Azasite Rocks (Take 2)

[pbeinetti]

I've used 3 drops so far -- 2 yesterday, and one this morning. The irritation has gotten worse, eyelids very red, glare and light sensitivity has increased, etc. I think it might be because of the preservative (BAC). Has anyone experienced this -- getting worse initially? I'm using compresses every 1-2 hours just to function. I'm about ready to give up. Maybe try DHEA drops.

[NYer]

Wow. Peter, I've been taking it exactly as long as you have and I have absolutely no issues with it. And the only side effects anyone mentioned to me or that I read on here were stinging/burning upon using the drops that might last for a while. In my ignorant opinion, I'd say it sounds like a reaction to the BAK, like you said. If you have a history of reacting to it, then that's probably what it is. If I were you, I'd call the doctor (leave a msg with the answering service because it's the weekend but tell them to have him get back to you) and tell him what's going on. Personally, I'd stop using it.

[pbeinetti]

I stopped using the Azasite last night. I'm sure it's the BAK. Plus I was in the Dr's office last Thursday and he put drops in my eyes to do tests. I'm almost positive that the drops have BAK in them. Every time they put drops in my eyes I go through 2 days of hell afterwards. I understand that Drs can get their drops nonpreserved. I sent him an email last night telling him what was going on, and to see if he can get nonpreserved drops for use in the office. I'm at the point of REALLY believing Dr Latkany -- that the only way to get control of dry eye and MGD is lid hygiene, warm compresses, lid massages, etc. I have read his book, and follow his posts on this forum. He does not appear to be a big believer in various eye drops, ointments, etc.

[NYer]

He's not...when I was in his office last week, I asked him not to use the yellow drops (I can't remember what they're called...you all know what they are...flouriscan or seomething like that?). So he didn't and he had no problem with that.

[skygoddess]

Well , I read very mixed reviews about the azasite. So I thought I would post an update on my experience.

3 weeks total usage, 2 weeks of 4x per eye per day, last week was 3x per day. Best 3 weeks I have had in over 2 years.

My husband made a comment, " Hey your eyes look almost normal"
This is from someone who didn't notice I changed my hair colour for 2 weeks,

I ran out one day, and what a difference! My blepharitis flared up so badly I just wanted to cry all day.
I was out of town and unable to get a refill till after midnight. I ended up having to get Tobradex to supplement the azasite.
But I can report they are once again almost normal !
Can't wait till the day I reach totally normal!

The azasite only burns slightly now, vs , burning like fire before.
The Doc is not sure how long I'll be staying on this.
He admits this is all an experiment. We are trying to taper off gradually.
But , this is by far the best result , and most hope I have had.

[NYer]

Wow, Sky, 4 times per day?? I'm on ONE time per day (first two days are twice a day and thereafter, once per day).
Taking it for more than a week is "off-label" prescribing but 4 times per day is way off-label. Did your doctor get into why he feels that's OK?

[pbeinetti]

I think the idea of the antibiotic is probably good. If the lids are infected, and the meibomian glands are swollen and blocked, then an antibiotic seems called for. I'm glad there are positive results. I'd like to get an antibiotic to try that is non-preserved. I'll talk with my Dr about that. I have taken SO many drops with BAC in them over the past couple of years that I'm convinced I react to it. Below is some info on BAC. Technical, but you get the point. I believe I have irreversible cytotoxic damage -- I just can't put the stuff in my eyes without getting a terrible reaction.

"Benzalkonium chloride (BAC), the most widely used preservative in ophthalmic solutions, acts on the ocular surface through toxic or immunoallergic reactions. Due to its surfactant properties, this quaternary ammonium strongly decreases lachrymal fluid stability. It also causes toxic effects to epithelial cells and increases corneal permeability. In vivo, strong histopathological changes are observed after topical treatments with preservatives, including infiltration by inflammatory cells, similar to those induced in humans by long-term topical treatments. We designed a series of in vitro experiments confirming the toxicity of BAC, even at very low concentrations. In vitro, BAC induces cell necrosis at the concentrations found in most eye drops after a few minutes, and apoptosis when applied at lower concentrations. This apoptotic phenomenon is confirmed by 4',6-diamidimo-2-phenylindole, dilactate (DAPI) coloration and with the use of flow cytometry. A decrease in cell size is observed with BAC at 0.001% and is confirmed by morphological assay. An overexpression of Apo 2.7 associated with an increase of sub G1 phase cells is also shown. BAC induces irreversible cytotoxic damages with some characteristics of apoptosis in a concentration-dependent manner."

[skygoddess]

Can someone explain to me what compounding pharmacies are exactly?

I have seen people post about using them before.
I think they can duplicate prescriptions , but maybe without a troublesome ingredient, like BAK.

Maybe someone who has used them before can tell me how it works.
What about medicines still under patent protection?

I am worried about the high dosage of azasite, because of the BAK,
but right now it works, and I am so happy to have finally found something,
I am willing to chance it. But if there is a way to get it preservative free,
I would much prefer that.

[NYer]

Sky, that's a really good idea. Here's info on Compounding Pharmacies:
http://drugs.about.com/od/buyingdrug...p_pharmFAQ.htm

[Brighteyes]

Anyone been using Azasite for more than the recommended 14 days or indeffinitely?

[pbeinetti]

Below is a link to an EXCELLENT article about Benzalkonium Chloride. If I had seen this article beforehand I would never have used an eye drop with BAC (BAK) in it. This is from an English web site. I am positive I have a damaged cornea from the use of this preservative -- and, the doctor never warned me.

http://preservative.free.fr/English/indexen.htm

[NYer]

Azasite does NOT rock for me

Well, the verdict is in - Azasite was terrible for me. I was on it for four days and had to go off of it. Although I didn't have the initial stinging or burning upon instilling it (as many people here have), it has irritated the heck out of my eyes and to no benefit. Over the past few days, my lids and rims have gotten redder and redder and this morning I have shadows under my eyes. Before this, my eyes actually LOOKED pretty much fine. Now they look like I was out celebrating St. Patrick's Day too much. The look terrible.
Also, I put the drops in last night before bed, as directed. I woke up a few times during the night and my eyeballs were really sore and dry and irritated. I had to put lots of Systane PF drops in. I've been up now for almost 4 hours and it doesn't feel much better.
So I'm much worse off than I was before I tried the Azasite.
I called Dr. L this morning and he said to stop using it.
Obviously it works for some people but not for me. (By the way, I have no history of issues with BAK, so I don't think that's what it is, but I can't say that for sure.)

[pbeinetti]

Nyer:

Looks like you and I have had the same lousy experience. Too bad! It would be nice if SOMETHING worked. BTW, I wouldn't discount the BAK issue. Maybe it isn't the problem, but how would you know? Azasite has both BAK and disodium edetate -- both can be irritating and cause irreversible toxicity. I suspect you looked at the 'Preserve our eyes, not our drops' web site I posted earlier. If not, I've linked it below. Read the whole web site -- it's scary! I am doing 4-5 warm compresses a day, and massage ala Dr. Latkany, at the moment. I'm slightly better after the Azasite experience, which irritated the hell out of my eyes.

Pete

http://preservative.free.fr/English/indexen.htm

[GeorgeT]

Leiter's Pharmacy

Hi,

It's worth to call Leiter's Pharmacy to ask about PF azasite.
All best!

George

[cookie]

reply azarsite

i use it too, have since dec. you only need it to clear up, i have been on it way too long, my doc is taking me off. i do not have stinging. i wash hands, drop on fingertip, open corners, place it on upper inner lid. it does not drip out. it will drip if you drop it in the eye. i do it 2x a day.
good luck, cookie in ga.