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What is "Advantage MCT ?"
Cyclosporine ophthalmic emulsion is an oil in water type of emulsion.
A. Cytotoxic effect of castor oil containing cyclosporine ophthalmic formulations:
- Castor oil, which mainly contains ricinoleic acid (90% of total fatty acid content), is the lipophilic vehicles used in most of the commercialy available cyclosporine eye drops.
- The commonest treatment related adverse effect observed with these formulations is stinging and burning eye sensation.
In vitro model of conjunctival cells has demonstrated that Castor oil induces-
a. Necrosis and Apoptosis (P2X7 receptor and caspase 3 activations) of conjunctival cells
b. Oxidative stress by intracellular H2O2 overproduction.
As a hypothesis, the cytotoxic effects of castor oil could be due to its ricinoleic acid content. This cytotoxicity could explain the side effects observed in patients using eye drops containing castor oil as a vehicle. Prolonged use of castor oil containing ophthalmic emulsions can jeopardize the health of ocular surface.
B. Cytotoxic effect of cyclosporine formulation dissolved in ethanol:
- Cyclosporine ophthalmic formulations dissolved in ethanol, can also have a cytotoxic effect on cornea. As the therapy is not acute, it can pose significant damage on ocular surface in long run.
Advantage MCT:
Cyclodrop which is cyclosporine ophthalmic emulsion which contains MCT i.e. Medium Chain Triglycerides oil.
Triglycerides reconstitute the physiological lipid shield and helps in rewetting of ocular surface and its optical properties and helps in rewetting of ocular surface.
It also contains fatty acids like Caprylic and Capric acids which are known to possess antimicrobial and antioxidant properties.
Most other commercially available cyclosporine emulsions contain castor oil 90% of which contains ricinoleic acid that has cytotoxic potential and also increases oxidative stress on ocular surface.
Hence Cyclodrop has a distinct advantage over other cyclosporine emulsions available in the market in terms of lack of castor oil and ethanol induced cytotoxicity.