Combined (Kombinil) eye drops. Price, instructions for use, analogs, where to buy, reviews

Combined - an effective remedy that belongs to combined medicines and has unique therapeutic properties. Eye drops are used for various disorders of inflammatory and infectious origin. The price of the product is quite high, but its economical consumption and high efficiency make it popular and in demand among patients.

Forms of release and composition of the drug

The drug can be purchased in the form of drops, which are packaged in 5 ml plastic bottles. Each bottle is placed in an individual cardboard box, where you can also find instructions for using the medication.

Drops are intended for instillation into the ears and eyes, they are a clear liquid. The solution can be transparent or light yellow, has no sediment and impurities.

The tool has a pronounced therapeutic effect due to the presence in the composition of 2 active components - ciprofloxacin and dexamethasone.

1 ml of the drug contains 3 mg of the first substance and 1 mg of the second hormonal ingredient.

The composition contains auxiliary components:

• Benzalkonium chloride.
• Mannitol.
• Disodium edetat.
• Hydrochloric acid.
• Water for injections.

Auxiliary ingredients are necessary to maintain the chemical composition, but they do not have medicinal properties.

Pharmacological properties

Combinil - eye drops, the price of which is quite high. They belong to the combined preparations of hormonal origin. They have anti-inflammatory, mild antihistamine and antimicrobial effects due to the combination of antibacterial and glucocorticoid substances.

The tool helps to relieve swelling, eliminates redness, destroys pathogens and prevents them from multiplying on the cornea or inner walls of the hearing aid. Additionally, the medication has protective properties, since it contains components that can create a kind of barrier on the surface.

The drug effectively fights against various types of microorganisms, helps not only to stop their growth and development, but also suppresses vital activity, which leads to the gradual death of microbes. Thanks to the complex effect of the agent, not only the patient's condition is improved, but also the progression of the pathological condition is stopped.

Pharmacodynamics and pharmacokinetics

The drug is well absorbed when applied to the cornea or into the ear canal. Its active components penetrate tissues and have a therapeutic effect. Ciprofloxacin in the composition of the drug has pronounced antimicrobial properties.

The ingredient is active against many pathogenic microorganisms, since it belongs to the group of fluoroquinolones, that is, it has a bactericidal effect on microbes.

This effect is carried out due to the impact on the vital activity of microorganisms and metabolic disturbances. As a result, the activity of microbes is suppressed, followed by their death.

Ciprofloxacin destroys many gram-positive and gram-negative bacteria, Legionella, Escherichia. In addition, it is active against Salmonella and some other types of dangerous bacteria.

Due to the high efficiency of the product, microbes are destroyed and their spread to healthy tissues is prevented. One of the features of the substance is the destruction of staphylococci and streptococci. These bacteria most often provoke inflammatory processes, and also aggravate the course of an existing disease.

Dexamethasone in the composition of the drug enhances the effect of ciprofloxacin, quickly relieves inflammation and has immunosuppressive properties. Thanks to this, the progression of even severe inflammation is stopped, as well as the prevention of various complications.

The antiallergic action of the agent helps to prevent various complications associated with allergies. The component reduces capillary permeability, which eliminates edema, and also prevents their fragility by strengthening the wall. As a result, the formation of scar tissue is suppressed, as well as a decrease in the activity of phagocytes, which has a positive effect on the course of the disease.

Additionally, the agent has prophylactic properties, helps prevent recurrence of chronic diseases, improves the general condition of the visual and auditory apparatus.

When the drug is applied to the cornea, the active ingredients are absorbed rather quickly, and their maximum concentration is reached after 30 minutes. The substances can be found in the fluid of the eye, as well as in the tissues of the inner ear. The components penetrate well through various membranes, but do not get into the lens, even when using large doses of the agent.

When examining blood, you can find insignificant concentrations of components that have no therapeutic value. The maximum plasma concentration is reached within 30-50 minutes after administration. The period of elimination of substances from the body is 3-6 hours, depending on the dose and duration of use.

There is a long-term preservation of dexamethasone in the lacrimal secretion, which ensures the preservation of the therapeutic effect over a long period.

