Legal Classification	P: For use and supply by all optometrists.
Available Preparations	Otrivine-Antistin: eye drops, 0.5% antazoline sulphate, 0.05% xylometazoline hydrochloride (Spectrum Thea)
Drug type	Anti-inflammatory
Classification	Anti-histamine
Indications/Use	For the temporary relief of redness and itching of the eye due to seasonal and perennial allergies such as hay fever or house dust allergy. See Clinical Management Guideline on Conjunctivitis- seasonal and perennial allergic
Contraindications	Hypersensitivity to antazoline, xylometazoline or any component of the preparation. Should not be used in patients taking monoamine oxidase inhibitors within the last 14 days.
Cautions	The only preparation available in the UK contains xylometazoline, which is a sympathomimetic and should be avoided in patients at risk of angle closure glaucoma. Use with caution in elderly patients with severe cardiovascular disease, including arrhythmia, poorly controlled hypertension, or diabetes. Similarly, sympathomimetics should also be used with caution in the presence of hypertension, cardiac irregularities, hyperthyroidism diabetes mellitus or phaeochromocytomas, also in patients with conditions causing urinary retention such as prostatic hypertrophy or patients who are currently receiving other sympathomimetic drugs. Contact lens wear should not be worn during treatment. Preparation contains benzalkonium chloride as a preservative, which may accumulate in soft lenses and cause irritation.
Pregnancy and Lactation	Pregnancy risk category C. Safety in pregnancy has not been established. Should be used with caution during pregnancy and only if the expected benefit to the mother is greater than any possible risk to the developing foetus. It is not known whether antazoline is excreted in breast milk. Its use in nursing mothers therefore requires that the benefits be weighed against the potential risks to the infant.
Interactions	Should not be used in patients receiving monoamine oxidase inhibitors or within 14 days of stopping such treatment (risk of hypertensive crisis). Should be used with caution in patients receiving other medications such as digitalis, beta-adrenergic blockers, guanetidine, reserpine, methyldopa or anti-hypertensive agents. Sedating anti-histamines can enhance the sedating effects of CNS depressants including alcohol, hypnotics, opioid analgesics, anxiolytic sedatives, and anti-psychotics. They also have an additive anti-muscarinic action with other anti-muscarinic drugs, such as atropine, and some antidepressants In the case of concomitant use of another topical eye preparation, allow 5-10 minutes between applications of each preparation.
Dose	Adults & children (12 years and over) apply 1 drop two to three times daily.
Ocular Side Effects	Transient stinging Blurring Conjunctival hyperaemia Conjunctival follicles Local allergic reaction (rash, oedema, pruritus) Acute closed angle glaucoma
Ocular Side Effects-Notes	Rebound hyperaemia may occur. Ocular side effects are uncommon and typically transient. Xylometazoline is a sympathomimetic and may precipitate angle closure glaucoma in susceptible individuals. Recent case reports of severe follicular conjunctivitis.
General Side Effects	Headaches Dizziness Drowsiness
General Side Effects-Notes
Storage	Store below 25șC.