Natamycin ophthalmic suspension is used for the treatment of fungal infections of the eyelids, conjunctiva and cornea caused by susceptible organisms, including Fusarium solani keratitis.

Natamycin is a tetraene polyene antifungal antibiotic obtained from Streptomyces natalensis. It works by binding to sterols in the fungal cell membrane, which alters membrane permeability and causes leakage of essential cellular components. It shows in vitro activity against a broad range of yeasts and filamentous fungi, including Candida, Aspergillus, Cephalosporium, Fusarium and Penicillium. Although its antifungal effect depends on the dose, Natamycin mainly acts as a fungicidal agent. Topical use provides effective concentrations within the corneal stroma, but it does not significantly penetrate into the intraocular fluid.

For fungal keratitis: The preferred initial dosage is 1 drop instilled in the conjuntival sac (s) at 1-2 hours interval. The frequency of application can usually be reduced to 1 drop 6-8 times daily after the first 3-4 days. Therapy should generally be continued for 14 to 21 days or until there is resolution of active fungal keratitis.

For fungal blepharitis & conjunctivitis: 1 drop 4-6 times daily may be sufficient.

Pediatric use: Safety and effectiveness in paediatric patients have not been established.

Use with topical corticosteroids may increase the spread of fungal eye infections.

Natamycin ophthalmic suspension is contraindicated in patients with a known hypersensitivity to Natamycin or any of its ingredients.

Reported side effects include eye irritation, eye discomfort, swelling of the eye, conjunctival chemosis and redness of the eye.

Pregnancy category C. Animal reproduction studies have not been conducted with Natamycin. It is not known whether Natamycin can cause fetal harm when used during pregnancy or affect reproductive ability. Natamycin ophthalmic suspension should be used during pregnancy only when clearly needed. It is also unknown whether this drug passes into human breast milk. Since many drugs are excreted in breast milk, caution should be taken when administered to nursing mothers.

Do not allow the dropper tip to touch any surface, as this may contaminate the suspension. Patients should avoid wearing contact lenses if they have symptoms of fungal blepharitis, conjunctivitis or keratitis. If keratitis does not improve after 7 to 10 days of treatment, the infection may be caused by an organism not sensitive to Natamycin. Continued treatment should depend on clinical re-evaluation and laboratory findings. The suspension may adhere to ulcerated epithelial areas or remain in the conjunctival fornices.

Ophthalmic antibacterial drugs

Store in a cool and dry place. Protect from light. Do not freeze. Do not use for more than one month after first opening the bottle.