Does or Has anyone use(d) AzaSite® (azithromycin ophthalmic solution) 1%?

[Santaklauzz]

Santaklauzz, Assuming you've read everything you can find in PubMed and Medscape http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130918/. We used Azyter for short courses of 6 days maximum. I would use it again for persistent chalazia, but only in a short course. If it's burning your eyes, maybe it's causing damage?

It's difficult, I know, but can you find a regular Ophthalmologist to work with? Maybe visit 3 or 4 times a year, and email or phone for advice meanwhile? Someone needs to monitor your eyes and help you. You deserve that at least.

I just can't seem to accept that now I finally got my hands on one of the only decent medications for MGD, it might not work for me.
I've read about this drug for more than a year, every time more convinced it would help and now it may make things worse.
So I'm giving it another week (the treatment was a month) and then I'll see.
Azithromycin has a halflife of 5 days in the eyelid tissue. Maybe the effect will linger on for a few days or weeks and maybe it will get better then.

I have an appointment with a prof. dr. opthalmologist specialized in the lacrimal passages at the hospital of my university. It's a two minutes drive by bike from my dorm.
I'm going to ask her to monitor me. I've already seen her a year ago but she couldn't diagnose me. But I've been diagnosed with MGD by dr. Geerling, so maybe now she can take up the thread.

[littlemermaid]

Almondiyz, We are using erythromycin on the face for p&p rosacea flares, which works well to keep the eyes good even though we use it nowhere near the eyes. Some people here are saying that using an antibacterial facewash, even when there are no obvious skin problems, helps the eyes.

Do you have a skin regime that helps?

[littlemermaid]

Santaklauzz, Assuming you've read everything you can find in PubMed and Medscape http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130918/. We used Azyter for short courses of 6 days maximum. I would use it again for persistent chalazia, but only in a short course. If it's burning your eyes, maybe it's causing damage?

It's difficult, I know, but can you find a regular Ophthalmologist to work with? Maybe visit 3 or 4 times a year, and email or phone for advice meanwhile? Someone needs to monitor your eyes and help you. You deserve that at least.

[Almondiyz]

That's what one of my doctor's also said to me. As well as Lotemax; yet with Lotemax you have to keep going in to test ocular pressure so how safe could something that requires so many visits be?

I guess I'll try AzaSite when I get it, I'll know right away if I can tolerate it or not if it burns. Anything that burns my eyes even if doctor's & product info say burning is common & resolves, I can't use.

I'm so used to being excited about something then crash & burn to depression & hopelessness. And to think I've only had such severe problems for almost a year.

[Almondiyz]

Thank you!

[LaDiva]

My doctor said it could be used forever without a problem.

[Santaklauzz]

I use Azyter, the European version. It contains no BAK, but it does contain POLYQUAD, which is a lot less toxic than BAK.
Still, it burns terribly for several hours so I only use it at night and then it's usually over in the morning if I sleep long enough.
When I close my eyes, it doesn't bother me. I only apply it to my lower eyelids, but it gets into the eye very easily.

I'm a bit scared that I might make it worse, but in terms of dryness or inflammation, nothing has changed. So I guess it's more or less safe.

Lately I've been able to identify the individual meibomian glands on my lower eyelids. Before, I didn't think it was possible, but you just have to look very closely in the mirror.
After warm compresses, I think I can sometimes see oil coming out of one or two glands. I'm really checking everytime now to see if it gets better the longer I use Azyter.

Does anybody know how safe it is to use azithromycin long term? Is it for instance a good idea to do one month on, one month off?
I'm just afraid that fungi and resistent bacteria could become a problem.

I used Azasite every night at bedtime 2 months on I month off for about 3 years.
I started a few years ago in January and by May my eyes didn't feel extremely dry anymore..

So your doctor prescribed two months on two months off for three years? Did he/she say anything about safety?

[Jade]

I used Azasite every night at bedtime 2 months on I month off for about 3 years.
I started a few years ago in January and by May my eyes didn't feel extremely dry anymore. I still had mgd debris and foreign body sensation from chalasis in one eye, but for me, it definitely improved the sensation of dryness.
I was on it for about 3 years. Eventually I decided to quit it because of concern about BAK over a year ago.

[LaDiva]

One of my eye doctors said that AzaSite could be used indefinitely, and that it is an option for people who don't tolerate oral antibiotics well. (Yeast, stomach upset, etc...) It simply didn't work for me, and it was not covered by my insurance. Almondiyz, I don't know if BAK was part of the problem or not.