Some of the active components of the drug enhance the effect of the main ingredients, which provides a prolonged effect and reduces the need for repeated, frequent administration of therapeutic doses. In patients suffering from pathologies of a chronic nature, there is a slight slowdown in the absorption and excretion of substances from the body, which does not weaken the therapeutic effect.

Indications for use

Kombinil is prescribed to patients for the treatment and prevention of many diseases. Eye drops are highly effective for varying degrees of damage, which justifies the high price.

The main indications for prescribing a medicine:

• Conjunctivitis of acute and subacute forms, an allergic type of the disease, as well as a chronic type of inflammation with regular relapses.
• Blepharitis as a result of aggressive external factors, as well as other conditions characterized by inflammation of the mucous membrane of the eyelids.
• Anterior uveitis, in which there are pronounced manifestations of the disease.
• Diagnosis of acute and chronic keratitis. In the second case, the use of the drug is carried out during the period of exacerbation of symptoms.
• Recovery period after removal of a foreign body or surgery on the eyeballs. At this time, the use of medication is required in order to prevent the growth of microbes on the damaged surface.
• A tympanic membrane shunt, in which otitis media develops.
• Inflammation of the outer ear.
• The formation of granulations in the middle ear, provoking the inflammatory process and aggravating its course.

In addition, the medicine can be used for an allergic form of conjunctivitis, when conventional antihistamines cannot eliminate the manifestations, and the patient's condition is aggravated.

Contraindications

Effective drops are not always allowed to be used. One of the main contraindications is the individual intolerance of the main or auxiliary components of the composition.

In addition, contraindications include tuberculous and fungal infections of the eyes, ears, as well as the viral origin of the pathology. In this case, the drug can only worsen the course of the underlying disease. You can not use the medication during pregnancy and during breastfeeding, despite the insignificant systemic absorption and minimal concentration in the bloodstream.

Contraindications include herpetic keratitis, when the use of an antibiotic can only aggravate the course of the disease. It is not recommended to use drops when a perforation of the tympanic membrane is detected. Severe forms of glaucoma are also considered a reason to refuse therapy, but sometimes the remedy is prescribed under the supervision of a doctor.

With caution, the medication is used to treat elderly patients who suffer from chronic inflammatory diseases of the ears or eyes.

At what age can the drug be used?

Combinil - eye drops (the price may differ in different regions), which is prescribed to patients over 18 years of age. This is due to the pronounced properties of the drug and a rather aggressive effect, which can adversely affect the state of the visual and auditory apparatus.

Instructions for use, dosage

For different diseases, the scheme for using the medication may differ, therefore, the appointment is made by the doctor after a preliminary examination.

Disease	The scheme of using drops
Blepharitis and conjunctivitis of various forms	1-2 drops of the agent are instilled into each eye every 6-8 hours. The duration of the use of the medication is 5-14 days, depending on the state of neglect. When instilling, it is important to exclude touching the tip of the bottle to the cornea. In addition, it is necessary to be in a comfortable position to ensure maximum distribution of droplets over the cornea. After instillation, it is worth closing the eye and gently massaging it several times over the eyelid, which will allow the solution to be distributed.
Chronic and acute keratitis	With such a disease, the duration of the use of drops is 2-4 weeks, depending on the neglect of the condition. Drops are injected according to the standard scheme, in a comfortable position, more than 2 drops in each eye. It is important not to exceed the dose and not to prolong the course on your own. The number of applications per day is 3-4 times.
Prevention of diseases after surgery	For prophylactic purposes, drops are applied for 5-30 days, depending on the rate of tissue repair. The scheme of administration is standard, it is necessary to repeat the manipulation every 8 hours.
Inflammatory pathologies of the ear hearing aid	For ear diseases, the drops are injected while lying on the side. After the introduction for 1 min, it is not necessary to change the position of the body in order to allow the solution to penetrate into the ear canal. 4 drops are injected into each ear. It is important not to inject a cold solution, it must be at room temperature. The procedure is repeated 2 times a day for 7 days. If there is no effect, other means are used or the therapeutic course is prolonged.

For other diseases, the remedy is used according to the same schemes, but not more than 10 days without consulting a doctor. In each case, the dosage and regimen may vary depending on the individual characteristics of the organism.

