Azyter is now available in the UK

[redandunhappy]

Dear all,

I've just recently been to see Professor Dart (consultant opthamologist - runs the external eye disease clinic at Moorfields).

He told me that Azyter (topical azithromycin 1.5%) has just literally become available in the last few weeks.

Just found this from MIMMS, which lists every drug available here:

http://www.mims.co.uk/more/LicenceCh...on-ocular-use/

Not yet licensed for blepharitis, but if you have a kind GP they can prescribe it for you.
I'm planning to try it very soon for my MGD/posterior blepharitis, as they told me at Moorfields that you should take a break from doxycycline every six months. And incidentally I've found that doxycycline isn't working so well now.....I will post separately about this.

Hope this is useful information for those in the UK.

[irish eyes]

Thanks for this.

I know this is an anti-bacterial, initially developed to treat conjunctivitis rather than chronic blepharitis as far as I am aware.

You say you are planning to try it soon. Do you mind me asking if John Dart is going to prescribe it - even though it isn't licensed for treatment of blepharitis?

Please keep us posted on this one.

Regarding Doxycycline; I switched to Minocycline because I have a stomach ulcer and I needed something `gentler'. (Stomach problems preceded antibiotic use). As I had to take additional medication for stomach, I tried stopping antibiotics altogether - but to go back to them if my eyes started to suffer. It's been a few months now since I discontinued the antibiotics and (thankfully) my eyes don't seem to be significantly any worse. I think they did their job initially though.

It's one less tablet to take.

[redandunhappy]

Hi Irisheyes,

John Dart's registrar gave me cyclosporine to try, which I'm in two minds about. I saw John Dart for about 1 minute and to be honest he wasn't very enthusiastic about Azyter - he said he only just happened to hear about it being available. He mumbled something about studies not showing it to be particularly effective (I think that's what he said).

He said that they can't prescribe it from Moorfields - not something they stock, but that I could ask my GP and the registrar has written a letter to my GP saying it's something that I want to try and he is happy for it to be prescribed. I don't think it's yet licensed for blepharitis, and the MIMMs description suggests that it isn't, but I'm not 100% sure.

However I think GPs are okay about prescribing off licence medication (it seems to be licensed for treating conjunctivitis) if a specialist has recommended it, or if you tell them that it's commonly used for something..

e.g. doxycyline - not licensed for blepharitis, but I told my GP it's regularly used for blepharitis, and she looked it up, then gave me the prescription.
Am going to doctor on Wednesday so will keep you updated about how to get hold of the Ayzter.

Thanks for comments re doxycycline - I've posted separately about this so won't respond here as will hijack the thread!

[irish eyes]

Hi Irisheyes,

John Dart's registrar gave me cyclosporine to try, which I'm in two minds about. I saw John Dart for about 1 minute and to be honest he wasn't very enthusiastic about Azyter - he said he only just happened to hear about it being available. He mumbled something about studies not showing it to be particularly effective (I think that's what he said).......Thanks for comments re doxycycline - I've posted separately about this so won't respond here as will hijack the thread!

Good luck with the Cyclosporine. I had a terrible reaction to it - sorry if I sound pessimistic! But how else would you know unless you try it? I was happy to give it a go at the time.

Back to topic of Azyter. Thanks in advance for future updates.

[littlemermaid]

Irish ~ What happened on cyclosporine?

[irish eyes]

Irish ~ What happened on cyclosporine?

Where do I start?

The consultant saw it as an option to deal with inflammation; I had been using PF steroids (minims) and I started to develop a cataract. This was not necessarily related to steroid use so I don't wish to alarm anyone who is using steroids.

I got Cyclosporine from Moorfields Pharmacy (via my local pharmacy). I expected it to sting initially but this was way beyond what was tolerable and it didn't get any easier. It felt as though my eyeballs were being flayed; I could be more graphic but will spare everyone the details. It was a few days of indescribable misery. I contacted the Moorfields for advice and they urged me to stop using them. An independent agency contacted me to get all the details so it was taken very seriously; letters were sent to consultants and GPs to inform them of what had happened.

I wouldn't want my experience to deter others from trying it if they have the chance but my eyes are particularly sensitive.

I'd be tempted to use Azyter although would need to check what was in it.

[redandunhappy]

A quick update.

My GP surgery didn't have Azyter on their formulary yet (as is brand new) - which meant the doctor couldn't print a prescription, but since it is listed in MIMMS, she begrudingly wrote out a prescription by hand.

The first chemist I went to couldn't get it it because their supplier didn't stock it....I then went to Boots who said they could get it in on a special order and it would take a few weeks, then the last chemist I went to, who happened to use another major supplier (A and H or something like that) were able to get it in for the next day. In a few months I imagine there will be no problem in getting hold of it...

So I have the drops at home ready to use - will post later with the exact ingredients.

[irish eyes]

A quick update.

My GP surgery didn't have Azyter on their formulary yet (as is brand new) - which meant the doctor couldn't print a prescription, but since it is listed in MIMMS, she begrudingly wrote out a prescription by hand.

The first chemist I went to couldn't get it it because their supplier didn't stock it....I then went to Boots who said they could get it in on a special order and it would take a few weeks, then the last chemist I went to, who happened to use another major supplier (A and H or something like that) were able to get it in for the next day. In a few months I imagine there will be no problem in getting hold of it...

So I have the drops at home ready to use - will post later with the exact ingredients.

Regarding the shopping around - I have done this myself with stuff that wasn't really `available'. Let us all know how you go on with the Azyter. I hope it works for you.

[redandunhappy]

hi, Ayzter is available now in the UK now - only just though - but not with all suppliers yet...but I'm sure all chemists should be able to get hold of it within a few months.

Ingredients as listed on the leaflet (in case anyone is interested) are:

Azithromycin 14.3mg
As azithromycin dihydrate 15mg for 1g of solution
One single-dose container of 250mg solution contains 3.75mg of azithromycin dihydrate

[littlemermaid]

Thanks R&U ~ really appreciate your insider info, v kind of you to help us, particularly glad you are comfortable with JD

[redandunhappy]

just an update on Ayzter - I finally tried it last weekend and it burned quite a lot for about 30 minutes. That settled down, but my eyes felt sore and looked a little more red than usual for about 2 days. So don't think I can tolerate it unfortunately.

I spoke to an opthamologist (friend of a dad) and he said that it's to do with the pHs and my tear film not being good enough...he recommended putting a lubricant drop in first then trying it....but I don't hold out much hope of being able to use it.

Interestingly it's quite an oily drop so would probably penetrate the lid tissue as well as covering the eyeball

[littlemermaid]

I think some people are using the ointment version and wiping it along lid margins only, as well as buffering with usual tear film subsititute drop.

I've often wondered why we are dropping into the lower pouch and covering the eye surface when the antibacterial is for lid margin disease, particularly as your dad's friend says, it wrecks the pH and damages/absorbs into the surface, esp in chronic or pulse therapy use.

I did read the advantage of azithromycin is that it is more penetrative to tissue and is retained in the eyelids around 5 days later and I can see the point of that for chronic MGD although not so keen on that for LM's dry eyeball surface - I'll see if I can find that research again.

[redandunhappy]

I don't think there is an ointment version for Ayzter - are you thinking of cyclosporine, which does come in an ointment version?

[littlemermaid]

I think there's an azithromycin ointment the French have, I'll look it up.

[Rui]

Had Azyter prescribed to me some time ago as one of the treatments I've tried for blepharitis. It burned so much for about 15 minutes in each eye that really made it difficult for me to use and eventually had to stop. Worst feeling I´ve had on my eyes, only surpassed by my corneal erosions.