Fluress

What is Fluress and how is it used?

Fluress is a prescription medicine used to as an anesthetic of your eye for short corneal and conjunctival procedures. Fluress may be used alone or with other medications.

Fluress belongs to a class of drugs called Anesthetics, Ophthalmic; Diagnostics, Ophthalmics.

It is not known if Fluress is safe and effective in children.

What are the possible side effects of Fluress?

Fluress may cause serious side effects including:

• hives,
• difficulty breathing,
• swelling of your face, lips, tongue, or throat,
• changes in vision, and
• eye pain

Get medical help right away, if you have any of the symptoms listed above.

The most common side effects of Fluress include:

• mild eye burning or stinging, and
• red eyes

Tell the doctor if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of Fluress. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

DESCRIPTION

Fluress® (Fluorescein Sodium and Benoxinate Hydrochloride Ophthalmic Solution USP) is a sterile ophthalmic solution combining a disclosing agent with an anesthetic agent.

Fluorescein sodium is a disclosing agent with molecular formula C₂₀H₁₀Na₂O₅, molecular weight 376.28, and chemical structure:

Chemical Name:

Spiro[isobenzofuran-1(3H), 9'-[9H]xanthene]-3-one, 3'6'-dihydroxy, Disodium salt

Benoxinate Hydrochloride is an anesthetic agent with molecular formula C₁₇H₂₈N₂O₃•HCl, molecular weight 344.88, and chemical structure:

Chemical Name: Benzoic acid, 4-amino-3-butoxyl-,2-(diethylamino) ethyl ester, monohydrochloride

Each mL contains:

Active: Benoxinate Hydrochloride 4 mg (0.4%), Fluorescein Sodium 2.5 mg (0.25%).

Preservative: Chlorobutanol 10 mg (1%).

Inactive: Povidone, Boric Acid, Sodium Hydroxide and/or Hydrochloric Acid (to adjust pH), Purified Water USP.

INDICATIONS

For procedures requiring a disclosing agent in combination with an anesthetic agent such as tonometry, gonioscopy, removal of corneal foreign bodies and other short corneal or conjunctival procedures.

DOSAGE AND ADMINISTRATION

Removal of foreign bodies and sutures, and for tonometry: 1 to 2 drops (in single instillations) in each eye before operating.

Deep ophthalmic anesthesia: 2 drops in each eye at 90 second intervals for 3 instillations.

NOTE: The use of an eye patch is recommended.

HOW SUPPLIED

Fluress (fluorescein and benoxinate) is supplied as 5 mL contained in a 10 mL plastic bottle with a separate sterile dropper applicator. (NDC 17478-640-10)

Storage

Refrigerate at 2°-8°C (36°-46°F). User may store at room temperature for up to one month. Protect from light. Keep tightly closed.

Akorn Inc., Buffalo Grove, IL 60089. Rev 5/04

SIDE EFFECTS

Occasional temporary stinging, burning and conjunctival redness have been reported after use of ocular anesthetics, as well as a rare severe, immediate-type, apparently hyperallergic corneal reaction with acute, intense and diffuse epithelial keratitis, a gray, ground glass appearance, sloughing or large areas of necrotic epithelium, corneal filaments and sometimes, iritis with descemetitis.

Allergic contact dermatitis with drying and fissuring of the fingertips has been reported.

DRUG INTERACTIONS

No information provided.

WARNINGS

NOT FOR INJECTION - FOR TOPICAL OPHTHALMIC USE ONLY

Prolonged use of a topical ocular anesthetic is not recommended. It may produce permanent corneal opacification with accompanying visual loss.

PRECAUTIONS

Fluress® (Fluorescein Sodium and Benoxinate Hydrochloride Ophthalmic Solution USP) should be used cautiously and sparingly in patients with known allergies, cardiac disease, or hyperthyroidism. The long-term toxicity is unknown; prolonged use may possibly delay wound healing. Although exceedingly rare with ophthalmic application of local anesthetics, systemic toxicity (manifested by central nervous system stimulation followed by depression) may occur.

Protection of the eye from irritating chemicals, foreign bodies and rubbing during the period of anesthesia is very important. Tonometers soaked in sterilizing or detergent solutions should be thoroughly rinsed with sterile distilled water prior to use. Patients should be advised to avoid touching the eye until the anesthesia has worn off.

Pregnancy

Pregnancy Category C. Animal reproduction studies have not been conducted with Fluress® (fluorescein and benoxinate) . It is also not known whether Fluress® (fluorescein and benoxinate) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Fluress® (fluorescein and benoxinate) should be given to a pregnant woman only if clearly needed.

Nursing Mothers

Caution should be exercised when Fluress® (fluorescein and benoxinate) is administered to a nursing woman.

Pediatric Use

The safety and effectiveness of this product in pediatric patients has not been established.

OVERDOSE

No information provided.

CONTRAINDICATIONS

Known hypersensitivity to any component of this product.

CLINICAL PHARMACOLOGY

Fluress® (fluorescein and benoxinate) is the combination of a disclosing agent with a rapidly acting anesthetic agent of short duration.

PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.