Before the introduction of drops into the ear canal, it is recommended to rinse and dry it, which will improve the penetration of the agent into the affected tissues.

Side effects

Adverse reactions when using drops may appear if the instructions are followed or violated. The second is more common. In this case, the patient has swelling of the eyelids, as well as severe itching, burning. Some talk about dryness of the cornea, discomfort when blinking and prolonged healing of tissues, if the medication is used as a prophylaxis for postoperative complications.

Many people note redness of the eyeballs, severe itching of the skin in the eye area, as well as the appearance of a small rash, which is a manifestation of an allergic reaction. On the part of the hearing aid, there is itching in the ear canal and ear congestion, as well as the appearance of nonspecific discharge.

Only in some cases are side effects manifested in the form of aggravation of the symptoms of the underlying disease. In rare cases, complications manifest themselves in the form of cataracts and the development of secondary glaucoma, damage to the optic nerve. Disturbance of taste perception is sometimes noted.

It is worth noting that such manifestations are rare and in most cases with prolonged use of the medication without a doctor's prescription.

Overdose

Combinil - eye drops, the price of which is quite justified. They rarely provoke an overdose. In this case, all side reactions are usually aggravated, and there is also a strong swelling of the mucous membranes of the eyelids, pinpoint redness of the eyeballs. Often, other manifestations join in the form of severe itching, as well as pronounced tearing.

Since the agent penetrates into the systemic circulation in a minimal amount, the likelihood of a systemic overdose is very small. If side effects or signs of overdose appear, it is important to stop using the product immediately. If the manifestations do not disappear, it is necessary to visit a doctor who will prescribe symptomatic therapy.

There is no specific antidote to the remedy, but the patient should rinse his eyes to weaken the manifestations, and also use local remedies prescribed by the doctor.

special instructions

Prescribing a medicine, determining the dosage and duration of use is carried out only by a specialist after a preliminary diagnostic examination and identifying the cause of the deviation.

It is worth remembering that prolonged use of the medication can lead to a significant increase in intraocular pressure with subsequent damage to the optic nerve. In addition, prolongation of the course provokes a weakening of the local tissue protection, which can lead to the addition of a secondary infection.

If the patient wears lenses on a regular basis, then they should be removed from the eye before the introduction of drops. It is allowed to put on the lenses again only after 20 minutes. This is due to the presence of a preservative in the drops, which can negatively affect the condition of the lenses. These are reusable devices. One-day lenses should be discarded for the duration of treatment with the remedy.

Drug interactions

Combinil - eye drops (the price of the drug is explained by high efficiency), which in very small doses are absorbed into the systemic circulation, therefore, interaction with systemic medicines does not occur. But experts do not recommend combining drops with other local anti-inflammatory and antibacterial agents in order to eliminate the risk of complications.

It is worth remembering that the combination with synthetic corticosteroids several times enhances the immunosuppressive effect. medications, therefore, you should not use several drugs at once, which contain dexamethasone.

During the treatment period, it is important to inform the doctor about any medications the patient is using. If the use of drops from another group is required, it is important to observe a break between means of at least 30 minutes.

Analogs

If it is impossible to use the drug, its analogue with similar therapeutic properties is prescribed.

The most popular and effective substitutes:

• Sofradex - an effective medication in the form of drops, which also contains dexamethasone and 2 antibacterial components, which enhances the effect. The tool is highly effective, can be used at different stages of inflammatory and infectious diseases.
• Dexon - one more drops, which contain dexamethasone, as well as neomycin. The second component belongs to the antibacterial group, therefore the medication is considered combined, helps to eliminate inflammation, destroys microorganisms and helps prevent complications.

Analogues can only be used as directed by a doctor.

Terms, conditions of sale and storage

You can store the medicine away from children, sunlight and moisture. The maximum period is 3 years, but an open bottle is allowed to be used no longer than 45 days, after which the drops cannot be used.

You can buy a medication at a pharmacy with a prescription from a doctor.

Price

The average price of a solution in 5 ml vials is 400-430 rubles.

Combinil - combined and effective eye drops prescribed to patients with inflammatory and infectious pathologies of the eyes and ears. The high price of the product is fully justified by its properties and performance.

Video about Combinil drops

Overview of eye and ear drops Combinil Duo: