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  • Azasite

    Hello All - I have been dealing with MGD, red swollen eyelids and Blepharitis for about 10 years. I've finally gotten things mostly under control by using warm compresses, lid massage, and fish oil supplements. My right eye feels much better now (almost normal). However, my left eye is not so good. It is almost constantly swollen and inflamed to some degree, more so when I'm emotionally stressed/upset, exposed to chemicals, certain foods, etc. It reacts to all the typical rosacea triggers. So I suspect there is rosacea in that eyelid. The MGD glands are still somewhat clogged in that eyelid from all the extra inflammation. I'd like to try Azasite to help reduce the inflammation cycle and hopefully clear up this eyelid. I've read many documented studies citing how useful and successful this drug has been in reducing inflammation in some cases of MGD, ocular rosacea, and blepharitis, by rubbing it into the eyelid. I want to try this approach but I don't know what doctor to go to who will prescribe it. I hate going to multiple eye doctors searching for someone who will give it a try. (the testing drops and dyes doctors use are really irritating to my sensitive eyes!) How can I find an eyelid doctor that would be open to this mode of treatment? I'm in Northern Virginia.

  • #2
    Hi there and welcome. I'm thinking it shouldn't be difficult to persuade a doctor to prescribe this under the circumstances. It's not as though it's an unusual use of the drug. For quite awhile some years ago it was definitely the drug du jour for MGD.
    Rebecca Petris
    The Dry Eye Foundation
    dryeyefoundation.org
    800-484-0244

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    • #3
      Thanks for the reply! Can an optometrist prescribe this for me or would I need to see an ophthamologist for this type of issue? I want to be sure they are informed about this type of use of Azasite before I go in. Do you think most doctors know about this "off label" use of Azasite?
      sigpic

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      • #4
        AzaSite is used quite common off-label for MGD. The only concern is there is preservatives in AzaSite which can cause problems long term.

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        • #5
          Yes, preservatives are a concern. My hope is to try it for a while to see if it helps the eyelid in my situation. If it does, I'll consider long term solutions. Isn't Azasite a solution of azithroymcin? Is it available from a compounding pharmacy without preservatives?
          sigpic

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          • #6
            ......................
            Last edited by MGD1701; 15-Sep-2018, 15:24.

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            • #7
              yes, topical opth azithromycin can be compounded for cheaper than azasite actually, around $25 cad per month in canada. however, i am unsure about the deliver vechicle, but should be good.

              azyter is available in the EU as is preservative free.

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              • #8
                Do you actually put it in the eye or just along the lid margin? Because if it is not going in the eye then the preservatives shouldn't be an issue.

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                • #9
                  Has anyone used Azasite just on the eyelids? How do you apply it - with your finger or a Q-tip? Do you put it on both the uppers and lowers? Does it sting at all with application? Does any get on the eye? What is your dosage/length of time for use? And finally, did it help MGD? Thanks!
                  sigpic

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                  • #10
                    Hi,

                    I've used Azyter (preservative free 1.5% azithromycin) on eyelids. 2x/day for 3 days, then 1x/day for 9 days. Didn't sting then but does when i've put it in eyes.

                    I found it quickly worked to loosen meibum, which started to flow within 30 minutes of application. Unless it caused reflex tearing of some kind.

                    My ophth. likes to do these 9 days pulses once a month for 6 months.

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                    • #11
                      Hi

                      It is my understanding that that Azyter is only available in the form of eye drops and not as an ointment, that it is supplied in vials and preservative free. It would be interesting to know if Azithromycin is available as an ointment. Does anybody know if this is the case? Given its anti-inflammatory properties smearing it directly on inflamed eyelids seems very appropriate to me. (I have used another antibiotic ointment precisley like this on the recommendation of my ophtahlmologist.) Something that has not yet been mentioned in this discussion is that Azithromycin, like all antibiotics, can lead to BACTERIAL RESISTANCE if used for a long period of time.

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                      • #12
                        Originally posted by hannsho View Post
                        Hi

                        It is my understanding that that Azyter is only available in the form of eye drops and not as an ointment, that it is supplied in vials and preservative free. It would be interesting to know if Azithromycin is available as an ointment. Does anybody know if this is the case? Given its anti-inflammatory properties smearing it directly on inflamed eyelids seems very appropriate to me.
                        Azyter drops are quite thick, and I was directed to apply one drop to each eyelid which seemed to work well.

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                        • #13
                          I believe that Azasite drops are also quite thick. I've heard that you can put it on a clean finger or Q-tip and then apply it to your lid margins. There must be a certain amount of time between treatments to avoid the danger of bacterial resistance.
                          sigpic

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                          • #14
                            Meibum Ian and kkahthesea - – thanks for this information.

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                            • #15
                              Originally posted by kkahthesea View Post
                              I believe that Azasite drops are also quite thick. I've heard that you can put it on a clean finger or Q-tip and then apply it to your lid margins. There must be a certain amount of time between treatments to avoid the danger of bacterial resistance.
                              Azasite is a gel, so yes, it’s a bit thick.

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