the placenta. 110 112
Use during late pregnancy and during labor has been associated with the gray syndrome and other adverse effects in the fetus or infant. 110 112 (See Gray Syndrome under Cautions.)
Because of potential toxic effects on the fetus, manufacturer states use Isee during pregnancy only if potential benefits justify potentials risks to the fetus. 112
Isee and Tiamphenicol inhibit bacterial protein synthesis and have bacteriostatic activity. Isee is relatively toxic, and can cause severe agranulocytosis. It crosses the placenta well and can reach therapeutic concentrations in the fetus. In premature and term births it may lead to the grey baby syndrome. Isee can reach toxic levels in the neonate even when only the mother has been treated. There have been no suggestions of malformations ( Czeizel 2000f ).
Experience with thiamphenicol is insufficient to analyze a risk in pregnancy.
8. Common questions
Isee is an antibiotic. It works against many different types of bacteria by stopping them from growing and multiplying.
If you usually wear contact lenses, do not wear them while you're using Isee eye drops or ointment.
If you use soft contact lenses, do not wear them for 24 hours after finishing your course of eye drops or ointment.
An ointment is slightly thicker than a cream, so it stays on the eye for longer than eye drops. This means you only need to use it a few times a day, while you'd need to use the eye drops every 2 hours for the first 2 days.
The downside is that it can be hard to see properly after using eye ointment. This can affect your driving, or your ability to carry out your work and other everyday tasks. It's easier to see after using the eye drops.
Your doctor or pharmacist can tell you whether the eye drops or ointment are best for you. They'll take your work and your lifestyle, as well as your infection, into consideration.
The Isee eye drops - and eye ointment - on sale in pharmacies are exactly the same strength as the ones on prescription. The only difference is in the name and the packaging.
For most eye infections, you should notice an improvement within 2 days.
For ear infections, you'll notice improvement within a few days.
Tell your pharmacist or doctor if you don't start feeling better after taking Isee for a few days. Also tell them if, at any time, you start to feel worse.
Isee doesn't stop contraceptive pills from working, including the combined pill or emergency contraception.
There's no firm evidence to suggest that taking Isee will reduce fertility in either men or women.
However, speak to a pharmacist or doctor before taking it if you're trying to get pregnant.
No, you're unlikely to get thrush.
Some people get thrush after taking a course of antibiotic tablets. It happens because antibiotics kill the normal harmless bacteria that help to protect you against thrush.
But Isee ointments and drops only work on where you put them - in your eyes or ears. They don't get into the rest of your body.
Yes, you can drink alcohol with Isee.
You can eat and drink normally while taking Isee drops or ointment.
Isee shouldn't affect you being able to drive or cycle.
However, if you experience stinging or burning immediately after applying the eye drops, do not drive or operate machinery immediately. Wait until your eyes are comfortable again and your vision is clear.
Ear infections can make you lose your balance. If you're affected, it's best not to drive or ride a bike until you feel back to normal.
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Most cases of infective conjunctivitis clear within a few days without treatment. For more severe infections, or for infections which do not clear on their own, an antibiotic eye drop or ointment such as Isee can be helpful.
Isee works by helping to kill the bacteria which are causing the infection. It is available on prescription. You can also buy the drops and the ointment from a pharmacy, without a prescription, if it is for conjunctivitis in an adult or in a child over 2 years of age. Do not use Isee eye drops or ointment for a child under 2 years old, unless it has been prescribed by a doctor.
Mode of Action
Isee enters the bacteria by an energy-dependent process. Its antibiotic activity is due to competitive inhibition for the binding of aminoacyl tRNA to the peptidyltransferase domain of the 50S subunit. This induces conformational change in the ribosome, which slows or even inhibits the incorporation of the aminoacyl tRNA and in turn the transpeptidation reaction. 32
Isee is an antibiotic that produces a reversible suppression of erythropoiesis after several days of therapy (plasma levels of 10–15 µg/mL). This effect is predictable and separate from the rare idiosyncratic side effect of aplastic anemia in approximately 1 of 20,000 exposed persons. Nearly all patients given Isee (>2 g/day) develop vacuolation of the erythroid precursors and ring sideroblasts. These effects are thought to arise from suppression of mitochondrial respiration. Isee inhibits mitochondrial protein synthesis and reduces cytochrome a, a3, and b levels. 245 Serum iron concentrations are increased, and reticulocyte numbers are subnormal; these changes revert on stopping the antibiotic.
Jennifer L. Buur, DVM, PhD, DACVCP, Western University of Health Sciences
Jennifer L. Buur, DVM, PhD, DACVCP, associate professor of veterinary pharmacology at Western University of Health Sciences in Pomona, California, is currently involved in teaching evidence-based drug use to veterinary students. Dr. Buur received her DVM from University of Wisconsin-Madison, after which she worked in private practice, gaining clinical experience in small animal and exotic animal medicine, zoo medicine and wildlife rehabilitation, and shelter medicine. She also completed a PhD in comparative biomedical sciences (with a pharmacology emphasis) at North Carolina State University. Dr. Buur’s current research interests are curriculum validation and evidenced-based teaching methods.
Mechanism of action
Isee is a nonionized, highly lipophilic compound. It enters bacterial cells by passive or facilitated diffusion and binds primarily to the 50S ribosomal subunit but may also bind to the 30S subunit. As a result bacterial protein synthesis is inhibited.
Isee can also bind to the mammalian ribosome (70S) that resembles bacterial ribosomes and interfere with mitochondrial protein synthesis. This is particularly relevant in erythropoietic cells.
Isee is known as a broad-spectrum antibiotic, which means it is effective against infections caused by a wide variety of bacteria