[glimmer-of-hope]

I found this study about AzaSite toxicity. But it’s with rabbits, not humans, and only if introduced into the anterior chamber, so it’s probably not relevant but I mention it anyway:

„Besivance and AzaSite eyes exhibited significantly similar and severe clinical damage, including severe corneal edema.“

http://www.ncbi.nlm.nih.gov/pubmed/20678751

Then I found another study with positive results. It’s quite long, here is the conclusion:

„Bacterial conjunctivitis and blepharitis are common conditions that are routinely encountered by the eye-care practitioner. The results of this literature review demonstrate that azithromycin 1.0% in DuraSite® is an effective and safe treatment for these ocular conditions in both the pediatric and adult populations. Additionally, contact lens related dryness improved after treatment with 1% azithromycin and the 1.5% formulation was effective for the treatment of trachoma. In addition to its anti-microbial and anti-inflammatory effects, AzaSite® in DuraSite® has been found to maintain prolonged drug residence time, have a less frequent dosing regimen, thus increasing patient compliance. This is of importance as AzaSite® continues to be studied for the treatment of ocular conditions beyond its clinical indication.“

Here is the link to the whole article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619494/

So I guess even if it has side effects it can be very useful for some people. The question is how long the improvement lasts after discontinuation of the treatment...

Almondiyz, I would probably give it a try to see if it works for you. It’s definitely cheaper option than IPL or Lipiflow (btw Lipiflow is not very effective with severe MGD). But I would also ask your doctor about his opinion on BAC and long term use of AzaSite.

Btw, I totally agree that medicine in the USA is all about money! It’s just business here! I’m actually shocked when I compare the health system here with Europe. It’s not good when money becomes more important than health…

[Almondiyz]

Azasite was prescribed for my chronic inflammation to deal with MGD & ocular rosacea. Not sure if I want to even try it now. My doctors (yes, plural) keep trying to get me to try IPL.

IPL is very expensive, insurance doesn't cover the treatments; the treatments are for life. The team of corneal disease specialists say I have to deal with the ocular rosacea first then do Lipiflow.

It's sad that doctor's are so far separated from people who can't just throw cash around. It's getting to the point where the doctors act as if I have only IPL 1st then Lipiflow 2nd left as possible treatments.

I really hate insurance companies. I also feel that physicians aren't doing enough (or anything at all) to get treatments covered by insurance since it potentially ruins they're cash flow. Everything is about money. Medicine certainly has changed.

I oftentimes wonder WHY the I keep going back to the doctors when they're not able to help these diseases. It's the desperation I guess.

[Almondiyz]

I started out with the liquid form of Lotemax, changed to gel. My eyes got worse. I actually think the gel was worse since it stayed in my eyes longer.

[glimmer-of-hope]

AzaSite didn’t help me at all. Also, I think it isn’t good to use it long term.


Information from the package leaflet:

AzaSite is a macrolide antibiotic indicated for the treatment of bacterial conjunctivitis caused by susceptible isolates of the following microorganisms: CDC coryneform group G, Haemophilus influenzae, Staphylococcus aureus, Streptococcus mitis group, Streptococcus pneumoniae.

As with other anti-infectives, prolonged use may result in overgrowth of nonsusceptible resistant organisms, including fungi.


Ingredients:

active: azithromycin 1%

inactive: mannitol, citric acid, sodium citrate, poloxamer 407, polycarbophil, edetate disodium (EDTA), sodium chloride, water for injection, and sodium hydroxide to adjust pH to 6.3

preservative: 0.003% benzalkonium chloride

[Nightbird]

It didn't help me, and I was allergic. Made my eyes bright red and painful. There are other posts here about how it helped some, but I was not one of those people. It burns like the devil.

I had a similar experience. Not sure if I was allergic, but the pain and the bright red eye part, yes. It was scary to see how red my eyes got from it. I had to flush it out with saline.

Lotemax now comes in a gel form. it still has BAK in it but much less. I was able to tolerate it that way. I'm not sure about this but I think I read somewhere that there is also an ointment form that is preservative-free Maybe someone else knows?

[Almondiyz]

Do you think it was the Benzalkonium Chloride (BAK)?

I tried Lotemax several times nearly a year ago, March 2013, & had a horrible reaction. Burned & made my eyes worse.

Lotemax has Benzalkonium Chloride in it as well but I didn't realize BAK had documented ocular toxicity.

What other eye med's have you tried? I've used ans am currently using Erythromycin Ophthalmic Ointment USP, 0.5% without problems. My doctor prescribed Azasite saying it's better than Erythromycin.