What are the uses of Muro 128 (5% sodium chloride ophthalmic ointment)?

Uses of Muro 128 (5% Sodium Chloride Ophthalmic Ointment)

Muro 128 (5% sodium chloride ophthalmic ointment) is primarily used to reduce corneal edema through its hyperosmotic properties, drawing excess fluid from the cornea to improve visual clarity and reduce corneal swelling.

Primary Indications

Muro 128 works through osmotic action to treat several ocular conditions:

1. Corneal Edema Management

   • Reduces corneal swelling by drawing excess fluid from the cornea
   • Particularly useful in conditions like:
     • Fuchs' endothelial dystrophy
     • Bullous keratopathy
     • Post-surgical corneal edema

2. Treatment of Corneal Epithelial Defects

   • Helps promote healing of corneal epithelial defects
   • May be used in cases of recurrent corneal erosions

3. Adjunctive Therapy in Dry Eye Syndrome

   • Can be used as a nighttime ointment for severe dry eye cases
   • Provides extended lubrication while drawing excess fluid from swollen corneal tissue 1
   • Used in step-wise approach for dry eye management when artificial tears alone are insufficient

Application Method

• Apply a small ribbon (approximately 1/4 inch) of ointment to the lower conjunctival sac
• Typically used 1-4 times daily, depending on severity of condition
• For nighttime use, apply before bedtime
• Morning lid hygiene is recommended after nighttime use to prevent blepharitis 1

Formulation Options

Muro 128 is available in two formulations:

• 5% sodium chloride ophthalmic ointment - provides longer contact time with the ocular surface
• 2% and 5% sodium chloride ophthalmic solution - for daytime use when ointment may cause visual blurring

Precautions and Side Effects

• Temporary blurred vision - common with ointment formulation
• Mild stinging or burning upon application
• Not recommended for long-term continuous use without ophthalmologic supervision
• Should be used with caution in patients with:
  • Known hypersensitivity to any components
  • Active ocular infection

Clinical Considerations

• For dry eye syndrome, Muro 128 ointment is typically used as part of a stepwise approach:

  1. First-line: Artificial tears containing methylcellulose or hyaluronate
  2. Second-line: Ophthalmic ointments like Muro 128 for nighttime use 1
  3. Advanced therapy: Consider anti-inflammatory agents for refractory cases

• For corneal edema, Muro 128 may be used as first-line therapy to rapidly reduce swelling and improve visual clarity

• In bacterial keratitis cases, Muro 128 should not replace appropriate antibiotic therapy but may be used as adjunctive treatment 1

Monitoring and Follow-up

• Regular ophthalmologic evaluation is recommended for patients using Muro 128 chronically
• Assessment of corneal thickness and clarity should be performed to evaluate treatment efficacy
• Discontinue use and consult an ophthalmologist if symptoms worsen or if no improvement is seen after 72 hours of therapy

Muro 128's hyperosmotic properties make it particularly valuable for managing corneal edema, which can significantly impact visual acuity and quality of life if left untreated.