What is the proper dosing for Carboxymethylcellulose (CMC)?

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Last updated: December 8, 2025View editorial policy

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Carboxymethylcellulose Dosing

For ophthalmic use, carboxymethylcellulose should be administered as 1-2 drops in the affected eye(s) as needed after shaking the bottle well. 1

Ophthalmic Administration

The FDA-approved dosing for carboxymethylcellulose ophthalmic solution is straightforward and patient-directed:

  • Instill 1 or 2 drops in the affected eye(s) as needed 1
  • Shake the bottle well before each use 1
  • No maximum daily frequency is specified, allowing for use based on symptom severity 1

Clinical Evidence for Ophthalmic Use

Carboxymethylcellulose 1% ophthalmic solution demonstrates significant efficacy in treating dry eye symptoms, particularly after ocular surgery:

  • In post-phacoemulsification patients, CMC 1% significantly improved tear breakup time (TBUT) to 8.5 ± 5.5 seconds at day 7 and 9.0 ± 5.9 seconds at day 30, compared to 6.6 ± 3.8 seconds and 6.7 ± 4.8 seconds in controls 2
  • Patients with pre-existing dry eye showed significant TBUT increases from baseline (P < 0.001) when treated with CMC 1% 2
  • The treatment demonstrated excellent safety and tolerability with no significant adverse effects compared to conventional therapy alone 2

Safety Profile

Carboxymethylcellulose meeting food additive specifications is considered safe across multiple routes of administration, though systemic toxicity can occur at high intraperitoneal doses:

Ophthalmic Safety

  • No significant safety concerns identified in clinical trials for ophthalmic use 2
  • Well-tolerated with no differences in adverse events compared to conventional therapy 2

Systemic Safety Considerations

  • Oral administration is considered safe for all animal species when meeting food additive specifications 3
  • Intraperitoneal administration shows dose-dependent toxicity: safe at ≤50 mg/kg, mild reactions at 320 mg/kg, and reversible adverse effects at 2000 mg/kg in rats 4
  • Systemic adverse effects from high-dose intraperitoneal administration are time-dependent and virtually disappear by 90 days post-injection 4
  • Oral toxicity studies in mice at doses up to 20 mg/g body weight daily for 3 months showed no treatment-related abnormalities in hematological, biochemical, or histopathological parameters 5

Important Caveat

The safety conclusions apply only to carboxymethylcellulose meeting food additive specifications, as proper identification and characterization are essential to exclude toxic impurities 3. The ophthalmic formulation is FDA-approved and meets these specifications 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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