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Viscous artificial tears (carbomer 940) Pregnancy: SPC 4.6: Liquivisc 2.5 mg/g eye gel was not studied in pregnant and breast-feeding women. Caution should be exercised when prescribing to pregnant or breast-feeding women.

Carbomers (eye gels)

Brand names: Viscotears, GelTears, Liquivisc

Carbomers are high-molecular-weight polyacrylic acid polymers formulated as ocular lubricant eye gels for the symptomatic relief of dry eye and tear-deficiency conditions.

Adult dose

Dose: Symptomatic treatment of dry eye syndrome. Product: Liquivisc 2.5 mg/g eye gel (carbomer 974P 2.5 mg/g; preserved with benzalkonium chloride 0.06 mg/g). Adults (including the elderly): instil one drop of the gel into the inferior conjunctival cul-de-sac 1 to 4 times daily according to the degree of ocular trouble.
Route: Ocular (one drop instilled into the inferior conjunctival cul-de-sac)
Frequency: 1 to 4 times daily, according to the degree of ocular trouble
SCOPE - UMBRELLA PAGE, ONE PRODUCT COVERED: these figures are the UK SPC for Liquivisc 2.5 mg/g eye gel only (Laboratoires Thea, PL201620009). This page names several carbomer eye gels (Viscotears, GelTears, Liquivisc); other carbomer products have their own SPCs and can differ in carbomer strength, preservative, stated frequency and contact-lens advice, so their doses are NOT covered here and must be taken from the product being dispensed. The page category says 'carbomer 940'; this product contains carbomer 974P, so the grade named on the page is not the grade of the product dosed. The SPC prints no maximum number of drops (1 to 4 times daily is the stated frequency range), so maxDose is left empty. ADMINISTRATION (SPC 4.2): after instillation, store the bottle vertically with the dropper downwards to facilitate the formation of drops when next used; do not touch the eye with the dropper tip; replace the cap after use. CONTACT LENSES (SPC 4.4): benzalkonium chloride may be absorbed by soft contact lenses and may change their colour; advise patients to remove contact lenses before using this medicine and to wait at least 30 minutes before reinsertion. CHILDREN: SPC 4.2 says the safety and efficacy of Liquivisc in children and adolescents 'at the posology recommended in adults has been established by clinical experience, but no clinical trial data are available'; the age range in the retrieved text is garbled by PDF extraction ('aged to 18 years'), so no paediatric block is written. The SPC gives no renal or hepatic dose adjustment.

Dose adjustments

Renal

No renal dose adjustment is stated in the SPC.

Hepatic

No hepatic dose adjustment is stated in the SPC.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via MHRA Products — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to any of the components of the product (the whole of SPC section 4.3)
  • Precaution (4.4): use with caution in dry eye patients and in patients where the cornea may be compromised, because the benzalkonium chloride preservative (0.0015 mg per drop) has been reported rarely to cause punctate keratopathy and/or ulcerative keratopathy, eye irritation and dry-eye symptoms, and may affect the tear film and corneal surface

Side effects

  • As for other eye drops: possibility of mild transient stinging or burning upon instillation (SPC 4.8)
  • Blurred vision may occur briefly after instillation until the gel is evenly distributed over the eye surface (SPC 4.8)
  • Benzalkonium chloride (SPC 4.4): rarely punctate keratopathy and/or ulcerative keratopathy; eye irritation, symptoms of dry eyes, effects on the tear film and corneal surface

Interactions

  • Other eye drops used concomitantly: wait 15 minutes between instillations, and Liquivisc 2.5 mg/g eye gel should be the last medication instilled (SPC 4.5)
  • Soft contact lenses: benzalkonium chloride may be absorbed and may change the colour of the lenses; remove lenses before use and wait at least 30 minutes before reinsertion (SPC 4.4)

Monitoring

  • Monitor patients in case of prolonged use (benzalkonium chloride preservative; SPC 4.4)
  • Advise patients that vision may be blurred briefly after instillation

Clinical monograph

How it works

They form a viscous mucomimetic layer over the ocular surface that increases tear-film retention time and protects the cornea and conjunctiva from drying.

Prescribing in practice

  • Transient visual blurring after instillation is expected because of the gel viscosity; advise appropriate timing of doses.
  • When used with other ophthalmic preparations, apply the carbomer gel last and separate applications in time.
  • Some products contain preservatives such as benzalkonium chloride; preservative-free options may suit frequent users or sensitive eyes.

Monitoring

No specific monitoring is required beyond reviewing symptom control and ocular surface comfort, with reassessment if relief is inadequate.

Counselling the patient

  • Vision may blur briefly after application; do not drive until it clears.
  • Preservative-free formulations are preferable if drops are needed frequently.
  • Follow the recommended discard time after opening to limit contamination.

Evidence & guidelines

Ocular lubricants such as carbomer gels are a well-established first-line option for managing the symptoms of dry eye disease.

Reference: RCOphth dry eye; TFOS DEWS II; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways