1. About carmellose sodium
Carmellose sodium is a lubricant used to treat dry eyes. It comes as eye drops that work like artificial tears. They soothe dry eyes and make them feel moist again.
Artificial tears can help dry eyes caused by conditions such as:
Dry eyes can also be caused by looking at computer screens or wearing contact lenses.
Carmellose sodium is available to buy from pharmacies or supermarkets. Some brands are available on prescription.
These eye drops have preservative in them. This is to keep the drops clean (sterile) and safe to use for longer. There are also single-dose droppers that are preservative-free.
2. Key facts
- You can usually use carmellose sodium 4 times a day, or as needed.
- Carmellose sodium should start to work straight away, but it may take several weeks before you feel the full effects.
- If you wear contact lenses or need to use carmellose sodium more than 4 times a day, a brand that does not contain a preservative may be best for you.
- Carmellose sodium is generally safe, with no long-term side effects.
- Do not share eye drops with other people. This can increase the risk of spreading infections to others.
3. Who can and cannot use carmellose sodium
Most adults and children can use carmellose sodium eye drops, although it may not be suitable for everyone.
To make sure it’s safe, tell your doctor or pharmacist before using the eye drops if you:
- have ever had an allergic reaction to carmellose sodium or any other medicine
- wear contact lenses – you can still use carmellose sodium, but check the leaflet provided to see if you need to remove your contact lenses first
Some brands of carmellose sodium contain preservatives. These are safe for most people to use.
Eye drops without preservatives are recommended if you:
- are sensitive or allergic to eye drops that contain a preservative
- have a moderate to severe dry eye condition, where you use eye drops more than 4 to 6 times a day
- if you use more than 1 type of eye drop or eye ointment that contain preservatives
- use soft or hybrid contact lenses
4. How and when to use carmellose sodium
Always follow the instructions that come with the eye drops, or as advised by your doctor.
Dosage
The usual dose for adults and children is 1 drop into the affected eye(s), 4 times a day, or as needed.
Carmellose sodium eye drops come in 2 different strengths:
- 5mg per 1ml, recommended for mild symptoms
- 10mg per 1ml, for moderate to severe symptoms
Carmellose sodium comes in a bottle with an eye dropper, or as a box of single-dose droppers. The single-dose droppers do not contain preservatives.
How to use the eye drops
If you wear contact lenses, you may need to remove them before using your eye drops, then wait 15 minutes before putting them back in your eyes. The drops may make your vision blurred if you use them with contact lenses. Read the leaflet provided with the medicine.
To use carmellose sodium eye drops:
- Wash and dry your hands first.
- If you’re using a bottle, remove the lid. If you’re using the single-dose dropper, twist the top off.
- Make sure the tip of the bottle or dropper does not touch anything, including your eye, eyelashes, eyelid or your skin.
- Use your finger to gently pull down your lower eyelid and tilt your head back.
- Hold the bottle or dropper over your eye, look up, and allow 1 drop to fall into your lower eyelid.
- Close your eye. Gently press your finger over the inside corner of your eye (over the eyelid) for about 1 minute. This helps to keep the drop in your eye.
- Wipe away any extra liquid with a clean tissue.
- Repeat in your other eye if you need to. There is enough liquid in 1 single-dose dropper to put a drop in both eyes if needed.
- Put the cap back on the bottle. If you are using the single-dose dropper, throw it away.
If you missed your eye when putting in the drop, you can try again immediately.
If you use carmellose sodium with other eye drops, wait at least 5 minutes before using your other eye drops. The second eye drops can wash out the carmellose sodium and it may not work as well.
If you also use an eye ointment, always use your eye drops first and wait 5 minutes before using the ointment.
If you find it hard to use eye drops, ask a pharmacist for advice. They may be able to recommend an eye drop dispenser. Using eye drops correctly can be difficult, but there are several useful devices (compliance aids) available to help. Speak to your pharmacist to see which device would best suit your eye drops. Brands include,Autodrop, Opticare and Drop Aid Single Dose.
Expiry dates and storage
Use the carmellose sodium eye drops within the expiry date on the bottle. Use them within 4 weeks of opening, unless your drops come with different instructions. This will help to prevent the risk of eye infections and the eye drops not working so well. Ask a pharmacist if you are not sure.
Single-dose droppers should usually be used as soon as you open them. But you can reseal some brands and use them again up to 12 hours later, for example Carmize, Cellusan and Melophthal.
You could write the date or time you opened the bottle or packet on the label or the box. This will help you to remember when you need to start using a new one.
Carmellose sodium eye drops can be stored at room temperature and do not need to be kept in a fridge.
What if I forget to use it?
If you forget to use your eye drops, use them when you need them next or when it’s time for your next dose.
What if I use too much?
Using too many eye drops should not cause problems.
5. Side effects
Like all medicines, carmellose sodium can cause side effects, but not everyone gets them.
Common side effects
The most common side effects, which happen in up to 1 in 100 people, are burning, itching and stinging. These are usually mild and only last for a few minutes after using the drops.
If these side effects continue, you may be sensitive to a preservative in the eye drop.
Speak to your doctor or pharmacist. They may recommend using a brand that does not contain a preservative, single-dose drops or other eye drops for dry eyes.
Serious side effects
Serious side effects are rare and may affect 1 in 1000 people:
Urgent advice: Call 111 now and do not use any more carmellose sodium if:
- your eyelid, or the area around your eye, becomes swollen (allergic reaction)
Serious allergic reaction
In very rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to carmellose sodium.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of carmellose sodium. For a full list, see the leaflet inside your medicine's packet.
You can report any suspected side effect using the Yellow Card safety scheme.
6. Pregnancy and breastfeeding
Carmellose sodium is safe to use if you’re pregnant or breastfeeding.
It has been used for many years with no reported problems.
7. Cautions with other medicines
It’s usually safe to use carmellose sodium eye drops with other medicines.S
Some medicines, such as antihistamines, antidepressants and medicines that make you pee more (diuretics), can make your eyes dry.
If you’re using carmellose sodium with another medicine and getting dry eyes, it might be that the dose of your other medicine is too high., Speak to your pharmacist or doctor to find out. They may suggest a similar medicine that does not cause dry eyes.
Mixing carmellose sodium with herbal remedies or supplements
There’s not much information about taking herbal medicines and supplements with carmellose sodium. However, very little of it gets into your body from the eyes, if any, so you’re unlikely to have problems.
Some herbal remedies or supplements can make your eyes dry. Speak to your pharmacist or doctor if you think this may be a possible cause of your dry eyes.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
8. Common questions about carmellose sodium
How does carmellose sodium work?
Carmellose sodium is a lubricant used to treat dry eyes.
It works as artificial tears, to help keep the surface of your eyes lubricated and moist.
How long does it take to work?
You should start to feel the benefits of carmellose sodium eye drops straight away. However, it can take several weeks of regular use before you feel the full benefits.
Speak to a pharmacist or your doctor if you still have symptoms after 4 to 6 weeks of regular use. They may recommend that you try different eye drops or an eye gel or ointment. See your doctor if you still have dry eyes after trying different medicines.
It’s important to get the right treatment. If not treated properly, having dry eyes could eventually damage the surface of your eyes.
How well does it work?
Many people use carmellose sodium eye drops for their dry eyes.
There are many different eye drops for dry eyes, but there’s no evidence that one type is better than another. Sometimes you may need to try different eye drops or eye treatments to find which works best for you.
How long will I use it for?
You can use carmellose sodium only as needed if your dry eyes symptoms come and go. This is often caused by:
- wearing contact lenses
- air conditioned or heated environments using
- computer screens for long periods of time
Treatment with carmellose sodium may be long term if your dry eyes are caused by conditions such as:
Is it safe to use it long term?
It’s safe to use carmellose sodium eye drops for as long as you need to.
Speak to a pharmacist or your doctor if you've been using carmellose sodium regularly and there's been no improvement after 4 to 6 weeks. They may recommend that you try different eye drops, an eye gel or ointment. See your doctor if you still have dry eyes after trying different medicines.
It’s important to get the right treatment. If not treated properly, dry eyes can eventually cause damage to the surface of your eyes.
Can I drink alcohol with it?
Alcohol does not affect carmellose sodium. But drinking too much alcohol can cause dehydration, which can lead to dry eyes.
How do other medicines for dry eyes compare?
Different lubricant eye drops are available to buy from pharmacies or supermarkets, that act like artificial tears to treat dry eyes.
These all moisturise the eye and have a similar effect to carmellose sodium. You could also try a lubricating eye gel or eye ointment.
Some lubricant eye drops also form a protective layer that helps to stop your tears evaporating. These may help if your dry eyes are mainly caused by too much evaporation of your tears.
You may have to try a few different treatments, or a combination of treatments, until you find what works well for you. Maybe eye drops during the day and an eye ointment at night.
If your symptoms do not get better after trying 1 or 2 different brands of eye drops, speak to your pharmacist or doctor for advice.
It’s important to get the right treatment, because if not treated properly, dry eyes could eventually cause damage to the surface of your eyes.
Will it affect my contraception?
Carmellose sodium does not stop contraceptive pills working, including the combined pill or emergency contraception.
Will it affect my fertility?
There's no evidence to suggest that carmellose sodium reduces fertility in either men or women.
Can I drive or ride a bike?
You may have blurred vision after you’ve just put the drops in. This should clear quickly. Do not drive a car, ride a bike, or use tools or operate machinery until you can see clearly again.
Is there any lifestyle advice to help with dry eyes?
To prevent your eyes getting dry, it can help to:
- take breaks to rest your eyes when using a computer screen
- make sure your computer screen is at eye level, so you do not strain your eyes
- blink regularly (ask your doctor or eye specialist for advice on blinking exercises if you need them)
- turn your heating down or use a humidifier to stop the air getting dry
- wear sunglasses or glasses to protect your eyes when out in a hot, dry environment
- get plenty of sleep to rest your eyes
- take out contact lenses if you wear them and wear glasses to rest your eyes
- use gentle make-up removers and do not scrub at your eyelids – also replace your mascara regularly
- stay within recommended alcohol limits
- stop smoking and avoid smoky, dry or dusty places
- avoid spending too long in air-conditioned or heated rooms
It’s also very important to keep your eyelids clean. Wipes, pads or rinses are available to buy from pharmacies, or you can simply use warm water.
Keep your eyelids clean by:
- soaking a flannel in warm water (not hot) and gently press it on the area around your eyes – this makes the oil produced by the glands around your eyes more runny
- gently massaging your eyelids with your finger or a cotton bud – this pushes the oils out of the glands
- soaking cotton wool in warm water (not hot) and gently wipe away any excess oil, crusts, bacteria, dust or grime that might have built up